Recognizing the distinction is essential to ensure access to health care as a basic human right
Note: This was first published in August, 2017. We re-publish it today because it remains as relevant as ever.
By Dr. Arthur M. Sherwood and Michael M. Barrick
The United States Congress has no hope of resolving any of the many health care challenges facing Americans until it understands that in the United States, health care is an industry, not a “system.”
This distinction is critical – and one would think, obvious. Just ask anyone seeking quality time with their physician, looking for an insurance company that won’t demand that their doctor discharge them from a hospital earlier than medically appropriate, and playing the pharmacy lottery forced upon them by the pharmaceutical companies. The difficulty in accessing health care is apparent to anyone who has had need of it, from difficulty in funding care to identifying appropriate care.
So, with the costs and complications of the health care industry evidently beyond reform – considering we’ve been debating this issue since the Truman Administration – it is time to transform how Americans access health care.
We believe that health care is a fundamental human right, embedded in the “life, liberty and the pursuit of happiness” phrase of the United States Declaration of Independence. Hence, we support universal health insurance with a single-payer system. Incidentally, it is far more efficient than the current puzzle of industries competing for profits, when the focus of health care delivery should be clear – exceptional care for every person.
First, though, members of Congress need to understand and concur that the U.S. does not have a health care system. Only by correctly understanding the issue is an intelligent approach possible.
We believe that health care is a fundamental human right, embedded in the “life, liberty and the pursuit of happiness” phrase of the United States Declaration of Independence. Hence, we support universal health insurance with a single-payer system.
Some have argued that the United States has the best health care in the world. It may be true that outstanding providers of health care can be found in the U.S. But it is certainly not true that we have the best health care system in the world.
Health care in America is anything but systematic; according to “Webster’s Universal College Dictionary,” systematic means “having, showing, or involving a system, method, or plan.” There is no plan. There has been no plan. There is not even method to the madness.
The good news is, Congress has an example from which it can learn – the Department of Veterans Affairs. It was created after the Civil War to honor Abraham Lincoln’s idea expressed in his Second Inaugural Address: “to care for him who has borne the heat of battle, and his widow and his orphans.” Indeed, the VA adopted this sentiment as its motto in 1959. The Veterans Health Administration is the largest single provider of health care in the United States, and provides care for millions of veterans. It has seen creation of many of the advances of modern medicine, including the very concept of clinical trials. Creation of electronic health records was facilitated by the VHA, as was promotion of preventative medicine. Provision of care is done via a network of small and large facilities spread around the country, with additional funding possible to provide care in every corner of our great country.
The absence of any real system can be seen in the lack of any structured plan for systematic care of the population. For example, if an individual sustains a serious injury to their spinal cord, there is no mechanism in place to ensure that patient gets sent to the centers best equipped to manage such injuries.
It is even much more evident in the nation’s depressing health statistics, where, e.g., the life expectancy for adult males has actually declined in recent years, the only advanced country in which that happened, reversing what had been a steady advance in life expectancy over the past century. Or, perhaps more importantly, where the rate of childbirth mortality is so high that the U.S. ranks 45th in the world in that category. Mothers in the U.S. are twice as likely to die in childbirth as are mothers in Canada.
During the past decade in particular, this inability to distinguish between a nation with a health care industry and not a system has misdirected the debate regarding the health care needs of Americans. Many of the arguments about financing health care miss the point. The fragmented nature of such financing is further evidence of a lack of a system. Currently, far too much time, effort and money is expended on cost shifting – playing games with peoples’ lives in order to minimize expenditures from each competing source, whether that be the individual, one or more private, for-profit, insurance or pharmaceutical companies, or local, state or federal governments.
Cities and counties bear much of the expense of indigent care; state budgets are severely impacted by costs of health care, and the federal budget allocates a great deal of money to health care. With all that money spent, the lack of timely and appropriate health care sends many people to the emergency room, with a lowered likelihood of good outcomes (compared to early, preventative care), utilizing the most expensive entry point into health care. Additionally, the lack of universal prenatal care results in unconscionable and unnecessary outcomes such as a higher percentage of premature births and prolonged stays in astronomically expensive neonatal intensive care units.
Our current approach to health care delivery makes no sense fiscally, and is morally bankrupt. It is absurd for a country such as ours claiming to be an advanced civilization to exhibit so little care for our fellow citizens.
Our current approach to health care delivery makes no sense fiscally, and is morally bankrupt. It is absurd for a country such as ours claiming to be an advanced civilization to exhibit so little care for our fellow citizens. And it is even more disturbing that those claiming religious affiliation and allegiance permit such a situation to persist in conflict with Matthew 25: 35-40.
It has been our experience, as professionals in health care and with spouses who have devoted their lives to providing loving, exceptional care, that almost all caregivers are motivated by a desire to help people. For the sake of the people needing such care, it is incumbent upon President Biden to call upon Congress to quit the political posturing, acknowledge that our current industrial approach to health care delivery is inadequate, and replace it with universal, single-payer coverage. We already know how to do it. It’s called Medicare. And, it is what the majority of Americans want. Upwards of 63 percent of Americans support it. It could be as high as 70 percent. Clearly, as is customary, the people “get it” first. The question is: Who in Congress and at the White House will stand up for the American people? Who will put people before profit?
About the Authors
Dr. Arthur M. Sherwood earned his Ph.D. in biomedical engineering from Duke University in 1970. He has devoted his career to helping veterans and others with spinal cord injuries maximize their ability to function independently. He has also been very active in the Baptist faith, having served as a Trustee at Southwestern Baptist Theological Seminary for 10 years, and staying active in a local congregation wherever his vocation has taken him.
Michael Barrick has a post-graduate Certificate in Community Preparedness and Disaster Management from the UNC Gillings School of Global Public Health. A reporter and teacher, he also worked for several years as a paramedic and has served as Safety Office and Disaster Preparedness coordinator at two hospitals. He is the owner of The Appalachian Chronicle and Grassroots Appalachia. Learn more about him here.