Health Care 2017: A Physician's Perspective
By Michael P. Fangman
As a physician, I’ve participated in a system of medical science that solves problems by first understanding the root causes of symptoms. Only making an accurate diagnosis can eventuate in effective treatment. Politicians regularly exhibit a mindset that does not look at causation of problems. Locked into electoral brinksmanship and unaccustomed to team work, they avoid collaboration and try to ram through their own ideological theory in legislating critically important issues like access to health care.
They fail to address the essential components of America’s system. In the case of health insurance, they assume that the past cannot be questioned and endeavor to fit a “square peg into a round hole.” They argue that nurturing “free market” forces will heal our complex system that consumes around 20% of our GDP — at least twice the fraction of GDP expended on health care by any other “developed” nation on earth. If only we got twice the value and better outcomes as participants in our system. In fact, most doctors will tell you that our health care system is broken. It is a complete mess, dominated by countless insurance companies that pay their executives thousands of dollars per hour to avoid paying claims made for reimbursement on health care delivered. The system is such a mess that only a small minority of Americans have any idea what it’s all about. In truth, doctors are the only health care professionals who experience a broad enough spectrum of the system to gain any real insights into the dysfunctional nature of this broken human endeavor.
Health insurance became all about profit in the 1980s, and has become ever more monetized since then. American medicine went from being generally altruistic before the mid ’80s to insidiously become all about greed in its many diverse manifestations. Greed can culminate in progress occasionally–perhaps the creation of improved battery technology or better telecommunication, for example. Declining health and suffering of human beings does not lend itself well to classic profit motivations. I submit that doctors and other health care personnel had far more job satisfaction, superior potential for material gain and equivalent creativity before making more money took center stage in our health care system. The profit and advantage has largely gone to the “half of one percent” in the health care field — as it has in the rest of our society. Today’s doctors are virtually pawns of insurance company “stop-loss” motivations, ridiculous electronic health records systems devised to enhance profit, and a red tape bureaucracy worse than any other industry. This was all established in the last 30 years of “free market” greed, replacing a traditional profession filled with integrity and motivation to help others.
Frankly, I still think that doctors working together could solve the medical system’s many conundrums far better than politicians secretly serving the goals of lobbyists from big pharma, big insurance and big hospital consortiums. Many health care researchers assert that every other health care system in the developed world functions more effectively to address the actual needs of their citizens with failing health than our U.S. health care system does. My sense is that this is mainly because they have freed themselves from the profit motivation in crucial ways and have stayed focused on efficient and pragmatic responses to the needs of sick people.
Capitalism has been made into a “sacred cow” by the right wing of America. Like any other human system, capitalism has many faults. The unintended consequences and injustices of capitalism are most glaring in our health care system. Medicare spends about two percent of their health care “dollar” on administrative work. Health insurance companies spend anywhere from 40 percent to 20 percent of the health care dollars they charge on non-productive administrative work, like advertising and lobbying congress for more profit potential. In general these companies run convoluted systems that make a mess of the daily living experiences of America’s sick and their families. Inscrutable communications, arcane accounting practices and explanation of benefits (EOB), details that no one can understand create a nightmare of paperwork for every American with a significant health problem. The system is broken, is a burden on all who get sick (and that’s all of us) and is not being addressed responsibly by politicians. America requires radical changes in our health care system.
Citizens need to come together and get over the artificial “left/right” divide that politicians have manipulated us with far too long. We need to start lobbying for radical change in the fundamentals of national leadership systems — from health care to taxation to the reform of capitalism itself. We can start by reading. Health care is clarified and discussed in practical terms in a new book, “An American Sickness,” by Doctor Elisabeth Rosenthal. Contrast the mess that we have in America to other developed nations using rational health care policy in the survey book written by T.R. Reid, “The Healing of America,” which explains health systems world wide. Reid also clarifies and contrasts our counterproductive political manipulation of taxation versus our irrational taxation in his recent book called “A Fine Mess.”
Now is the time to get at the cause of all our nation’s problems. If citizens do not act, the future will become unmanageable. Our leadership systems have never been so clearly evidenced as being broken. There is no reason to believe that Washington has the will or the means to reform itself. America needs a fresh start. Only activist citizens can restore a sane, rational system of governance and problem solving to America.
I write about “Information Activism” as the essential missing element in restoring America’s democracy. I believe that only the power of knowledge in the hands of American voters can save our democracy and allow America to lead the world rationally again. In a book called “Political Revolution in a Trumped-Up America,” I try to offer simple ideas for emphatic voter rejection of our current status quo in D.C. It advocates applying the logic of successful problem solving seen in medical science to the ever worsening and largely self induced problems in America’s complex society. Motivated, insightful citizen voters must get involved. Time is fast running out, and the margin for error is disappearing. The 2016 election and the subsequent chaos in our capital should prove that to us all. America requires rational change — right now.
Michael Patrick Fangman M.D. is a working physician, Board certified in Medical Oncology and Internal Medicine. He is a Fellow of the American College of physicians. He founded the Cancer and Blood Disease program in Fort Collins Colorado. He has been an NIH/NCI registered clinical cancer researcher for many years. As a young doctor he established a Native American and Latino clinic for those without healthcare options. He volunteered in the Indian Health Service and served as a Major in the U.S. Public Health Service. He has served as a Clinical Professor at the University of Colorado medical school, on his county medical board of directors and other boards.