Every Four Years

One in seven Americans is uninsured, America spends the most per capita on health care in the world, and American health care is among the least effective in the industrialized world. According to an August report by the Centers for Disease Control, precipitous increases in wait times and overcrowding show that emergency departments are delivering an unsustainable share of our nation’s care. To repair this crisis we must recognize hard truths. For starters, there is no ‘American health care system.’

 

It is misleading and destructive to imply the existence of a ‘care system’, a phrase that conjures visions of a unified administrative body whose aim is to maximize the quality, accessibility, and efficiency of American health care. There is no controlling or administrating body with this goal. The invisible hand of the market is the primary administrator, and profit is the final arbiter. This is because we have a free market system in which health care services are traded for profit—not a health care system.

 

We may as well be calling the maker of iPods, the Apple corporation, a provider in the ‘musical satisfaction care system’. The absurdity is apparent. The Apple corporation’s bottom line is not ‘care’, it is profit. The same is now true of American hospitals. While individual hospitals may offer little to no high quality care, they must all derive profit or shut their doors.

 

The solution is to put care above profit, either within the confines of a market-based system or not. But health care must come first. When this occurs costs will drop, quality will rise, and we will have a true American health care system.