Cost containment has replaced concern for the uninsured in driving healthcare restructuring. What does this imply?

Cost containment has replaced concern for the uninsured in driving healthcare restructuring.
What does this imply?

Dr. Marcia Angell’s May 23, 2009 Boston Globe article, “Held Hostage by the Health System,” brings up a number of points not usually heard in arguments for single payer:

  • Whether we like it or not, cost containment is becoming a more important driver than the uninsured in healthcare restructuring,
  • measures that would improve health outcomes, like electronic records, case management, preventive care, and comparative effectiveness studies won’t save much money,
  • What’s needed is not only abolishing health insurance companies, but eliminating profit in providing healthcare, such as doctors, hospitals, clinics etc.,
  • When doctors are businesspeople and you pay them per patient, there’s an incentive to under-treat us,
  • When  doctors are businesspeople and you pay them per procedure, there’s an incentive to over-treat us,
  • The only way to remove these dangerous incentives is to have doctors on a salary, to have them as workers, not businesspeople.

Her comments also inspire other interesting questions:

If  it’s not OK to profit off healthcare, is it OK to profit off food, housing, education, water, and other necessities of life?

And suppose society were restructured to really promote health (including mental health) instead of treating sickness.

  • Suppose  everyone had the right amount of healthy and safe food and water.
  • Suppose  everyone had safe, healthy, and low-stress work places and living places.
  • Suppose  everyone had enough time with family and friends to allow sustaining relationships.
  • Suppose  everyone had wholesome and empowering education to promote an active, inquiring,  and engaged attitude toward life.

Would all this cost more, or cost less, than the billions spent on the sickness-care system we have now?

It would probably cost more, but we still have a right to it, even though getting it would mean turning the present power relationships of society upside down.

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