The news that the former chief executive of UnitedHealth Group is forfeiting at least $618 million to settle claims related to backdated stock options points to everything that’s wrong with the U.S. health care system.  The system really has nothing to do with health. It has everything to do with extracting profits for those who run and game health care to the detriment of most Americans.

Take Dr. William W. McGuire. He’s the former United Health CEO who reached that settlement with the Securities and Exchange Commission and UnitedHealth shareholders. According to the New York Times, Dr. McGuire will still be allowed to keep stock options valued at more than $800 million.

I assume Dr. McGuire worked hard to make UnitedHealth the largest health insurer in the country, but you have to question the equity of a system that gives Dr. McGuire stock options worth $800 million, an amount that would pay annual health insurance policies for about 69,000 families of four, assuming an annual premium of about $11,500.

Why does the American health care system generate huge profits for the few and exclude the many from reasonably priced health care services?  The answer is that the United States has lost its sense of community.  Politicians give lip service to the concept of the common good, but the reality is that most America’s politicians and business leaders place self-interest above all else.

The individual has run amuck in American society.  As Forbes magazine reports, we are in the gilded age with more than 400 American billionaires. True, a few billionaires like Bill Gates, Warren Buffett and Ted Turner have pledged billions for philanthropy, but the U.S. health care system can’t depend on handouts to serve the needs of its citizens.  In 2005 health care expenditures in the U.S. represented 16 percent of our gross national product. Each year we’re spending more and getting less for our health care dollars.  Public health is suffering. For example, a recent study in the New England Journal of Medicine revealed that only about 50 percent of children from 12 metropolitan areas in the U.S. were fully immunized by age two.

So what do we do? Eliminating the influence of big money from the political process would help, but that’s not going to happen overnight in the United States. The insurance industry will not willingly give up the golden goose that laid an $800 million egg for one former CEO and smaller but significant eggs for many others. Nor is the pharmaceutical industry going to loosen its grip on Washington.  We all remember how big pharma lobbied Congress in 2003 to pass the so-called Medicare Modernization Act of 2003 that, among other provisions, prohibited Medicare from negotiating drug prices with pharmaceutical companies. The legislation turned out to be a multibillion-dollar windfall for the pharmaceutical industry.  As Congresswoman Louise Slaughter wrote in the New England Journal of Medicine, “The final legislation, heavily influenced by drug-company and health insurance lobbyists, focused mainly on the needs of those industries instead of those of the seniors it should serve.”

So if we can’t turn to Congress and if we can’t expect the health care industry to kill its golden goose, what can we do?  The coming election provides an opportunity to elect a Congress and a President who could put common good above private gain.  Most of the candidates have shared at least an outline of their plans. You can view their positions on YouTube.  The question I ask is will the U.S. electorate recognize the exigency of the moment and elect representatives and a President who put the health and welfare of all its citizens ahead of the financial interests of the rich and powerful? It’s that simple.

(Tom Linden, MD, is a professor of medical journalism at the University of North Carolina. Opinions expressed by Health Commentary guest bloggers do not necessarily represent the views of Health Commentary.)