“Affordable” Care

If they can get you asking the wrong questions, they don’t have to worry about answers.

-Thomas Pynchon

This is a quote from a book that I’ve never read that was written before I was born. But it resonates. As a student smack in the middle of my formal medical education, I get asked a lot about the new healthcare plan being rolled out in the US. It should be noted that I don’t have any political affiliations. Both parties are equally good at screwing things up for everyone. But I will state my position emphatically. Anything that gets quality healthcare to more people is something I support. Whether the new legislation achieves this goal is yet to be seen. And like anything involving the federal government, there is so much back door dealing, cronyism, and convoluted goings-on that the deck is stacked against us. I don’t hold out much hope for the current legislation being a definitive solution. But this is not because they are bad ideas. It is just that the government’s (doesn’t matter who’s in charge) ability to mishandle important issues seems inexhaustible. If only oil was inexhaustible. That being said and my pessimism being obvious,  I still support any event that brings about the discussion of better, broader healthcare, especially if it benefits the most vulnerable among us. Whether this whole thing is a step in the right or wrong direction, I think it’s a good sign that the machine is finally moving.

Ultimately, though, all these political debates, concerns over tax hikes, and gripes about lazy people abusing the system are moot. Why? Refer back to the quote. The real question is this:

Why is an IV bag of normal saline (less than two teaspoons of salt dissolved in water) billed at less than $5 in a hospital in Paris and more than $700 in a hospital in the US?

If you read this article, these IV bags cost between 44 cents and a $1 to manufacture. Yet through some kind of acrobatic rationalization process on the part of those who are in a position to exploit, the end consumer gets stuck with a bill containing a 70,000% markup. This is just one of numerous exploitations that can be uncovered with a free afternoon and the ability to do an internet search. It doesn’t take a huge mental leap to see that insurance companies, large (not) for-profit and for-profit hospital networks, and pharmaceutical companies, among many others should bare some of the blame for making access to basic medical care cost prohibitive. This is why the phrase Affordable Care Act is so ironic. It guarantees business for the sectors of medicine that have done their best to make sure that healthcare remains unaffordable and inaccessible.

This is just a conjecture. But I’m willing to bet that if we brought the prices of medical products somewhere in the neighborhood of a reasonable markup, many Americans would be able to afford to pay cash for their medical care and those that couldn’t would only make a small blip on the taxscape because medicine would be reasonably priced.

So while everyone is involved in political bickering, I’m wondering how far we let greed go before we identify it as the root cause of many of these problems. If what happened in the banking industry is any indication, though, I’m not optimistic. Our federal government and corporate business are intertwined, like, well, like mating dogs stuck together.

Mating dogs stuck 1To be fair, these dogs seem a tad more graceful than either gov’t or corporations.

It seems absolutely insane to me that there are people out there who view the suffering of others as an opportunity to squeeze money out of them. Once this behavior stops, the rest of this will just kind of work itself out. But first we have to pull those dogs apart.

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