17% of our GDP is bound up with health care, a much larger percentage than most other advanced nations spend, although as I look around I find it rather hard to imagine we are a much healthier group of people than we were in 1969 when I arrived on this third stone:
When I was born health care required 5-6% of GDP. I know that there's a lot more to it, but we've tripled the share we spend on health care since then, but we most certainly haven't seen a tripling in our actual health.
This is an unfair argument, I know. The truth is, well before 1969 we had already cumulatively spent trillions to develop "public health infrastructure" that provides good bang for the buck -- vaccinations, clean water, sanitation networks, food safety, emergency medical facilities -- things that by themselves separate us from second and third world status. This is the first tier in health care. To expose my ignorance on this topic, I have no idea whether or not sanitation/waste water treatment should be included in that 17% or not. You could argue it either way.
The next level of health care is basic primary care, the second tier: Dental check ups, cavity filling, tooth extractions, turn-and-cough hernia identification, prostate exams, gynecological visits,
prenatal care, sleep studies, ingrown toenail extractions, gonorrhea shots, nutritional guidance, lower back pain management, asthma medication, insulin delivery, arthritis care, high blood pressure medicine, alcohol and substance abuse treatment, admonishments to exercise, admonishments to eat fruits and vegetables, admonishments to avoid trans-fats, stitches for knife wounds, elderly care, tetanus shots, well-baby plans, physical therapy....The problem is, primary care is affordable. The other problem is that it has major health benefits. It provides the biggest bang for the buck. These pose huge problems. It interferes with the ability to turn 8-15% annualized profits for for-profit pharmaceutical, biotech and health care organizations. I argued some time ago how we could hire teams of $50,000 preventative care specialists to assist people to live more correctly, but instead our government subsidizes corn syrup and dead, processed food production for mass consumption while consumers are then carted off to $384,000 surgeons and specialists to pull out gall bladders and perform gastric bypasses and knee surgeries for the chronically obese...
Gastric bypasses, boner pills, CAT scans, acid-reflux disease solutions, breast enhancements, MRIs, botox, Paxil & Zoloft, hydrocelectomies -- This represents the third tier of health care, the high-tech solutions, the first of which I participated in last week. If things go well for the rest of my life, I should expect to consume about $837,360 in tier III care for all my future diabetes and elder care management. Even while declaring my ignorance of the true breakdown of health care costs, I'm pretty sure this third tier is the most expensive, produces the least benefit, but man, is it ever profitable. I argue that most of these ailments come as a result of failures to manage basic primary care. Failure to get out of our cars and walk to the corner stores...um...er, scratch that; we don't have any corner stores. Failure to get out of our cars and bicycle to our consumptive depots.
Republicans sold us the idea of pre-emptive war in 2003. Not surprisingly, Republicans today are not trying to sell us the idea of pre-emptive health care; no, campaign contributions & quarterly reports from Astra Zeneca trump long term health care sustainability. They are also doing everything they can to upend the latest health care bill, to ensure continuation of an unsustainable trajectory in existing health care that makes most of its money from third tier care.
There's no doubt our health care lobbies would argue that if we just ate from the Pharmer's market rather than the farmers market we'd all be healthier.
Indeed we are healthier. Just look at yourself in a full-length mirror...
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