The New Yorker’s June 1st article, "The Cost Conundrum" by Atul Gawande, is the most succinct discussion of the health care conundrum that I have read. Gawande’s lucid approach to the current state of the medical industry should be required reading for Obama’s administration and anyone who is concerned about our health care. Thanks for making a clear statement about this important and difficult issue; now to see if anyone is paying attention.
Gawande makes a good case. The Republicans preach "free markets," but some human activities are better accomplished by society such as national defense, fire-fighting, highways, streets; and it now appears, health care.
The USA’s health care system is broken and bankrupting businesses. We pay more and have the worst medical outcomes of any modern industrialized nation. Conservatives talk about "free markets," while insurance corporations tell patients which "preferred provider" physicians they can see, and tell the physicians how many diagnostic and therapeutic procedures they cannot order.
There is a fundamental conflict of interest in "corporate health care" because corporations by law must put the stockholder's profit above any other consideration, including patient care and the environment. For-profit healthcare reduces the Hippocratic Oath of "First, do no harm" to "You money or your life."
To quote Gawande,
" When you look across the spectrum from Grand Junction [CO] to McAllen [TX]—and the almost threefold difference in the costs of care—you come to realize that we are witnessing a battle for the soul of American medicine. Somewhere in the United States at this moment, a patient with chest pain, or a tumor, or a cough is seeing a doctor. And the damning question we have to ask is whether the doctor is set up to meet the needs of the patient, first and foremost, or to maximize revenue."
And cardiac surgeon Dyke hit the issue on the head.
"Dyke is among the few vocal critics of what’s happened in McAllen. "We took a wrong turn when doctors stopped being doctors and became businessmen," he said."
The problem that is articulated is complex and the solutions must involve not only the physicians, patients, and health care teams; but also the medical corporations’ CEOs, bean-counters, and federal bureaucrats. Getting greed out of health care will not be easy.