The Inevitable Collapse of the "Healthcare"/Sickcare System
(November 12, 2009)
The sickcare system is itself sick on fundamental levels. Its collapse is thus certain; only the timing is uncertain.
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Declaring the collapse of the U.S. "healthcare" system to be inevitable is akin to declaring the insolvency of the Federal government to be inevitable: unthinkable. Yet both statements are equally true.
The financial impossibility of increasing "healthcare" costs at 6-7% per year in an economy which grows at best 2% (assuming the GDP numbers have any accuracy at all, which is doubtful) is clear; at some point in the near future, the entire GDP of the nation would have to be devoted to "healthcare."
But the system is completely unstable on non-financial levels as well. The entire "employer pays the costs" model is hopelessly divergent from the realities of global wage/benefit arbitrage--the more costs you dump on employers, the more jobs they cut or move offshore-- and the "sickcare for profit" model is intrinsically at odds with the goal of wellness (wellness is unprofitable, managing chronic illness is highly profitable).
Lastly, both the insured and those receiving free Medicaid are totally detached from the cost of their care, and thus from responsibility and choice--the two key features of an adult understanding and response to complex issues.
We turn to correspondent C.P. for a first-hand report on the pervasive sickness of the opaque sickcare system:
I want to commend you for your excellent commentary on healthcare reform. I couldn't agree more and as a former medical scientist I used to have a front row seat, observing in nausea and disbelief the cronyism, horrific waste, ineptness, and outright corruption. The most egregious example being my supervisor's use of our facility and his credentials as the institution's vice president and dean of the medical school to test experimental drugs synthesized by a biotech company he co-owned and held an executive position at.
Thank you, C.P., for this report. The people struggling to provide care in such a profoundly contradictory system face unresolvable double-binds. As C.P. notes, they experience an intense indoctrination akin to brainwashing that "this is the best healthcare system in the world" even as they see on a daily basis how the system fails the patients, the caregivers and thus the nation itself.
Frequent contributor Kevin M. (proprietor of the Out of Your Rut blog) questions the system's implicit assumptions made about cures, care and the process of healing:
People get lost in the minutiae of the issue, converting it to a debate that needs to be won, rather than a crisis that needs to be solved. Personally, I think most find the truth to be too disturbing to confront, and somehow find comfort in the details and debates. No matter, that approach will get us nowhere.
Thank you, Kevin. Providing well-care is not what the present system is designed to do or incentivized to do; therefore it is incapable of doing so.
I think the model of vast Federal bureaucracies solving every citizen's problems is inherently insolvent and irredeemably broken. Well-care will have to come from a wellspring of individual responsibility and small-scale community effort, not some gigantic institutional machine which stripmines the entire economy to feed its voracious and insatiable appetite for more money to fund a crazymaking jumble of completely perverse incentives.
Wellness requires an integrated understanding of the oneness of food, diet, fitness, physical and mental health and the culture which sustains or erodes this understanding; without this full-spectrum understanding, then well-care will remain forever beyond reach.
Reaching such an understanding is the over-arching goal of
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