hope?

John Geyman, MD
Monday, Jun 22, 2009

Now that we have a new president espousing health care reform and a Democratic majority in both houses of Congress, isn’t this a time to be excited and optimistic for long-overdue reform? Much as we would like to say “Of course!”- we cannot. The “reform” effort is already way off the track, despite the hype of “progress” in the uncritical mainstream media.

So what’s going wrong? For starters, not all interests are at the negotiating table; noteworthy in its absence of advocates for the public interest. Fundamental questions as to the goals of reform are not being asked, and in fact are being kept out of the discussion. These questions include:

Who is the health care system for (e.g. patients and their families vs. corporate market stakeholders and their investors)?

As a basic human need, is health care a right or not?

Should our system be based on the for-profit business model or a not-for-profit public financing system of social insurance?

Are there any alternatives that will actually save money?

Should the debate be based on evidence, ideology, or political power of the stakeholders in the present (failing) system?

The “debate” over health care reform has already been taken over by the very interests who are themselves a big part of the problem (reminds us of the banking industry and the bailout in process). True to their business model, the insurance, drug, medical device, medical equipment and related health care industries are naturally more interested in their future markets, profits and returns to investors than building a sustainable system of universal access that would rein in their profiteering and hold them more accountable to the public interest. For them, health care costs are revenue, and the “reform process” is an opportunity to protect and expand their future financial wellbeing.

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