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 k / o
                                       politics + culture

Wednesday, January 11, 2006

healthcare: our national shame

Here's a chilling quote from a must read article in today's NYT about how three of four diabetes clinics providing preventive care shut down for lack of 'profitability' since their founding seven years ago, even as Type 2 diabetes cases doubled in NYC:

They did not shut down because they had failed their patients. They closed because they had failed to make money. They were victims of the byzantine world of American health care, in which the real profit is made not by controlling chronic diseases like diabetes but by treating their many complications.

Insurers, for example, will often refuse to pay $150 for a diabetic to see a podiatrist, who can help prevent foot ailments associated with the disease. Nearly all of them, though, cover amputations, which typically cost more than $30,000.

Patients have trouble securing a reimbursement for a $75 visit to the nutritionist who counsels them on controlling their diabetes. Insurers do not balk, however, at paying $315 for a single session of dialysis, which treats one of the disease's serious complications.

(Byzantine is right....our nation's health care system is in Critical Condition and has been for decades.)

The broader question is, as wu ming (someone I hope gets Best Commenter in the Wampum awards for all he's done at so many blogs) points out: because we put a financial incentive at the heart of our 'health care system' we don't do much preventive care at all. It doesn't "pay." That's perverse.

Preventive care, of course, benefits society as a whole. In fact, it's high time we started thinking about the nation's health as a national resource, something we protect, nurture, defend and pass on to the next generation.

The Republican Party is inexorably tied to the idea that the dollar incentive fixes everything. It doesn't. Not with the new Medicare Drug Plan, not with Social Security, and not with preventive care in the face of an unprecedented epidemic of diabetes.

The GOP does the bidding of the almighty dollar, and the almighty dollar would rather amputate your leg than help you stay healthy in the first place.

For shame.


  • the utter irrationality of running a public good like pirates makes it clearer than ever why health care needs to be brought into the public sphere as an entitlement, if for no other reason than the fact that the system will not start to address preventative care until it has an actual financial imperative to do so. people matter, and the current system treats us like cows in a feedlot or caged chickens, ever chasing the lowest common denominator in the service of the greates possible extraction of profit. it is utterly immoral, and has to stop.

    By Anonymous wu ming, at 1:28 AM  

  • I'm not much of economist but the topic of healthcare for me triggers thoughts concering positive and negative liberty and subsequently rights: the right to life. It seems like typical conservative ideology is mostly concerned with negative liberty.. freedom from coersion, and not positive liberty.. freedom to healthcare access.

    The thing that I find interesting is that the more that scientists discover genetic or biological bases for certain mental health disorders, amongst many other areas of health, it seems like these issues without a doubt fit into the conservative ideology.. to have the freedom from mental illness, to have freedom from diabetes, etc.

    By Blogger Dean, at 5:24 PM  

  • Thank you, k/o -- I've read your work for a couple of years. But this is my first comment.

    I've been wondering how we can build a network of people committed to a national healthcare system. I've started my small piece by creating eat4today a place to talk about food and eating and the state of the world. And, it seems healthcare.

    Anyway I love this post.

    By Blogger katiebird, at 5:33 PM  

  • National health care is *the* winning political issue. It actually has been so for a very long time--at least since 1994 when Bill and Hillary Clinton ALMOST created a national health care system in the U.S. We lost because the Democrats and the Clintons did not quite understand the lengths that the private Insurance Industry would go to in order to defeat a public national health care system.

    Unfortunately, that failure has haunted all of us for over ten years, and because it is so closely identified with Hillary it is likely to continue to haunt us.

    Nevertheless, it is an issue that profoundly affects *every* American. Even people with health insurance---an increasingly smaller percentage of us---are pissed at how cumbersome and bureaucratic and expensive our private health care system is.

    The trick is to clearly articulate the problem and the solution in one easy and memorable phrase that voters will understand. My favorite is:

    "Medicare for All."

    By Anonymous willyr, at 6:07 PM  

  • Refer to Diabetes for
    useful information

    By Anonymous Anonymous, at 1:02 AM  

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