The runaway inflation in the cost of living in America is worst in precisely those sectors of the economy that the 99% can’t live without — higher education, housing, and healthcare. In An American Sickness, Dr. Elisabeth Rosenthal describes in excruciating detail how American healthcare has been hijacked.
How did this happen? How did we Americans get so divided that a plastic surgeon dares to bill $50,000 for 3 stitches – just one of the many examples that Dr. Rosenthal sites. (I also read a story not long ago in the New York Times about an “out-of-network” surgeon who ambushed an unsuspecting patient, sewing him up after his operation, and then billing him for a quarter of a million dollars!)
Medicare has become a vast, publicly owned resource – a huge accumulation of money, automatically withheld from the paychecks of working people for their entire working lives – that is ripe for systematic looting by private interests. In exactly the same way, private insurance companies don’t complain about extortion by the drug companies, and the newly privatized “not-for-profit” hospitals and their incorporated medical practices, because they can pass the extortionate billing on to their tens of millions of subscribers – you and me.
The corruption of the American system of healthcare has become institutionalized. Indeed, our healthcare system now fits Irving Goffman’s description of a “total institution” – an institution that, whatever its original or nominal purpose, has as it’s real priority perpetuating itself and benefiting its hangers-on. Such total institutions are, as Dr. Rosenthal suggests, a sign of a culture in decline.
When President Eisenhower left office in 1961, he warned us about what he called the “military-industrial complex.” In the decades that followed, military production did, in fact, become a juggernaut of profit-making for private interests and, simultaneously, an institutionalized parasite on the productive resources of the American economy and the needs of the American people. Healthcare in America has now become just such a parasite – the “medical-industrial complex!”
As Dr. Rosenthal astutely observes: “In healthcare, entrepreneurship outsmarts regulation every time.” In the independent political movement, we know this pattern very well. We’ve learned, for example, that trying to stop the flow of money to Democrat and Republican politicians by campaign finance reform can’t succeed, because new regulations, written by those politicians, come with new loopholes. The development of new corrupt practices is impossible to keep up with, in both politics and in healthcare, without addressing the question of political power. We can’t reclaim either our government or our healthcare without creating a new political culture.
Lou Hinman lives in New York City and is an activist with IndependentVoting.org and the New York City Independence Clubs.
I won’t say that I “enjoyed” reading An American Sickness by Dr. Elizabeth Rosenthal. It corresponded too closely to experiences of my family and friends – not merely the illnesses and deaths but the difficult engagements with all aspects of a system that creates economic and existential insecurity which have nothing to do with “health.”
Whether based on personal interviews or other research, the stories Dr. Rosenthal shares help us to understand and are devastating critiques of the (mis)organization of healthcare in the United States. So many people are failed by this “system”. I kept wondering what those who supported it might say in its defense. More to the point, I wondered what we as a country would need to do to produce a system(s) other than what we have. What can we do about the overweening power of hospitals, insurance companies, and pharmaceuticals — all of which have enormous political leverage as well as economic incentive to keep things as they are? Would it be possible to build partnerships between those who currently profit from this state of affairs and those who are not served well by it? How might that be organized?
I really appreciated Dr. Rosenthal’s suggestions about what individuals can do. However, I feel similarly to Susan Massad and others who have written that something bolder — more grassroots and more challenging of the larger system of which healthcare is a part — needs to be undertaken.
As I read An American Sickness, from my location as an activist in the mental health arena who also has been a community organizer, I thought of areas of concern and contention in healthcare which might have been more fully explored, e.g., severe mental disorders, aging, and lack of access and education for marginalized groups. While addressing these may not have strengthened the very strong case Rosenthal makes, including these populations as resources would be powerful elements of a movement for change.
I also thought about my brother, my mother, my life partner — all of whom died of serious illnesses — the challenges we faced, the diversity of people we met, the pharmaceuticals that were prescribed, the offices, clinics and hospitals we entered — and how all of us were shaped (deformed) by the economic and political forces that organize the practice of medicine — and everything else in our society. We can and must do better.
Jeff Aron has been active in independent political efforts in New York City and nationally since the late ’70s. He is a passionate supporter of IndependentVoting.org.
Politics for the People
An American Sickness
With Author Elisabeth Rosenthal
Sunday, Dec. 2nd at 7 pm EST.
Call in number: 641-715-3605