Lucy! This make no sense. 'Splain.
Henry Kaiser envisioned a system which allows companies to take care of their own workers and compete with other companies' health care systems to attract the best and the brightest. Surely there would be a continuing demand for ever better systems of health care which would continue to push the medical marvels of American hanky-panky ingenuity far into the future, right? Not quite. His son, Edgar Kaiser, had different ideas. His idea was to make the health care system profitable in and of itself and his way to do so comes at no surprise to those who understand capitalistic principles. But rather than explain it, here is Ehrlichman's discussion with President Nixon on the future HMO system for America:
"February 17, 1971
5:26 pm - 5:53 pm
Oval Office
Ehrlichman: Edgar Kaiser is running his Permanente deal for profit. And the reason that he can-the reason he can do it-I had
Edgar Kaiser come in-talk to me about this and I went into it in some depth. All the incentives are toward less medical care, because-
President Nixon: [Unclear.]
Ehrlichman: -the less care they give them, the more money they make.
President Nixon: Fine. [Unclear.]
Ehrlichman: [Unclear] and the incentives run the right way.
President Nixon: Not bad."
And US health care has been heading downhill ever since. The important guiding principles of the US health care ever since has been almost solely capitalistic in nature, that is, providing the highest amount of profit to the shareholders through any and all cost cutting measures available. Where most of the rest of the world has been looking to improve the care for their citizenry, the US has been looking to improve the profit margin for their shareholders. And these same guiding principles don't stop with the health care industry.
Cost cutting is a way of life in capitalistic countries. The overriding principles are: (1) reduce the cost to produce or present the product in question, and (2) increase the output and availability of the same. Forecast models have become increasingly complex to help each company maximize profit and minimize cost. While there is nothing inherently wrong with these ideals, there is something inherently wrong when these ideals are used solely for the profit of the rich and the detriment of the person on the street.
It seems that reducing the cost of health care has become every corporations' number one priority because the less they pay, the greater the profit for THEIR bosses, the shareholders. </p><p>Think this sounds too Kafkaesque? Think again. The role model for today's "Kaiser-like" American company is WalMart. It has grown to be among the world's giants. It's a behemoth that is found in Communist China and Dixieland, USA. It doesn't just have lower prices, it has L-O-W-E-R prices. Check anywhere else. Look around. Why is everyone and his brother going to WalMart to buy their needs? Because it has the lowest prices. According to Wakeupwalmart.com, "Wal-Mart reported in January 2006 that its health insurance only covers 43% of their employees. Wal-Mart has approximately 1.39 million US employees."
So, math students, here's your assignment. If WalMart only provides health insurance for 43% of its employees, who provides health insurance for the remaining 57% of its employees? And no, you can't say that it's the husbands. </p><p>Industry standards point to an average of 66% of employees covered, or an additional 319,000 more than they currently have. Not only are fewer given health care, but the service is worse as well. The waiting period is up to six months before being eligible. And there's the cost. WalMart employees can spend up to 25% of their take home pay just for normal medical expenses. Since WalMart doesn't have to pay those outrageously expensive medical bills, their costs are a whole lot cheaper. You can practically see the numbers fall right off their price board and into the lap of the employee who must now pay for the health care costs that were once covered by his employer. </p><p>WalMart has found the secret nest of benefit eggs inside the cost reduction model of modern pricing systems, and the CEO has just earned himself one big, fat paycheck, a huge pay raise, and champagne for all with smiling shareholders just beaming at their new wealth. AND, since WalMart is THE industry model of frugality and cost cutting à la American Way, its profit model will be copied and improved upon by others in all industries.
Okay, US health care is on the ropes. Cuba?
Um, okay. The US model of health care efficiency can be considered on life support once and for all. Let's look at Cuba. Since the rise of Castro, and the fall of mafia-owned Cuba, the US has invoked an impenetrable cordon around Cuba and effectively pushed its possible trading partners into feats of incredible skill in order to pass all the hurdles and sell even the most mundane of equipment of any kind to Cuba. It's only suitor of size was the Soviet Union and when that relationship turned military, in 1962, Uncle Sam sent a few of his most daunting ships to the area to say, "No way, José." The Soviet Union had to remove their missiles from Cuba and the US had to remove their missiles from Turkey so that equilibrium, and distance, could be maintained. But the economic embargo was never lifted, not in nearly fifty years and with an entire world pleading the US to stop it.
It would seem completely normal to assume that with the most powerful nation on Earth intimidating all possible trading partners, Cuba's economy would collapse and with it, whatever's left of its health care system. But just the opposite happened. According to Dr. Howard Waitzkin, a well organized and accessible health-care system has enjoyed a high priority in Cuba since the Revolution of 1959. Training programs have produced large numbers of physicians, nurses, and allied professionals, who practice in a system that assures access to services in even the most remote parts of the country. Curricula for these training programs have been developed centrally by the national Ministry of Public Health after input from educators and practitioners in all areas of the country; the curricula have been implemented in large part through decentralized training facilities, including medical schools that have been initiated in each of Cuba's provinces.
Because the production of physicians came to exceed the country's internal requirements, Cuba's physician per population ratio is 1 per 255, as compared to 1 per 430 in the United States. Yep, you read right, the ratio is smaller in Cuba. AND GUESS WHAT? Education is free. Hundreds of American medical students apply every year to study at Cuba's universities. Cuba has been able to export primary care practitioners and specialists for periods of service in other Third World nations. Decisions to send doctors abroad have responded to official requests by the governments of these countries. More than 10,000 Cuban physicians have served abroad. Tens of millions of patients around the world have been treated.
The results are nothing short of incredible. In 2002, Cuba could only afford $186 per person per year for health. Yet, the number of beds per 1,000 jumped from 5.5 in 1964 to almost double in 2002. Their number of 68 nurses per 1,000 people almost rivals the US rate of 98 and distances the rest of Latin America. And since it is homogeneously spread across the country, rural and urban areas both profit. The infant mortality rate in 1960 was at 59 per 1,000 live births in Cuba and 25 per 1,000 live births in the US. By 2008, that number had narrowed to 6.9 in Cuba and 6.1 in the US. Dental health care in Cuba displayed far more dentists per capital than the US with 8.45 per 1,000 in Cuba vs 5.98 in the US in 1997.
Since money has been at a premium since the earliest days of modern Cuba, due primarily to the US economic embargo, other methods were needed in greater degree. Doctors now have a set section of town under their care. Home visits are performed on a regular basis. Each doctor keeps the same patients over the years and therefore, has a more cognizant understanding of their individualist medical needs, weaknesses and level of health. Their clientele stay the same, whether they change jobs or not. Medical classes and seminars are given to improve public awareness and home remedies are shared where available. Literature is also available.
After WWII, most countries around the world, with the major exception of the United States, began seeing health care as a right, not a privilege. All over the world, people demanded a growing level of medical care as a baseline regardless whether they were millionaires living in gay Paree, or farm workers outside Strasbourg. It was no longer sufficient to have wonderful hospitals and super rich physicians adorning gold inlaid tapestries at Versailles, when a farmer ten miles away couldn't get sufficient health care to take care of his child's diarrhea. People everywhere started demanding a minimal level of health care for all. </p><p>Everywhere, that is, except the US. The US is stuck on an irreversible spiral slide into total health care meltdown. The only ones who are allowed to influence the government are those who stand to profit most from this crumbling system. And this has been the same for almost 40 years. </p><p>Big Pharma and the big insurance providers will sit there before Congress, as they have been doing for four decades, and decry the system. They will point to nonexistent issues, faulty graphs and erroneous comparisons, and lament for all to hear that these issues are causing the problem. But one thing they will never tell the public is how much money they've been making on the backs of a failed system that only increases the number of uninsured, the cost of treatments, and the number of agonizing decisions for more and more Americans who have to decide what else they must give up just to stay alive.
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