The emerging and even rear view perspective on healthcare is messy. Although I visit Washington regularly to listen to the dialogue and witness the emerging themes--I am not what you would describe as hopeful. Nothing I am hearing is poking deep enough into the meat of the issue.
The truth bombs have arrived from an unexpected source...Mr. Henry Rollins. A self-described solipsist, Henry has a cinematic and raw perspective of the world around him. Communicating through spoken word, his music, books, movies, and published musings he is controversial, scatologic, and beautifully sentient.
It sucks that the entire economy is based on dependency, financial insecurity, lifelong debt, incarceration, prolonged global conflicts, bad health, poor personal care and lethal foodstuffs. Remember what all those beansprout eaters were called decades ago? Health food freaks. That’s the gastrointestinal equivalent of “Looks like we got ourselves a reader ...”
I figure that any health care plan that can truly serve vast amounts of people in America isn’t in the cards. It would have surfaced decades ago.
Henry speaks truth. It may be raw and use language that bristles but there is a lot at stake and mock indignation doesn't serve anyone. In 1986 the Emergency Medical Treatment and Active Labor Act (EMTALA) was enacted and requires hospitals to "treat any person who either has an emergency medical condition or is in advanced labor" regardless of ability to pay. Some of those decisions evolved because hospitals were affected with a public interest. Still others invoked the reliance interests that were arguably implicated when emergency rooms held themselves out as open to the public—a move that features prominently in cases involving public callings.
The solution would be healthcare as a public utility. As described back in the 1920s:For public utility regulation to be considered appropriate or for that industry to be “affected with public interest,” early courts and legislatures agreed that two conditions should be met: (1) that the industry meets “an important human need” (i.e. necessity); and (2) some feature of the market presents a “risk of oppression” (i.e. power).--Charles Wolff Packing Co. v. Court of Indus. Relations, 262 U.S. 522, 538 (1923); Block v. Hirsh
If there had been the will or forward thinking imagination, health care would be a utility. You can read about An evolution of medicine--charitable entity to market power but as Henry states--that ship has sailed. "The pharmaceutical industry doesn’t make its profits on health, just as weapon manufacturers don’t earn their keep when there’s an outbreak of peace."
Nature has it wired. Cancer, plague, viruses, parasites and other grotesque, microscopic killers are there to thin the herd. Of course we fight back. This being the case — along with other factors such as our inability to always play well with others — not everyone is going to have a long, healthy life.
The thing about our industry that I find the most disingenuous is nobody asks the tough questions. I get it, Upton Sinclair nailed it with "It is difficult to get a man to understand something when his salary depends upon his not understanding it."
Health care, like justice, is for those who can pay for a favorable outcome.--HR
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In a world of "evidence-based" medicine I am a bigger fan of practice-based evidence.
Remember the quote by Upton Sinclair...
“It is difficult to get a man to understand something, when his salary depends upon his not understanding it!”