18 hours Ago
The premeditated killing of the CEO of UnitedHealthcare was very tragic and cannot be condoned. Many of the social media comments that followed were unusual in that they were angry, unsympathetic and vitriolic, recalling horror stories about insurance denials. Such responses bring into focus the failure of our health care system as it exists now.
As a retired physician, I have been exposed to the system as both a physician and a patient. When I began my surgical career in the early 1970s, I was a “doctor,” not a “provider.” Almost all hospitals were nonprofit and run by altruistic-minded individuals and charities.
Health care as a for-profit business was foreign. Not anymore. Here are some notable changes that have occurred in both the diseases and their management that must be recognized to understand its complexity.
First, there has been a dramatic decrease in mortality from infectious diseases. As a result, we are living longer. This should be credited to the advent of vaccines and the effectiveness of antibiotics.
Unfortunately, however, this success appears to have been taken for granted. A few very vocal and perhaps misinformed people are more focused on the side effects while disregarding the enormous benefits. If this significantly changes our acceptance of these advances, it likely will turn back the clock.
Do we really want that? Second, our longer lifespans have led to to more chronic diseases such as diabetes, heart disease and cancer. It is important to recognize that these diseases are not really curable. While some may be preventable, most require lifelong management and expenditure.
This new health care requirement has to be taken into account. Third and most important is the advent of “for-profit” heath care and its transformation into a “business.” Therein lies the conflict.
Patients demand and deserve a service, while the business exists to make a profit. It is a source of great frustration and disenchantment for both patients and physicians. The middleman in this endeavor is the insurance industry.
In order to remain profitable, insurance companies control costs by denying payments whenever possible. This is capitalism. And patient suffering is a cost of doing business.
The brunt of this change is borne mostly by the middle class and the poor. Unlike other businesses, health care is neither discretionary nor elastic. You can't go shopping for a better price when you have chest pain.
Of note, three of the stalwarts in American business — Warren Buffett, Jamie Dimon and Jeff Bezos — with thousands of employees set out to create an efficient health care system but failed miserably and quit. My plea to our leaders is to recognize these changes and treat health care as a human right and take appropriate action. One way would be to treat it as an essential service like the utilities — water and electricity are allowed to make a reasonable profit — and not unregulated businesses whose profit motives drive their actions.
Otherwise, things will only get worse. Dr. P.
R. Rajagopalan of Charleston is an emeritus professor of surgery at the Medical University of South Carolina..
