Free Enterprise is not always THE ANSWER

stop holding up free enterprise as the holy grail. Healthcare especially. Our citizens get less healthcare for more dollars than any any country in the world, according to the measurents most commonly used. Go figure. Actually, the reasons are simple: Administration, marketing, and insurance chew up as large a part as the actual "healthcare." That's because the HMOs and insurance companies have one objective: to pay our as little as possible, so as to boost profits and and benefit the investors.

So you don't think I'm a communist, I assure you that I do believe in free enterprise, the profit motive, and private investment. I would much rather see our nation's capital in the hands of individuals. I trust individuals (I'm thinking of Bill Gates and Warren Buffett) to be be better at putting the capital to work. It's behind much of our country's success. (That's why I don't want to see us fuck it up!)

I submit that capitalism does not work in healthcare. Profits cannot be the end all. (There's nothing wrong with "profits", but it doesn't work in healthcare).

The accepted wisdom among the unthinking right wing seems to be: We need profits in order to be motivated. I have worked off and on for the UCSD School of Medicine Dean's Office for over three years and I can attest that far and away the "best doctors" were not motivated mainly by money. Sure, they wanted to make a good living -- they should -- but they were not in pursuit of hedge-fund-type riches. That's not what turned them on.

Despite what the dumb half of the country assumes -- that government "can't do anything right" -- I have NO DOUBT we would all be better served if the government (i.e., the people collectively) ran the healtcare system. If the rich want to get a supplemental policy on top of government-provided health care, fine, let them.

The pharmaceutical industry likes to talk about the money it spends on "research", but the fact is they spend more on "marketing". That's a published fact. If I may share a personal experience, I worked for a year at the UCSD Hospital in an office that encountered a steady stream of well-dressed, and well paid, young men bearing gifts of pens and pads and candy for the office staff -- and I'm sure something much nicer for the physicians they were calling on.

Isn't it strange that the doctors' contacts are "sales representatives" who presumably memorize a pitch about the drug or pill their peddling? It's all so silly - and wasteful. (I wonder: Does the fact that it provides "jobs" to nice young men and women count for anything? Should it?)

Another huge marketing expense are all those TV ads for Lipitor, Viagara and Celebrex -- ads that designed with one purpose: to persuade TV watchers to "ask your doctor about Lipitor"(or whatever)

I'm influcenced by my USMC experience. If you were sick in the Marines you saw the corpsman (same as a medic in the Army), or you could go straight to the dispensery (like a neighborhood clinic) where a nurspe practitioner equivolent would look at the problem and either handle it (like a serious blister) or send you to the Navy doctor on duty. It worked! And it wasn't dependent on a "profit motive" in order to work efficiently. In fact, the lack of a profit motive made it work better. (Remember, the U.S. is most "inefficient" worldwide in providing healthcare to our citizens).

Don't you get it? In the area of "healthcare", the profit motive gums things up. In part, it's because the consumer is incapable of choosing wisely on his or her own. Not only can it be a matter of life and death (literally), but the consumer is no match for an industry whose GOAL is to provide the smallest amount of care for the best price.

Get that!!! Please. It's a fact.