Three recent events, one of them local and closely covered by this publication, are indicative of the parlous state of the American health care system. The local event, of course, is the announced closing of two facilities in The Valley because of a fiscal crisis at the UVM Health Network, with which the targeted facilities are affiliated. The others are the announcement – since retracted -- by Blue Cross/Blue Shield of Connecticut that it would not cover the cost of anesthesia to the extent that its delivery lasted longer than standards that BS/BC deemed appropriate, and the murder in New York of the CEO of the largest health care insurer in the country, an act apparently carried out by a person angry at the delays and denials of coverage by the insurance industry.
The systemic deficiencies of which these occurrences are symptoms are attributable to a common cause: the continued deployment of a capitalist system where it doesn’t belong. No rational person could deny that enormous prosperity has arisen under the capitalist system. But neither could a rational person fail to recognize that capitalism is highly incompatible with an efficient and equitable health care system. The reasons are readily discernible, and largely boil down to the inelasticity of demand for medical services and the expense of significantly increasing their supply.
Under a rational health care system, resource allocations, such as the location of health clinics, would be made on the basis of an assessment of long-term needs. They would come with a commitment to maintain necessary services and would not be tied to the fortunes of other components of the delivery infrastructure. These features are compatible only with a system in which (a) medical care is recognized as a right of every citizen, (b) taxpayer funding exists for the system, and (c) there is no third-party intervener between the provider of service and payment to the provider, i.e., where there is a single payer system.
Proof that such a system is viable is abundant: virtually all the health care systems in the rest of the developed world utilize such a model. Those systems not only survive, they are less expensive, provide better medical outcomes, and yield higher patient satisfaction. We are surrendering those benefits simply because we are in thrall to an economic system that is inadequate to the task and that is maintained only by the enormous sums of money showered upon legislators and lobbyists who work not only to keep this justly reviled system in place, but also to propagandize the public with the bogeyman of socialism.
Patients of the nation, unite! You have nothing to lose but delay, denial, and dysfunction.
Thomas N. Wies
Fayston
