Articles by JCS

Reforming Healthcare

 

REFORMING AMERICAN HEALTHCARE

“It is time to heed the Golden Rule of Holes, which says: When you are in a hole, stop digging. Well, we have dug one whopper of a hole by failing to emphasize prevention and wellness. And it is time to stop digging.”

Senator Tom Harkin, (D-IA)

 

During the Obama healthcare debate, Sen. Tom Harkin[1] mentioned American healthcare has “dug one whopper of a hole.” But this hole appears more like Alice in Wonderland’s rabbit hole with never-ending twists and turns with strange characters offering their vested opinions.

Image result for Medicare for All”Years later healthcare reform remains at the forefront of issues among Democratic presidential candidates peering into this medical abyss that only goes deeper into debt for most Americans.

Despite the debate over universal coverage, aka, “Medicare for All” or “single-payor” vs. “for-profit” private healthcare insurance, this conversation misses the elephant in the room—the fact the American medical-industrial complex did not build its empire practicing free enterprise on a level playing field.

Instead, this medical cartel took a lesson from other American monopolies to dominate this market by ruthlessly gerrymandering to eliminate competition altogether or with severe restrictions in health insurance coverage.[2] For over a century, the AMA has defamed competitors such as homeopaths, osteopaths, chiropractors, naturopaths as quacks in the media by using syndicated journalists such as Ann Landers to cast aspersions, the AMA used the courts to arrest anyone helping sick people as practicing medicine without a license, and used the legislatures to restrict the scope of practice by competitors.

As example of the medical war against chiropractors was explained by the namesake of the federal antitrust case, {Wilk v. American Medical Ass'n, 671 F. Supp. 1465, N.D. Ill. 1987}. Chester Wilk, DC, the lead plaintiff in the antitrust case, wrote of this clandestine effort by the AMA to destroy the chiropractic profession:

“The negative propaganda against chiropractic became more dishonest than  ever yet we still did not know its source. And then we got our answer when an underground book surfaced exposing the AMA entitled, “In the Public Interest” by William Trever. The book provided photocopies of many of the AMA’s secret internal memos exposing its covert and sinister plot to destroy the public image of chiropractic through dishonest negative propaganda for the prime intent of ‘containing and ultimately eliminating chiropractic.’ These were frightening words and I was the intended target.”[3]

William Trever was very clear in his disgust of the AMA:

Image result for “In the Public Interest” by William Trever“Behind the closed, guarded doors of the AMA headquarters there is an elite and secretive group of men who have worked with the diligence, tenacity, shrewdness and deceit of the KGB, Gestapo, and the CIA combined. This book is a chronological, historical, factual outline of this medical government’s scheme and activities concerned with misleading the public and legislators in their attempts to do away with chiropractors.”

The net result of the AMA’s effort worked to create a healthcare system resulting in the lack of a free enterprise system, the lack of patient choice/access to non-drug providers, the lack of cost containment, and the lack of emphasis on wellness/prevention. Unlike other monopolies such as AT&T and US Steel, the AMA cartel has firmly established itself as the 4th branch of government, albeit non-elected, self-managed, and self-serving.

This is not a new issue since the AMA’s goal always has been to serve its own economic interests. In 1949, writer Milton Mayer in Harper’s magazine summarized the impact of the “Medical Mussolini” of the AMA, CEO Morris Fishbein:

“In the course of thirty-seven single-minded and single-handed years, he had converted a panty-waist professional society into the most terrifying trade association on earth.”[4]

And the medical cartel continues to terrify the American public with its gun-to-the-head policy — “pay outrageous prices for inferior services or else we’ll pull the plug.”

Although most people are held captive to this cartel, some Americans now speak with their feet by traveling abroad. Every year, millions of Americans leave the country in order to save money on exorbitant medications, dental, and surgeries — a phenomenon called " medical tourism" saving thousands of dollars in other countries for dental work, undergoing surgeries, picking up prescription medication, and even giving birth.[5]

The six countries that take top places according to the Global Retirement Index offer retirees first-rate care, American educated doctors, plus the service is top-class and affordable according to John Michael Arthur, a medical doctor from Texas, has a lot of praise for the Costa Rican healthcare system. “High quality healthcare—medical, surgical, and dental—is easily found and at about one third the cost of U.S. prices in the private system.”[6]

The top 6 countries for medical tourism by Americans include:

1.   Malaysia

2.   France

3.   Thailand

4.   Ecuador

5.   Mexico

6.   Costa Rico

Realistically, many people cannot afford a medical vacation despite the benefits, so they are subjugated to the medical tyranny here in the states, which explains why 66.5 percent of all bankruptcies were tied to medical issues — either because of high costs for care or time out of work. An estimated 530,000 families turn to bankruptcy each year because of medical issues and bills.[7] Many others simply go without care.

The hope of reforming of the current medical system brings little solace—similar to putting a new coat of paint on a gas guzzling car with a bad transmission. Even by some miracle reform were to happen, if advocates of “Medicare for All” think the medical or dental professionals are willing to work for Medicare rates, they are totally mistaken. These two professions are accustomed to their inflated prices as monopolies and will strike at any legislation to work at the same rates as their poor counterparts — those pitiful chiropractors.

REFORM: DOA

Not only has America dug itself into a very deep hole with an expensive, ineffective “sickness care” system, any significant reform in healthcare away from the present “for-profit” model will be DOA in Congress considering the lobbying money from the medical-industrial status quo prefers the present system just as it is—a virtual monopoly controlling 20% of the gross domestic product.

Image result for medical expense of GDP

Not only is the American health consumption the highest in the world compared to nationalized healthcare systems, the cost per capita is also the highest, nearly twice the “comparable country average”:

 

Image result for medical expense of GDP


To preserve such an expensive and ineffective medical system certainly requires a lot of political pull and massive public relations effort to keep the Congress and population convinced there is no better healthcare system in the world. We continually hear the medical advocates decry “socialized medicine” as inferior, but the statistics don’t bear out that claim. Despite the highest net cost and per capita cost, American healthcare overall ranks among the lowest according to the Commonwealth Fund Scorecard:

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The present system was aptly described in Time magazine: “[W]hat a sinkhole the country’s healthcare system has become: the U.S. spends more to get less than just about every other industrialized country.”[8]

There have been other calls that liken the medical-industrial complex to the military-industrial complex such as Beware the Medical-Industrial Complex:[9]

"‘We must guard against the acquisition of unwarranted influence, whether sought or unsought, by the military industrial complex,’ said Dwight D. Eisenhower, 34th President of the United States (1953-1961). Farewell Address, January 17, 1961. If Ike were with us today, he might well expand his views on power and influence to include modern American medicine. The corporatization of health care in the United States has moved rapidly in recent years.”

POLITICAL CLOUT

The medical-industrial complex rapidly became the largest lobby on Capitol Hill, now three-times bigger than the military-industrial complex according to attorney and journalist Steven Brill in his TIME cover article, “Bitter Pill: Why Medical Bills Are Killing Us.

He characterized the market dominance by the medical cartel as the “prosperous island” in healthcare:

“It’s about facing the reality that our largest consumer product by far—one-fifth of our economy—does not operate in a free market… We’ve created a secure, prosperous island in an economy that is suffering under the weight of the riches those on the island extract. And we’ve allowed those on the island and their lobbyists and allies to control the debate…”[10]

Without a doubt, if America spent on defense as much as the next seven countries in the world[11] but had the worst national defense system, there would be uproar. However, when American medical care ranks at the bottom while spending more than any country in the world, very little is said in the mainstream media, which is also controlled by Big Pharma as it spews the “pill for every ill” mantra daily.

An exposé in The New York Times, “Think You’re Seeing More Drug Ads on TV? You Are, and Here’s Why, found 771,368 drugs ads were shown in 2016, an increase of almost 65 percent over 2012. Crunching this number by 365 days in the year reveals there were 2113 drug ads on TV daily throughout the US. Sadly, Big Pharma has hijacked the medical profession making pushers of these highly trained physicians.

Just as the NRA controls the gun debate, the medical cartel controls the narrative about healthcare reform by controlling the media and Congress. According to OpenSecrets.org, the medical-industrial complex comprises 4 of the top 10 lobbying organizations in 2018:

·         Pharmaceutical Research & Manufacturers of America    $27,989,250

·         American Hospital Association                        $23,937,842

·         Blue Cross Blue Shield                                  $23,884,221

·         American Medical Association                         $20,417,000

 Here is a sampling of some smaller groups who pay to play on Capitol Hill:

·         American Dental Association                          $2,580,000 

·         Medical Device Manufacturers Assn:                $1,200,000

·         American Association of Orthopaedic Surgeons $2,809,000

These samplings combined total $102,817,313, which equates to $192,181 per Congress member.

In comparison, the American Chiropractic Association, contributed a bit more than $169,000, which equates to $315 per Congress member, which equates to 0.164% of the medical cartel’s contribution.

Of course, these for-profit medical organizations have no interest in Medicare for All as noted in the 2019 article by Karl Evers-Hillstrom, Big Pharma, insurers, hospitals team up to kill Medicare for All:

Medicare for All is up against serious challenges — and it’s unclear whether the measure has enough muscle, or money, behind it.

Though the bill has drawn praise from several major unions, including National Nurses UnitedNational Union of Healthcare WorkersAmerican Federation of Teachers and Service Employees International Union, few industry groups — outside of those dedicated to backing single-payer health care — publicly support the bill.

The Medicare for All bill (H.R.1384) introduced by Rep. Pramila Jayapal (D-WA) on Feb. 27 has 106 co-sponsors in the House, far fewer than it needs to pass, and does not have the support of House Democratic leaders.

Every attempt to completely overhaul the healthcare system has failed or become watered down due to opposition from the healthcare industry, from President Harry Truman’s universal health care plan in 1949 to President Bill Clinton’s universal health care plan in 1993. Supporters of Medicare for All are hoping this time will be different

But the giants of the healthcare industry agree on one thing: Medicare for All cannot become law.

Partnership for America’s Health Care Future (PAHCF), a group comprised of major drugmakers, insurance companies and private hospitals, has spent the last several months lobbying members of Congress, running online ads and working with the media to drive down popularity of Medicare for All, a single-payer health platform that continues to gain popularity in the Democratic party.

The partnership includes some of the biggest names in the healthcare industry, including the American Medical Association (AMA), Pharmaceutical Research & Manufacturers of America (PhRMA), Federation of American Hospitals (FAH) and Blue Cross/Blue Shield.

All told, the members of the partnership have a lot of money and influence to spend on Capitol Hill. They spent a combined $143 million lobbying in 2018 alone, according to data from the Center for Responsive Politics.

As a result of this massive political clout since the days of the Medical Mussolini, America has one main trade association—the AMA—spearheading a cartel of allied professions that virtually controls the entire healthcare system in practice and politically.  Even government agencies designed to regulate the healthcare industry are manned primarily by medical doctors who are members in proper standing with the politics of the AMA.

In Part 2, you will learn how the Trump Administration issued a report on reforming American healthcare that was outstanding, yet few people have heard of this impressive report.


[1] Sen. Harkin was a strong chiropractic supporter on Capitol Hill from 1975 until his retirement in 2015.

[2] As example, the Wilk et al. v. AMA et al. antitrust case illustrates the depths to “contain and eliminate” the “chiropractic nemesis.”

[3] Wilk ibid. p. 25 .

[4] M Mayer, ibid. p. 76.

[5] People are ditching US healthcare and flying to other countries for medical procedures they can actually afford, Nian Hu, Insider, Jul. 3, 2018

[8] Karen Tumulty, “Can Obama Find a Cure?” TIME  174/5 (August 10, 2009)

[9] Stevens CW1, Glatstein E, Oncologist. 1996;1(4):IV-V.

[10] Steven Brill, America’s Bitter Pill; Money, politics, backroom deals, and the fight to fix our broken healthcare system, Random House, NY, 2015

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