American Health Care’s New Year’s Resolution: Confront The Lie.

Posted on | December 31, 2018 | 1 Comment

Mike Magee

On the last day of a rather disastrous 2018, the Washington Post ran the headline, “Our agents did everything they could.”

The article captured the performance of Kevin McAleenan, head of the U.S. Customs and Border Protection defending his agencies oversight of the death of a second migrant child in the week after Christmas.

On ABC News’s “This Week” his justification read somewhere between ineffectual and reactive. The words: “our agents did everything they could as soon as these children manifested symptoms of illness to save their lives.”

As wicked and depressing as this performance, the words cut deeper still as an indictment of the U.S. Health Care system at large.

In the immediate post WWII period, we never asked the question, “How do we make America and all Americans healthy and productive?” We believed that we could “defeat disease” as we had “defeated the Nazis” – through high-tech, profit-driven, cross-sector collaboration. And that in defeating disease, health would be left in its wake.

Over the half century that followed, practitioners in government, industry and academic medicine discovered each other, and manners of collusion that assured career advancement and steady streams of revenue. In this increasingly organized medical-industrial complex, everyone who cooperated was dealt in – except the patient.

Nearly seven decades into this experiment, this remarkable miscalculation, members of the medical-scientific elite feel more than comfortable suggesting that America’s unhealthy culture is not their problem, and ignore the fact that our’s is the only developed nation that spends more on health care than all other social services (themselves determinants of health) combined.

In 2019, we need to confront the lie that “we did all that we could.” We have not. It is time to return to the original question we ignored, “How do we make America and all Americans healthy?” If we acknowledge the learnings of all other developed nations, we will embrace:

1. Universality: Health coverage and quality accessible health services are a right of citizenship in the United States.

2. Public Administration: Administration of basic health coverage is organized in the most cost-efficient manner possible with central oversight by the government. Incremental steps allowing the option of public sponsored plans to those already insured should be encouraged.

3. Local Control of Delivery: The actual delivery of services to ensure quality and cost effectiveness is provided by health professionals and hospitals at the local and state levels.

4. Health Planning is a Priority: Creating healthy populations is a high priority forour national and state leaders. Working to establish health budgets and priorities, leaders must integrate health services with other social services, advance prevention planning and manage vulnerable populations.

5. Transparency: Providers submit bills. Government ensures payment of bills. Patients focus on wellness or recovery. All essential services (those defined under the ACA) are covered.

Wishing you a happy and healthy New Year!