I think one of the shameful indicators of the failure of our health care system lies in the striking difference in the infant mortality rate among African-Americans and Americans of European origin. Needless to say this difference falls heavily along economic lines as well. The system works for wealthy or well-insured people, pretty abyssmally for working class people.

It is my understanding that in large part our public health system was initiated during and after World War One because public health in general was so poor that it was difficult to find citizens fit enough to serve. Certainly even conservatives could see some advantage there.

The “magic of the free market” reminds me a bit of Rousseau’s “State of Nature” being some mythical, natural situation that sets all things right. Nice fantasy, if you can believe it.

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The profit squeeze affecting medicine does take place in hospitals which claim non-profit status [ property tax exclusion benefits, et al], and the ‘medical’ profit squeezers include collection agencies who are now partnering with the medical profiteers to herd bunches of folks into small claims courts to get those last drops of blood out of the unfortunate.

Yes, Bonnie…..our system is offering extended shelf life, especially inasmuch as Medicare pays, rather than offering a quality of life which would include a natural dignified death. Do note that this extended shelf life program now includes legal mechanisms which force estate transfers, not to heirs, but to non-heirs ready to scoop up all remaining assets.

That said, one of the factors stressing the US health system, and I suspect all health systems is the belief in applying all available technology to save the lives of the elderly who are near the end of their lives anyway. All the technical improvements in medicine you cited I suspect are used disproportionately by the elderly.

I presently am caring for an ailing, elderly parent, and have spent a great deal of time in nursing homes and hospitals. I have seen firsthand how so many members of this age cohort live out their lives in suffering every day. Extrapolating from my own family’s situation, I can see the age 80+ cohort sucking down the lion’s share of health care, and I suspect (I could be wrong) driving up the cost of it for everyone.

Were our beliefs about life and death, and assisted suicide different, I don’t think you’d see the age 80+ cohort hanging on for every last second of dear life. I believe that painless, assisted suicide, a la Dr Kervorkian should be available, instead of being stigmatized and illegal. It says much about our culture that we have all these exotic, expensive technologies to prolong life, and yet we are terrified of death, which is as natural as birth.

Given these facts:

-Our health care system is very broken
-Exotic technologies have arrived which extend life, esp for the elderly
-Our country is deeply in debt and will likely be cutting back on things like social security and medicare; if some sort of socialized health care system is created (I’d give it a 50:50 chance) it’s likely to be quite lame

I think you’re going to see legalized, assisted suicide revisited, simply as a cost saving measure, although it will take a weakening of the religious right for this to happen. In the meantime, I’m shopping around for another country…

Years ago hospitals got along partly with government/charitable subsidy and the rest from getting paid for services by patients or insurance companies. The problem is that years ago medical care wasn’t ruinously expensive because there was only so much doctors and hospitals could do. No CAT scans, no heart transplants, etc. Now there is technology available to save people who couldn’t have been saved in the past, but it costs zillions of dollars. If we could go back to the level of medical care available in the 1950s we could cut medical costs down to a little fraction of what it is now, but I don’t think that would be a popular idea.

The cost of providing medical care has ballooned to the point that only the extremely wealthy or well insured can pay for the medical services that modern technology has brought us. And for a whole lot of reasons we allocate resources in stupid and wasteful ways, so that even though we are spending huge amounts of money on health care more and more people are having to go without basic medical care because they can’t pay for it.

I’m 55, and remember from childhood going to the doctor for 10-20-ish dollars, and if you had insurance, you filed a claim and got re-imbursed.

I don’t know how that would relate to hospitalization. I’m just asking, maybe someone knows. Wasn’t there a time when hospitals were not all for profit businesses? Granted, many of them might have been Catholic or private hospitals, with donors, private funding, etc.

Great post, and the most succinct explanation I’ve seen of the underlying problem with market-driven healthcare.