No System To It

Rob Thomas is the film critic for The Capital Times here in Madison, and I always find his reviews to be informative, insightful, and well written. The one he did last week was no exception. It was a sympathetic interview with Milwaukeean Steve Burrows, director of the HBO documentary Bleed Out, about his decade-long struggle to find justice for his mother, who had been seriously disabled in what should have been a routine medical procedure.

Something about the review nagged at me, however, and I finally realized that it was the use of the term “health care system” in the headline and thruout the article. It perpetuates the mistaken notion that there is such a thing in America.

There is not.

I’ve done a fair amount of systems analysis in my time, and I’ve got a good grasp of what a system is supposed to be. Above all, it’s something that’s been designed, something to serve an intended purpose, with all its parts properly constructed to fit together smoothly to produce the desired result. If that were the case here in the US, we’d actually have proper health care for everybody. But it’s not. It’s stupendously excellent, world-class, cutting-edge health care for the privileged few, occasionally adequate and fitful attention for the bulk of people in the middle of the economic spectrum, sincere wishes of good luck for the people between jobs, bad nutrition and emergency-room visits for the poor, and “suck it up or please die quickly” for the desperate.

No, health care in America is like our measurement system. Not neat, orderly, consistent, and easy to learn and use like the metric system used by 95% of the world’s population. Instead it’s a cobbled-together patchwork of disparate profit centers like hospitals, pharmacies, independent medical practices, X-ray and lab-test providers, insurance companies, employee-benefit plans, lawyers, accountants, marketers, lobbyists, claims deniers, and of course corporate CEOs whose only joy greater than their annual 8-digit bonuses is pissing all over their competitors. The sole purpose of each of those independent components is not health care or patient sympathy but the ability to make a buck. And if there’s no money to be made, there’s no service.

That’s why, for example, you can get mail delivered to your front door 6 days a week for any address in the United States, or flip a switch and be assured that the lights will go on anywhere in America, but good luck if you need an emergency appendectomy in the northwoods of Wisconsin. No money in it, you know.

And that’s Wisconsin. Imagine what it’s like in Appalachia. Or Alaska. Or ranch country in Wyoming. Or Indian reservations in the Southwest. Or even inner-city Los Angeles, with no public transportation.

We can do better than this. Congress needs to buckle down and give us a serious health-care SYSTEM, like every other industrialized democracy on Earth! Sorry to say, they apparently have higher priorities. Instead of health care, they’re focusing on wealth care. But my rant on big money in politics is a topic for another day.


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Health tip: If you can’t afford a doctor, go to an airport. You’ll get a free X-ray and a breast exam. And, if you mention al-Qaeda, they’ll throw in a free colonoscopy.