HCA, a Perfect Example

I made an assertion below, and will repeat it in light of an article in the New York Times, 15 August 2012: Health care in the modern world cannot be economically addressed by anything other than a comprehensive national plan.

As the Times article shows, profit at HCA, the largest for-profit hospital chain, is far above its nearest competitor. Where does this money come from? It can only be the result of such things as overcharging, over-treatment, excessive test orders, downsizing personnel and/or service, and unwise cost-cutting. It is not a result of better medical care.

Health care in the modern world
cannot be economically addressed
by anything other than
a comprehensive national plan.

Profit seeking has no more business in health care than witchcraft. Profit seeking in health care is another form of “rent seeking”, the practice of extracting additional money without providing additional service. 100% of profit is money that should have been spent on health care, not investors. That is an extreme statement, probably considered un-American by some, but one I will stand by.

Some people claim that American health care is the best in the world. Those people are not among the 120 who die daily from lack of health care altogether. They may be members of Congress, whose premium health care is subsidized by tax dollars. They may be employees of companies that are doing well these days. They may be wealthy people for whom cost makes no difference. They may be people like me, who retired from a public institution with generous benefits. But they are not among the 19% of Americans, over 59-million, who have no health care insurance because they can’t afford it.

How can anyone claim we have excellent health care when one person out of five has no health care at all?

I’ll say it again: Health care in the modern world cannot be economically addressed by anything other than a comprehensive national plan.

There is an inherent clash between
the capitalist profit imperative and
the moral imperative to provide
everyone with the best health care.

The reason is that there is an inherent clash between the capitalist profit imperative and the moral imperative to provide everyone with the best health care that we can afford. Being the richest country in world history, there is no question whether we can afford it. Yet, 120 people die daily for lack of health care, largely because of our unwise fetish that dictates that everything possible must be privately owned and operated. This all but guarantees an uneconomical system because of the capitalist profit imperative.

Health care services life itself. It is challenging and difficult at every level, and when it is well done, the patient is sincerely grateful, sometimes for the saving of their own life that might otherwise have ended. Providers of health care services at every level understand and appreciate this gratitude.

But what can be said of a system that tells every fifth person, “Sorry, you do not deserve this care; we’re not particularly concerned that you may die now.”?

Our system fails to provide even
basic care to every fifth person.

Who are these people who have no health care? They are all people with low income, a demographic category that is growing rapidly. Many are not able to work. Others do work, sometimes two or even three jobs, but they are so poorly paid that buying health care insurance is impossible. Perhaps they are waiters, earning the legal minimum wage of $2.13 per hour (you read that right), their tips bringing their income to an average of $18,000 yearly—about the cost of health care insurance.

The provision of health care is a national concern. Our system fails to provide even basic care to every fifth person, something that every national system does, even when the country is poor and service is basic. But national health care in modern wealthy nations is the best in the world. Not just because they provide for everyone, but because the health care they provide is the best in the world.

The entire question of health care in the US is intimately bound up with questions of wages, the work week, the quality of education, and a number of other concerns. In essence, the country needs a comprehensive makeover of the American Dream, so that everyone can earn a decent living, obtain health care, and enjoy a reasonably comfortable retirement.

We’re doing a terrible job at much of this. Republican promises to eviscerate the programs we do have are exactly what we should not be doing.

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