Monday, August 10, 2009

We Need a New Bottom Line

Andrew Weil is right: Even if health care reform with a public option sails right through Congress without a hiccup, it won't begin to approach an accurate or useful diagnosis when it comes to the United States and health care. According to Weil,
What's missing, tragically, is a diagnosis of the real, far more fundamental problem, which is that what's even worse than its stratospheric cost is the fact that American health care doesn't fulfill its prime directive -- it does not help people become or stay healthy. It's not a health care system at all; it's a disease management system, and making the current system cheaper and more accessible will just spread the dysfunction more broadly.
I would go further. The problem with the current system is that it is driven not by the need to provide care and promote health but by the need to make a profit. That's not to say that the people who participate in the system hold this value, but the system itself is designed to promote profit for its stakeholders. That some people may be helped in the process is incidental to the drive for an attractive bottom line.

Fundamentally, at the very heart of what troubles us as a nation is that we have placed the drive for profits way ahead of the well-being of ordinary people. The people decrying health care reform are defending not the needs of people but the needs of corporations. Our agriculture and food systems value profits to the exclusion of the well-being of people and the planet.

The corporations that continue devouring each other and the people and communities who get in their way are absurdly wealthy. They are like a gaping black hole that must be fed regardless of the consequences to the nation and the planet.

Look at the term "bottom line": its original meaning was "the essential or salient point," but now it has come to mean "financial considerations." When are we going to learn to make the well-being of people, families, and communities our national bottom line?

Weil ends his blog as follows:
Washington needs to take a step back and re-examine the entire task with an eye toward achieving the most effective solution, not the cheapest and most expeditious.
Actually, way before Washington steps back, we the people must step back and take a long, hard look at ourselves and what we value. Are we willing, at long last, to put people before profits?

All the loony right-wing scare tactics about "death panels" don't compare with the nightmare that is the current system. Do you really want a corporate bottom-line driving whether your child is able to get a life-saving surgery? Why would a profit-driven entity be more trustworthy than the United States government, which at the very least has the potential for accountability and reform.

Are we ready to turn the corner, to turn off the spigot that dumps all of our hopes and dreams into the endlessly greedy profit-driven black hole? Are we ready to make the well-being of our families, our neighbors, our communities, our nation, the world, and the planet our new bottom line, regardless of how our efforts affect corporate profit margins?


  1. One of the reforms that does address this, though, not completely is the call for paying doctors on a different basis than fee for services. Fee for services gives a great, big economic incentive for keeping people sick.

  2. That would definitely be a step in the right direction. There are other industries, as well, that profit from people's ill health. It would be well to make pharmaceuticals, for example, a nonprofit industry. I doubt that will happen anytime soon, but I still think it's shameful for anyone to profit from anyone's illness.