A Short History of Health Care: Let Doctors Be Doctors

I just ran across this on another website.  It’s a column I wrote for Indiana Policy Review a couple of years ago that seems more appropriate than ever now.

A Short History of Health Care: Let Doctors Be Doctors
By Andrew Horning

Healthcare is an odd business in that it has always been both expensive and unpleasant. Until the 1920s, the average doctor couldn’t even help with the average ailment. While medicine then included a range of arts like phrenology, acupuncture, homeopathy and allopathy it really was a coin-toss whether you’d be saved or killed by a doctor’s work.

Then the 20’s brought insulin, sulfa, other “miracle” drugs and sterile fields that meant, for the first time, that healthcare actually worked more often than not. From there, doctors, scientists and medical engineers really took off; rapid advancements increased life expectancies and decreased suffering. And because of increasing effectiveness and supply, healthcare was even becoming cheaper in real cost-benefit terms.

However, politicians had nothing at all to do with this, and that was apparently a problem. Teddy Roosevelt proposed a German-style, cradle-to-grave “socialized” healthcare system, but it was assailed as “the Prussian Menace” in those anti-German years before WWI, and Teddy’s scheme died. Even so, politicians wanting to seem compassionate started promoting socialized healthcare. The July 1919 issue of the Insurance Monitor made this prescient assertion: “The opportunities for fraud upset all statistical calculations. . . . Health and sickness are vague terms open to endless construction. Death is clearly defined, but to say what shall constitute such loss of health as will justify insurance compensation is no easy task.”

No matter. Between The Revenue Act of 1939’s health-related tax breaks, and 1943, when the War Labor Board excluded employer-paid health insurance from its wage freeze, American politicians charged into health care on their favorite horse, income tax.

In a nutshell, here’s what happened: Tax breaks for employer-paid health insurance meant that health insurance became a part of employment, and insurance became an integral part of healthcare. This inserted middlemen, which of course made everything more expensive. But who cared? The tax-subsidized, payroll-deducted cost was invisible enough that Americans started using insurance to pay for routine visits, dental checkups, eyeglasses and even plastic surgery. Group insurance offered large corporations better plans than small companies could muster, giving large corporations even greater advantages in hiring and competition than corporate laws already gave them. This also meant that the poor, or worse, the self employed, were even further distanced from the rich and incorporated in a very serious way. Obviously this created problems, but politicians never admit error, do they?

Four days before Tax Day, 1953, President Dwight Eisenhower established the U.S. Department of Health, Education and Welfare, giving government even more direct control over some of humanity’s most precious commodities. More political money and power meant more reasons for businesses to make campaign contributions and lobby. Of course, politicians at every level of government have used healthcare policy to reward their friends and punish their enemies. That’s their stock in trade.

Now tax money and policy is sifted and sorted through political appointees, immortal bureaucracies and defense-contract-style arrangements to feed a dwindling number of profit-starved insurance companies who then deny your claim. Doctors hire legions of workers to manage the regulatory, litigative, and insurance paperwork hassles; or leave private practice to become an employee within a clerically staffed healthcare corporation. So healthcare is still both expensive and unpleasant. But now it’s only because politicians, not doctors, are practicing medicine. Our healthcare injustices and vital statistics have decayed into an embarrassment at just the time when technology should make healthcare cheap, effective and available to all.

It is hard to imagine what politicians could have done to make our healthcare situation any worse.  Yet, according to a July 2006 Harris Poll, Americans rate the issue of healthcare well-behind Iraq, the economy, immigration and even gas prices.  Even more strangely, most people now think we must, to some degree and by some unspecified method, “socialize” healthcare just as Europe, Canada and other nations are now scrambling back toward free market reforms.  What are we thinking?

Can you imagine granting our corrupt politicians, already bought out by Big Pharma and other Big Corporations the power to determine what we do to, and with, our bodies?

Let politicians have their way with Iraq, the Colts and toll roads. Let them run lotteries and practice voodoo.  But please, let doctors do healthcare at last; they’ve earned the right.


I wish I’d said that…

I read this column by Roger Roots some time ago (I’m guessing in November of 2008), and came across it again today.

It’s brilliant.  I can’t do better.  So in honor of Constitution Day, I’m reposting it:


Published in: on September 17, 2009 at 6:06 pm  Leave a Comment  

Politics isn’t cool. It’s deadly.

It is the all the rage to blame “big corporations,” “profit motivation,” and “the influence of money in politics” on our social problems.  But that is a dangerous self-deception for at least three reasons:

  1. Corporations are not creatures of a so-called, “unregulated free market.”  On the contrary, corporations are inherently political creations with special legal privileges allocated by politicians, and intended to thwart the absolute accountability in truly free markets.  The “corporate veil” is a layer of protection against evil decisions, in other words.
  2. Corporations can’t buy influence that’s not already for sale.  It’s politicians who’re the influence peddlers.  Politicians are in fact the agents of all large-scale injustice.
  3. Yet Americans have no problems that voters haven’t repeatedly chosen with a greater-than-98% incumbent reelection rate.

We citizens need to understand our power and accountability.  The last thing we need is an imaginary whipping boy.  Our economic and social troubles will abate only when, or if, we come to our senses, act like grown ups, and quit putting our faith in politicians.  Politics isn’t cool and it’s never safe.  After all, the history of politics is the history of oppression, slavery genocide and war.  The whole point of constitutions is, in fact, to put politicians (not corporations, and certainly not you) on a leash.  

Do something unusual on Constitution Day.  Read the Constitution.  You’ll find that:

1. You’ve been lied to for long enough.

2. The truth really can set you free.

Published in: on September 9, 2009 at 10:19 pm  Comments (1)