Anyone who has been a board member of a for-profit or not-for-profit organization knows that, as a trustee, you are required to act in the best interest of that organization. Often the interests of the organization align with the interests of their customers, but not always. The two most notable exceptions to this alignment of interests are medical care and education. While education is outside the scope of this article, I wish to expound on healthcare with insight accrued from nearly 30 years of experience.
The titans who control the multibillion-dollar healthcare market, by using clever marketing techniques and catchphrases, have been extraordinarily successful in shaping public perception of their mission, generally casting themselves as more noble than those in other crucial industries. Healthcare businesses are very important but are no more noble than other industries. Shall I go out on a limb and say that Farmers are more important than Physicians? I have gone six months without a doctor’s appointment, yet I cannot go more than a few days without food. One reason healthcare businesses get away with excessive virtue preening is the historical intertwinement of healing with religion, most notably traditional Christianity, in which healing powers are attributed to divine intervention. Healthcare executives know of this and use it to manipulate public opinion. They should be very pleased with their success. Now the U.S. population accepts higher healthcare prices than any other nation on Earth.
I often hear claims that healthcare is a human right. Those of us on the front lines agree- access to quality healthcare is extremely important. But if healthcare is a right, can consumers choose not to pay and still receive it? Can I ignore my deductible when I need a CT scan? Is it ethical for a provider to refuse care for someone with adequate resources who refuses to pay? Should a pharmacy be required to give medicine to someone without expecting payment? Should a large pharmaceutical company be required to provide their medication for free? And if healthcare is a right, is food a right? Is shelter a right? Is a mate a right? Should people be allowed to remove food from the shelf of a market or squat in someone else’s home to make due on their rights? Should we be allowed to force a non-consenting person to be our mate because companionship is a right? Of course not; all of this is silliness. Unfortunately, scurrilous politicians have encouraged these kinds of cockamamie arguments in service of advancing their personal and political agendas—my how the public square has been debased by idiocy.
Our current political environment has witnessed the recrudescence of radicalism in which old techniques are being used to silence speech. Techniques that originated in the ancient empires of Egypt and Rome, honed by past kingdoms in Asia and Europe, and perfected in Nazi Germany, Soviet Russia, and Communist China, are now being wielded by those claiming a higher level of virtue. While not without risks, it is amusing to watch these morose new intellectuals, people entirely lacking in self-awareness, go down this pedantic road. Even before this alarming new trend developed, attempts to silence would-be reformers in healthcare have utilized these techniques. Those who have questioned the high cost and low value in healthcare have been vilified by politicians and the healthcare oligopoly as uncaring or cruel. As a result, large health care organizations, which have evolved to function as cartels like OPEC in keeping prices high, have largely avoided having to answer for high costs.
Getting back to healthcare as a right: As an American Citizen in good standing, you have the right to receive high-quality medical care at the lowest possible price. Unfortunately, the federal government has abridged your rights and pursued policies that have resulted in the proliferation of higher-cost, lower-quality care. Take, for example, a woman with breast cancer who needs chemotherapy. At a community cancer center, the total cost of care over a month, for example, maybe $2,000. At a small hospital cancer center, it may be closer to $5,000 per month; at a large hospital center, it could go up to about $15,000 per month, all without a demonstrable increase in quality (and often with provable lower quality). Why are costs higher at hospital cancer centers? Healthcare titans have manipulated politicians to pay their institution more per unit of care than smaller, more efficient, and more personal centers. This added cost may seem invisible at first (because much of it is absorbed by insurance), but is ultimately passed on to you, the consumer, by way of higher insurance premiums, bigger copays and deductibles, and depletion of the Medicare trust fund, which must be replenished with taxpayer funds.
Many studies have shown that community cancer centers are the crucible of value and innovation in cancer care. We at ICOP acknowledge that larger institutions have a vital role in rare diseases and specialized procedures; however, larger centers have failed time and time again to provide high-quality, low-cost care on a large scale in the realm of general oncology and hematology.
It is time to acknowledge that the preferential treatment politicians give to their mega-healthcare allies (and donors) has harmed the American consumer and impoverished our country. Additionally, the high cost of health care has driven American jobs offshore to countries with lower health care costs. This is because health insurance in America is borne, at least partly, by employers who have reached a breaking point.
The titans of healthcare in America know the truths in this article very well but would publicly disagree because they serve their organization first and their customers second. The mega-healthcare organizations routinely cherry-pick data to cast themselves in a favorable light. Mark Twain once observed, “There are three kinds of lies: lies, damned lies, and statistics.” We must view with skepticism the arguments from wealthy health care conglomerates while acknowledging the good that they do and the unique challenges they face.
Keith Lerro, M.D., Ph.D.
Regional Medical Oncology Center