What A Difference A Year Can Make.

Posted on | May 3, 2020 | 4 Comments

Mike Magee

What a difference a year, and a global pandemic, can make. In this self-enforced pause, there is a great deal of self-reflection going on.

Back in 2019, Michael Bloomberg, looking for support in New Hampshire declared about Medicare-for-all proposals, “I think we could never afford that. We are talking about trillions of dollars… [that] would bankrupt us for a long time.” And fellow billionaire candidate at the time, Howard Schultz added, “That’s not correct. That’s not American.”

Today, with the health care system visibly tilting and scrambling, and policy loyalists and lobbyists for the Medical-Industrial Complex praying for “silver bullets” while searching for “silver linings”, the terra firma beneath their feet is shifting.

At the time though, neither man made the connection between large-scale health reform’s potential savings (pegged to save 15% of our $4 trillion annual spend according to health economists) and the thoughtful application of these newly captured resources to all U.S. citizens without discrimination.

Bloomberg’s own 2017 Health System Efficiency Ratings listed the U.S. 50th out of 55, trailed only by Jordan, Columbia, Azerbaijan, Brazil, Russia. Yet he seemed unable to connect addressing waste with future affordability.

Schultz was similarly short sighted. While acknowledging that the manmade opioid epidemic, mental health crises, and income inequality are “systemic problems” and at levels “the likes of which we have not had in a long time”, he failed to connect the cause (a remarkably dysfunctional and inequitable health care system) with these effects.

“Universal health care” is an end point goal that reinforces the principle that health is a human right rather than a privilege for the most entitled. It is an expression of national solidarity and reflects a shift in our culture. That is to say, it is the exact opposite of what we are experiencing now – a level of disorder and dysfunction that threatens life and limb, paralyzes our economy, and all with no concrete end in sight.

The reality today is identical to what it was one year ago: The U.S. has no government-directed, national health planning apparatus. Service levels and reimbursement vary widely across an endless array of private and public offerings that have devolved into a “free-for-all.” Our profit-driven, scientific research community continues to divert resources from health planning and patient care, and our insurance system harbors an enormous number of health system middlemen profiteers to support “non-real” work (16 positions for every one physician – half with no clinical role).

What we do have are $4 trillion already committed (albeit badly misallocated), a remarkable array of educational institutions, a dedicated network of public health schools and practitioners, under-utilized nurses and pharmacists, and a testing ground of 50 different states. These remarkable, yet undervalued and under appreciated resources, are the true bright spots in this pandemic.

The full impact of spiraling health care costs and their secondary effects—including stagnant wages, income inequality, a lack of job mobility, high rates of medical bankruptcy, the closure of rural hospitals, an inability to invest in infrastructure repairs, and our exploding national debt – remains to be calculated as the covid-19 dust eventually settles.

But let us be clear – there is another way. We could have the courage and the will to reapply our more than ample health care assets and reject this insanely reactive and helter-skelter status quo. We could vote in change on a large scale. We could elect leaders willing to honestly address a simple, long overdue question that is at the very center of this pandemic: “How do we make Americans healthy?”

Comments

4 Responses to “What A Difference A Year Can Make.”

Larry McGovern
May 4th, 2020 @ 10:50 am

Thanks, Mike. Puts it all out there.
A large part of the answer to your final, basic question is reform of the insidious, grotesque situation where money influences everything. Get rid of Citizens United, institute public financing, severely limit lobbying, among other reforms.
Lawrence Williams
May 5th, 2020 @ 10:42 pm

Mankind’s hubris and underestimation of the raw power of nature are monumental. And so here we are. The entire human race is being ravaged by a biological entity 1/10,000,000th our size. Mother Nature has sent our species a message that we do not own or rule this planet. We are mere tenants here and She can cancel the lease anytime She pleases. Perhaps this is a wake up call for us and if we can get those who worship wealth and political power above all else out of control of the planet we might be able to stick around for a while. We shall see, but the price is going to be unbelievably painful.
I think the message goes something like this:

“Hey there Homo Sapiens this is just a little reminder that you do not own this planet. You are just another tenant here and I am the landlord. You had better get smart pretty soon or I will be sending you an eviction notice for your entire species and I will find another one that will live here and not keep acting like an owner who just wants to squeeze out every last drop of oil no matter the devastation it causes the the planet and the other species living there. I have long thought that perhaps yours is a failed species but up till now I have been reluctant to deliver that ultimate good-bye. So this is your final warning. I am making it devastating on purpose to get your attention. Stop behaving stupidly, stop tearing my planet apart in your search for something as temporary as money, and start taking care of each other. Do these things and I might let you stick around for a while but if you refuse, this pandemic will seem like a walk in the park compared to what will come next. Love……Mother Nature”
Mike Magee
May 8th, 2020 @ 1:03 pm

Thanks, Larry! Couldn’t agree with you more. It remains to be seen whether we humans have gotten the message. We certainly stand warned! Best, Mike
Mike Magee
May 8th, 2020 @ 1:05 pm

Thanks, Larry! I agree. There’s a great deal hanging on this next election! Best, Mike