Greed should have no place in the providing of health care services, but there it stands like an insatiable dinosaur.
With boasting pride, for-profit hospitals woo thoughtful investors to jump on their remarkably successful bandwagon. Traditional medicine and even the complementary kinds of health care (holistic, wellness, chiropractic, acupuncture, massage, etc.) often appears to be trying to milk the market for all it can.
Health care costs have outdistanced military costs as the country's major expenditure, accounting for 11 percent of the GNP. This figure does not include such aspects of health as health foods, vitamins, running shoes and so on.
What has happened to this profession once so romantically represented by the selfless doctor and the community hospital?
I do not think it is new to medicine that individual providers may prey on the suffering, knowing full well that those afflicted will agree to any procedure and cost. Hippocrates warned against that kind of physician.
But before this century the sovereignty of the doctor-patient relationship and the juvenile nature of our technology inhibited health care as a profit-oriented commodity. All that has changed.
The medical power structure is shifting from the doctor to the drug companies, hospital supply companies and for-profit hospitals. Appealing to the heart of each person, paying lip service to the idea of equal care for all, these super-wealthy businesses say they are helpless to lower medical costs.
The current expensive health care system has in large part grown out of the third-party reimbursement programs, both private and governmental, which gave little incentive to cut costs. If people had to pay for care out of their pockets, the current system would collapse because not enough people could afford it.
I think this unchecked system of support is writing its final chapter, because neither the private companies nor the government can pay the price.
The greed among physicians also has led to a current great myth -- the physician glut. How paradoxical that we hear of an excess of physicians at a time when we have such a sick society.
I have been in family practice for 13 years in the Washington area, where there is an "excess" of physicians. How can we say there are enough doctors if so many people are on psychiatric medicines or stress medicines and are getting cancer and suffering heart attacks? These are preventable problems.
If there are enough healers available, why is the suicide rate so high? This hoax of a physician glut simply refers to the greed of an elite group who do not wish to divide the divided pie further.
Which brings me to my point. One cannot rely on the people making the money from health care delivery to cut costs -- and those who are in the field for service are already practicing as inexpensively as they can. As long as the income in health care delivery is based on profit from disease, encouraging a healthy society remains a rhetorical exercise.a
I contend that humanized care cannot coexist (beyond an occasional isolated situation) with for-profit medicine. Health care providers should be servants to their society.
One possibility for changing the system could be the co-op health model.
For a family of four, annual health insurance or health maintenance organization membership is roughly $2,000. For this money you have no control of what kind of care you get, nor do you have anything to show for it if you don't get sick. The future of this system is that the cost is going to go up and/or the benefits are going to go down.
But let's say you join together with 20,000 families each willing to put $2,000 per year into a common fund for three years. At the end of three years you have $120 million. With that money you could build your idealized health complex.
The facility would include a full medical complex with all the kinds of health care you want in one central location -- plus perhaps a full health spa and (why stop there?) how about a food co-op? (Food bills could be cut dramatically if 20,000 families bought in bulk.)
The remaining funds could be placed in secure investments, the interest from which could pay your staff salaries, buy needed materials, and pay medical bills acquired outside the facility.
And the people would own their facility. Profit would not drive administrators to fill the beds -- in fact, the emphasis would be to keep the constituency healthy. Of course, the possibilities are only limited by the trust of the 20,000 families, who could share a much broader base of interdependence, sharing skills and services and buying in bulk.
There is no shortage of graduates of medical and nursing schools who would love to have such a setting to practice in.
As for the indigent population, I can only hope that these co-ops offer a percentage of their services to the surrounding population.
In a society hailed for its self-serving and alienating nature, one wonders if such a solution is possible. I would suggest that we have never had such an opportunity as now. All it takes is some seeds and lots of watering. Life's action always remains your choice.