We’ve traded away our health in pursuit of profits

It’s time to visualize a new goal for our health care system

Despite having the best-trained doctors and best-equipped hospitals in the world, America has one of the worst health care systems. Approximately 82 percent of our population has health insurance of any kind, and only half of those have insurance that adequately covers their medical needs.

Unfortunately, that’s the good news. Health care costs continue to rise above the rate of inflation and faster than the average wage of most workers. Many businesses are either passing those rising costs on to their employees or simply dropping health care coverage altogether. All of this started to happen before the Affordable Care Act (aka “Obamacare”) was enacted. These were some of the reasons Obamacare was conceived, but it just didn’t fix the problem.

The American health system is not designed to deliver or even manage health. A system that delivers health care would decrease the chance of getting a disease, which in turn would reduce the number of sick days and lower the overall cost of care. Managing health is best done on a community or even national or international scale: clean water, effective waste disposal, a proper diet, regular exercise and community-wide vaccinations. The more universally these measures are taken, the lower the cost per person.

The major goal of the American health system is to manage disease. Our doctors are trained to treat high blood pressure and diabetes, not cure it. You might “feel better” after taking your medication and get your blood pressure or diabetes “under control,” but still have the diagnosis – and here’s the point: You still have to keep taking your medication.

There are a few exceptions. Doctors can help us get over the flu or pneumonia. They can knit together broken bones and take out a diseased appendix and drain an abscess. But wouldn’t it be cheaper to prevent those things from happening in the first place? The truth is, this is not part of the training for most doctors and they’re certainly not paid to do it.

A health care system that manages disease is designed for profits, not for health. That’s because managing disease has short-term economic benefits.

For example, more money can be made by keeping Americans obese than by achieving and maintaining a healthy weight. Obesity leads directly to hypertension, diabetes and heart disease. That alone accounts for more than half the dollars spent on health care.

The pharmaceutical industry relies heavily on profits from diet pills, anti-hypertensives, statins and lipid-lowering medications and the ever-growing number of diabetes medications. Hospitals and doctors profit from frequent office visits to monitor blood pressures and blood sugars. Diseases related to obesity, hypertension, heart disease and diabetes account for the majority of today’s hospital admissions.

In the middle is the most profitable group of all, the insurance industry, brokering the monetary transactions. Reducing obesity would result in a loss of money to everyone in the medical field.

But that doesn’t even scratch the economic surface of the “hidden costs” of an inadequate health care system in America.

From farming to fast food, the economics of nutrition is centered on a carbohydrate-rich and antibiotics-laden environment, rather than a diet rich in healthy proteins and fats.

We can sell whole pizzas for $5, hamburgers and fries for $1, but a salad will cost you $7 to $10. We can buy a two-liter bottle of soda for the price of a one-liter bottle of water. Controlling obesity would hurt all of these industries as well. 

Given the focus on profits over health management, there is little wonder as to why the health care discussion in the past five years has focused on the ACA rather than the problems within the health care system itself. The ACA didn’t change the profiteering direction of our health care industry; it merely adjusted the rules on how to do so. As a result, financially and politically, both political parties found it much easier to criticize the changing of the rules of the game than to refocus the goals of our health care delivery system altogether.

It’s time to visualize a new goal for our health care system.

Dr. James Fieseher is a family-practice physician who lives in Dover.