2010: A Good Year for Radical Health-Care Reform
" A Return to Healthing" Blog: Fri, 01/29/2010 - 14:35 — BBelitsos
By Dr. Len Saputo
When Barack Obama became president-elect of the United States, most of us felt a sense of hope we hadn't experienced in years. We trusted that a new era of transparency in politics was just around the corner and that America would finally tackle its social, economic, and political problems. We anticipated a turning point in American history--a social transformation of major proportions. We imagined the rebirthing of the principles of the Declaration of Independence and the Bill of Rights. And we had our first African-American president to boot!
While this "high on America" feeling swept across the land, a counter movement was also coming to a boil. It was being engineered and directed, as it always has been, by a wealthy elite that is and has been determined to resist change at all costs. After all, their wealth and power depends on maintaining the status quo of a corporate-dominated America. As Obama took the oath of office, they still ruled the country; but now, a year into the new presidency of Obama, we are discovering that they still do. One indication of this condition is the state of health-care reform legislation in early 2010.
Make no mistake, what is happening to health care is no different than what applies to any other industry or sector of our society—be it business, law, religion, politics, science, and even sports. In fact, the unwritten rules governing things remain quite the same. The fatal, systemic flaws that cause a dysfunctional health-care system are at the root of every aspect of our dysfunctional society. What we are learning about the impediments to genuine health-care reform applies to everything else about who we are, how we operate, and what we do as both individuals and a society. Health care is just one case in point.
Being a veteran physician whose experience of medicine dates back 45 years gives me an insider's perspective on what happened to health care. During these decades I have discovered some bad news and uncovered lots of good news. First, here’s the good news: The "change we need" is indeed possible; we have the tools and the power to make it happen. America’s health-care industry and medical community have always had this ability, but we haven't had the courage to step up to it. On the other hand, the bad news is also powerful: We are sleeping under a spell cast by corporate America. The stranglehold of corporations on the process of change ensured, for example, that the new legislation did little more than rearrange the chairs on the deck of the sinking Titanic. President Obama failed to educate and rally the public and especially his political base, and few people in Congress understood the full implications of the House and Senate bills. Worse, too many legislators focused primarily on how much money and power they could get in return for their vote, as well as on ideologically narrow ideas for reforming the system. (Some of our earlier blogs point to this problem, especially with the thoroughly corrupt Senate Finance Committee.) Big Pharma, big hospital chains, and the insurance industry did stellar working at investing their money and promoting their narrow, self-serving “solutions” in the US Congress and even the White House. Their “ROI” will be exceptional. And relatively speaking, their lobbyist money and their campaign contributions were little more than pocket change for corporate America.
Pharma and the insurance industry invested in an excess of $500 million in "donations" to Congress in 2009 that are nothing less than outright bribes. Let's do the math. There are 435 members of the House and 100 members of the senate. That comes to 535 people divided by $500 million dollars. Hmmm, that's nearly a cool $1 million per Congressperson! It is impossible to follow the dotted lines and come to any conclusion other than Congress has an allegiance to preserving and enhancing the status quo for Big Pharma, the insurance industry, and the very wealthy who control them and many other highly profitable industries. It would seem that the value of a political soul in 2009 had a price tag of about $1 million!
What by contrast do Americans really want? They want honest health-care reform that provides affordable health insurance for everyone and shifts the focus from managing disease to promoting wellness and vitality. We're outraged that we didn’t get anything near this, but we’re still asleep at the wheel if it still holds true that informed consent is the essence of democracy.
What has become more clear with each passing day is that without radical health care reform, the future of medicine in the US will remain exactly where it is, far below its potential. Quality of health care will continue to be split into two factions. The first faction, one that is mediocre, will be offered to the middle and lower socioeconomic classes. That is why millions more Americans will now be insured under the new bill, but with what? Medicaid! But medicaid is not anywhere near the quality of Medicare, let alone the best private health care plans such as what Congress and the wealthy get. Millions more will get to choose a plan from state-run exchanges that present health insurance plans from the same old venal private insurers, with a few progressive regulations tacked on and inadequate subsidies for those who can’t afford them. Yet untold millions will still not get access to any insurance!
The second faction gets the best health care possible; the wealthy can afford to pay for it out of pocket. Money talks! It gets you in the hospital you want, the doctor you want, the tests you need in a timely way, any treatment there is, and there are no exclusions, long lines, or red tape that gets in the way of getting the best care on the planet. Overall, however, for the rest of us, there is no sensible reason to predict that we can rise significantly above our present WHO ranking of 37th in the world in overall quality of care without radically changing how we design and deliver health care.
It’s been said that our thinking has to evolve to a new and higher level if we want real change in any area, including health care reform. So what is that new and higher level, and how do we achieve it?
This higher level will come from questions like these: Why haven't we acted at the grass roots level by developing healthy programs that would prevent disease and promote wellness? Have we been so deeply brainwashed that we actually believe we need the government to take care of us and that therefore we don't need to take care of ourselves? Have we fallen so deeply asleep that we've given up our responsibility to take part in the democratic process?
We also have to think anew from the standpoint that we—the consumers of health care—are actually the ones who are in control. Through the mechanism of our purchasing power, it is incumbent upon us to step up and dictate our preferences to big business through the purchase of only those products that are healthy and necessary. But we have failed to appreciate the power of our collective spending; corporate America is completely dependent on how we spend our dollars. We have also fallen victim to clever advertising that we all know does not tell the truth—yet entices us to buy products that are not healthy or necessary, or environmentally unfriendly.
So, how can we change this scenario? Should we clean out Congress and replace it with honest politicians by voting every incumbent out of office? At least it takes a certain amount of time for the new faces in DC to become corrupt. Is it realistic to create legislation prohibiting Big Pharma and the insurance industry from its disregard for service and its greed for profit that has finally become obvious? Is it possible to safeguard our precious medical research by prohibiting the publication of scientific literature that lies about or distorts research data? Can we force Congress to provide the financial support the FDA needs to make it an independent agency that can regulate Big Pharma without having an incestuous partnership that jeopardizes its regulation of drugs, cosmetics, household products, and foods? Can we pass laws that prevent the pollution that puts us at risk for poor health and injures our environment? Is the answer going to come from legislation or through inspiration; from education or law enforcement? Or both?
As we go about this work, we must remain free from the tendency to demonize the other. Pogo was right after all; we are the enemy. It has become clear that we are waging a war against ourselves! We have become brainwashed to worship the almighty dollar and have forgotten our true purpose in life—that of loving one another and living in community where we all pitch in and take responsibility for our social, economic, political, legal, spiritual, and medical practices. We have forgotten that true community embraces and rewards for giving and graciously accepting, but not for taking. We have forgotten the principles of the village where every person is interconnected and an inseparable part of the whole. We have replaced this philosophy with one based on competition and have placed our own self-serving desires above that of the community. So where is the community?
The pitiful squeaks of the enlightened few are barely decipherable above the powerful roar of corporate America. Today's politicians beg us for votes and make grandiose promises to serve us as their primary objective, but in the final analysis their pocketbooks and their hearts are owned by corporate America.
Health care reform may be considered by many to be the most important domestic issue in America, but is it really? Indeed it is important, but is it more important than the loss of our democracy and the loss of the voice of the people? Is it more important than the pollution, poor quality food, and high levels of stress that are causing much of the epidemic of chronic diseases that now affects 50% of all Americans? Is it more important to strengthen the health care system we have today that has fatal and fundamental flaws to more Americans than dealing with improving our health and wellbeing through a true health care system that is based on prevention and wellness? Is it more important than fighting the two wars we've been engaged for such a long time? And at a much higher level, is it more important than solving the global issues of preventable disease and hunger?
We have partially awakened from our trance and are instinctively beginning to come together; that is what people generally do when faced with disaster. We're screaming about our lost rights and feeling helpless about creating change. We have been duped but we're beginning to realize the importance and magnitude of our naive lack of taking action.
Is there hope? Is it too late? There are very worrisome signs that our government is so far out of the hands of "we the people" that it no longer does much good to "write to our Congresspeople!" In fact, even voting in many respects no longer offers much choice; does it matter in any substantive way whether you vote Democratic or Republican? Is there that much, or even any, difference between the two parties as far as corruption is concerned? Has either party come up with a solution to our health care issues that is sensible? Have we become involved with a colossal struggle characterized by politics so polarized that we have lost sight of what we're trying to accomplish. Why is it that every single Democrat votes one way and every single Republican votes the other on health care reform? Is anyone in either political party thinking for themselves? Is following political party lines more important than working together to make America a better place? Are we doomed to crumble under the weight of our own corruption as have so many empires of the past?
Perhaps Gandhi had the answer when it comes to effecting social transformation. Our natural instincts are to fight against what we believe is wrong. However, where has this gotten us? Into fights! Sometimes there is no other option, but generally, even when this works, it causes change through fear and dominance rather than inspiration. How about we behave by becoming the change we want to see? There's no fighting involved in this approach. But, it may be more difficult to change our behavior rather than do what comes naturally to us; fighting back. Change through inspiration tends to be lasting because it comes from within and is what we choose. Change through fear and dominance may impose change, but it is not likely to be lasting because it is not our choice.
What if we took action at the local level and engaged in community programs based on good things such as developing programs that support a healthy lifestyle? What if we began participating in local government to create policies we believe in? What if we created educational programs that teach the golden rule first, and then how to build community? What if we learned to listen and care about everyone in our community? What if we spent our dollars to achieve these goals and refused to spend them on what we don't believe in? What would happen if we took this kind of responsibility?
The answer is obvious! We'd control our destiny. We'd take back democracy without the firing of a single shot. We would become leaders rather than followers and would elect only those Congresspeople who would represent us completely. We would stay in constant contact with our elected officials and participate in all governmental decisions. We'd eliminate any corporate or private business that did not offer service as the first priority because we would not purchase their goods or services. We'd be teaching our children how to get along with one another and live in community. We'd have health care that we could afford and would encourage wellness rather than react for the most part only after we get sick. In short, we'd be healthier, much happier, and would control our own destiny! We'd have a meaningful purpose in our lives. We'd also have far more resources to allocate to whatever projects we believed in.
The choice is ours: reacting to corruption with complacency and outrage, or being the change we want to see.