Hey, America — Here’s A Really Dumb Idea: Let’s Put PROFIT INCENTIVE At The “Heart” Of Our Healthcare System…

There’s a very good reason no other industrialized country has profit incentive built right into its healthcare system: a corporation’s bottom-line fiduciary responsibility is to its shareholders (the ones holding preferred shares, not the poor, dumb humps holding “common” shares) and NOT “health care customers” aka “patients”.

If a profit-driven health insurance company gave in to patients instead of providing a generous dividend next quarter, it might face a stockholder revolt. The price of its shares might plummet — and with it, the value of the company. All because it did the right thing instead of the financially expedient thing.

Ever wonder why pharmaceuticals are so much more expensive here in America than in pretty much any other country? Have you seen Big Pharma’s bottom line? They’re making money hand over fist from ;us. Be thankful you’re not a diabetic in America. The real production cost of a vial of insulin is between $2.28 and $3.42, while the production cost for a vial of most analog insulins is between $3.69 and $6.16, according to the study in BMJ Global Health.

“Anyone with Type 1 diabetes should be able to buy insulin for under $100 per year, including the long-acting forms,” said Andrew Hill, a study co-author and senior visiting research fellow at the University of Liverpool. “Pharmaceutical companies cannot justify charging governments $532 per person per year in the U.K. and $1,251 in the U.S. Yet, they do.

$100 vs $1251 for a year of insulin. That’s quite a mark up for a LIFE-SAVING PRODUCT. Know why that mark up exists? Profit incentive.

It’s the same reason an ibuprofen tablet that costs a few pennies to make costs $100 if a hospital hands it to you. It’s not costing $90 to make, package and transport that tablet. Virtually all of it is profit.

How did we get here? How did we let the biggest wolf of all – the insurance companies — become head gate-keeper in our health care chicken coop? That’s what insurance companies are — they’re gate keepers who get to decide which doctors we get to see. No one — repeat, NO ONE — loves their insurance company. They like that the company — with its clever “plan” — allows them (with deductibles and out-of-pocket costs) to see the doctors they like. They like that the GATEKEEPER says yes.

But the gatekeeper can say no, too. And often does. The gatekeeper can make up all kinds of bullshitty rules to “explain” why we CAN’T have the care we need.

The fact that we have insurance companies as gatekeepers is a historical anomaly. During WWII, all financial resources were poured into the war effort. Companies weren’t allowed to give employees raises. That made attracting new talent to a company (or retaining good talent) harder. To incentivize workers, large companies offered health insurance. People liked it. Why wouldn’t they? More big companies started to do it.

Then the war ended. But the employer-provided health insurance didn’t. In fact, it proliferated despite the fact that it really wasn’t good for any of the companies to keep providing it: it’s expensive — and when you factor in the cost of providing this perk, it makes the good or service that much more expensive. Example — in the competition between Boeing and Airbus to build and sell large commercial airplanes, Airbus always had a huge advantage. The cost of worker healthcare was built into the cost of every Boeing plane — making them more expensive to buy and less profitable for Boeing. Airbus, on the other hand, didn’t have to pay for its workers health insurance — that cost was born by whatever government the worker lived under because that country provided universal singer payer health CARE.

Europeans needing health care get it — no one asks how they’re going to pay for it first. Everyone KNOWS how it’ll get paid for. They skip that and move right on to the health CARE — like they’re supposed to.

America has great health care for those who can afford it. Otherwise, we have a system designed to make rich people richer and sick people die.

Americans Need To Get It Out Of Our Heads: We DO NOT Do Everything Right

My gut is, this very American attitude — “How WE Do It Is How It Should Be Done” — flows from, the MALE of the American species. It’s definitely got a “I alone can fix it” pong to it.

You know how men are kind of “famous” for refusing to ever ask for directions when lost? Yeah — same chromosomal character flaw. We don’t HAVE to know how to do something, we assume we can figure it out. Then, when we stare at the wreckage our ignorance produced, we can blame the manufacturer or inadequate customer service for the mess. Men — dirty little secret here that I just KNOW I’m gonna pay for — are a lot like Ikea product instructions. You’re never going to “read them” through first; instead you’ll plunge in and get two-thirds of the way through before you realize you put the key piece on BACKWARDS at the very beginning and now the whole goddamned thing has to be taken apart so you can start over.

That’s men. That’s us. No kidding.

Men were mostly responsible not so much for founding the country as taking credit for it and making up all the rules. Women’s role in the founding has gone — shocking, right? — under-reported. I guess, in the men’s minds, someone had to “put the kettle on”. Being men, in whose same minds they were always right, they applied that fallacy to the document (and the country) they created.

If we — White Christian Men — say a thing is so, it MUST be so. Now go and Manifest Destiny already.

White Christian Men decided that slavery was okay. They thought it passed muster that black people were 3/5 of a white person. These things are embedded in our character. They’re part of our swagger (along with the things for which we’re justifiably celebrated as a culture). It’s a package deal. Like everything. Good is a fellow traveler with bad.

But, in our case, that “bad” has caught up with us. I blame the high bullshit content of our swagger.

America does not do healthcare right. We don’t do public education right. We don’t do secondary education — college, university, trade school — right. We don’t do taxes right. We don’t do humanitarianism right any more (we’re hellbent on the exact opposite). On healthcare — we’re the only country that ties healthcare to employment. There’s a REASON we’re the only country stupid enough to do that.

During WWII, employers weren’t allowed to give raises to employees (the money was redirected toward the war effort). To keep good employees from leaving — and to entice new hires — companies offered up healthcare instead. Lots of companies did that. Then the war ended. But that job benefit didn’t. The companies found it hard and expensive to keep providing healthcare. Insurance companies took over the workload — and sank their hooks in deep. They put themselves at the core of American healthcare.

The first question you get asked when you seek medical attention in America isn’t “How can we help you?”, it’s “And how are you going to PAY for this?”

Money, sadly, sits at the heart of what ails America. Greed has undermined the Greatest Experiment in Human Self Government Ever. Let’s be honest, if greed’s involved, the fix is always in. Nothing “trumps” greed. Ever.

America’s greatness flows from its largesse — which, in turn, flows from its diversity. Nothing but cold, Christian calculus (as opposed to Jesus-like, Do-Unto-Others thinking) flows from the White People who believe THEY and they alone are the keepers of the American Flame. They’re the remnant of the Boys Club that — thinking it was always right — sat down to make up the rules some of us still follow that others (Republicans all) blatantly piss on.

I guess “doing it right” is a matter of perspective. If you’re the majority of Americans — we feel in our gut that children dying on our southern border is us DOING IT WRONG. If you’re a republican however… if you’re Donald Trump — you’re a guy waving his dick around, thinking how awesome you are — and how “right” everything is in the world.