Why US Healthcare Will Stay Broken

In a feature for ZDNet titled Top 5 reasons healthcare in America is broken Alex Rivlin, CEO of InsureMonkey, briefly spells out the hard truth about US healthcare. Here are a few excerpts from his top 5 reasons:
  • Doctors are rewarded for prescribing drugs. Big pharmaceutical companies are known to hand out “consulting agreements” worth more than your annual salary to doctors who prescribe their drugs like candy. ... This is one of the worst practices I can think of that drives a stake right through the heart of healthcare’s credibility.
  • Big Healthcare, i.e. pharmaceutical companies, hospital networks, insurers and their support industries, spend hundreds of millions each year lobbying Congress to make sure there are not major changes to the business structure we call healthcare.
  • Tens of millions of healthy people choose not to pay for health insurance, putting the financial solvency of the system at risk. This leaves those that do pay into the insurance system paying more.
  • We are killing ourselves. Our choices bring on diabetes, heart-attack-inducing high blood pressure and cholesterol, obesity, chronic illness, and the like. We eat crap. We supersize it.
  • The current system is set up to reward sickness. Doctors get paid when you see them. And you only see them when something’s wrong, right? ... Everything revolves around us being sick.
I suggest that you read the rest of his article here. As I ponder this weighty issue I am more and more convinced that our government will not address the real problems with US healthcare. Too many hands are in the pot.. the special interests of drug companies are just too powerful..and there is not a desire in our country to get and stay healthy.


  1. I agree with the Top 5 Reasons. I doubt that the government is capable of drafting legislation that will address all the issues adequately. However, doing nothing will ensure that our problems will worsen. Healthcare reform was first proposed by President Truman and since then we did nothing while our situation worsened.

    The United States is the only wealthy, industrialized nation that does not have a universal healthcare system. 47 million Americans are uninsured and medical expense is the primary cause of personal bankruptsy.

    Opposition to reform is well-funded by the healthcare industry. Many who oppose reform share an attitude that healthcare, other can emergency care, is a privelege not a right.

    I support doing almost anything while their "may" be adequate votes in Congress to support reform. This is a condition that may not last long and once the opportunity to act politically passes we will likely face another 50 years of inaction. We can't afford to wait until we have the perfect reform. We must get a legislative "foot in the door" now and then work on improving our reform.

  2. I also support action Joe but fear that govt action may make things worse.. I suspect that, as I write, lobbyists are influencing how the legislation is being written.

  3. Very true Bob. Action does need to be taken, but what is making the cost to go up needs to be addressed.

    Also, tort reform needs to be addressed as well. The cost of the liability insurance that hospitals and doctors have to pay is ridiculous.

  4. I agree with you both. Too many parties will earn less profit if the system is adequately reformed. Thus, you have to find a solution to a huge problem while beating back the self-interested opposition that benfits from its high cost.

  5. I don't fear action as much as I do inaction. Things are bad and getting worse. I don't see how government action is likely to make things any worse than they would be otherwise.

  6. Not sure Brian.. the government's RX program for seniors was unfunded bad news.. let's hope this congress doesn't go that route and actually funds what they pass.

  7. KB,

    I gonna say that these are all great points and the article is very insightful.

    To me, no party addresses the real issue: this is a four-headed beast and slaying one head only makes the other two stronger.

    I see the four heads as:

    Insurance Companies
    Pharmaceutical Companies

    When one sets the screws to one of these groups, the others rise to compensate for the void. In the end, it is those who do the right thing and pay into the system that take the financial hit.

    An example: Litigators found that they could sue hospitals for denial of service to uninsured people. So congress made a law forcing hospitals to help ALL who walk through the door (without preference). The hospitals, in turn, negotiated affordable prices with the uninsured who can play, while absorbing the cost of those who can't. Since the hospital is there to make money (no duh), this cost has to be passed on to someone. Thus it is passed on to the insurance company, since most insured people don't scrutinize their bill because they assume that it is all covered by their insurance company. Ultimately, though the insurance company passes the 'costs' on to us with their own overhead tacked on top.

    The result of all of this is that not only are insured-taxpayers paying through the nose for social security for the uninsured, we also are paying for the uninsured through our insurance.

    This same thing occurs for doctors and the need for malpractice protection because of a lack of litigation control. Pharmaceutical companies who 'grease' doctors to promote their product then pass the costs onto us. Class action lawsuits against drugs that have already warned of side-effects, but people aren't 'happy' with the results.

    For any solution to have a chance of working policy must be set to assure that government's intervention doesn't allow the opportunity for these other elements to rise because the result is that those who pay end up paying much more.

    God Bless

  8. Great points Doug!

    Reminded me of when my first wife began dialysis treatments about 20 years ago. I got a letter from my insurance company saying that they would only cover the first year of dialysis and after that my wife would be covered by Medicare. I was mad when I found out that congress passed legislation (I think in the 70s) to bail out insurance companies at the expense of patients. My wife had great insurance coverage as long as she was well but lost it when her kidneys failed and was forced to be covered by the govt care.

    I guess that is what I think of when I think of the govt getting involved.. the focus shifts from protecting the patients to protecting the system.

  9. I like the 3rd point. The healthy go without insurance and therefore, only the sick pay. I'm not buying a car right now because mine runs fine, should I have money taken out of my account to go to a car fund. That point goes to the marxist view of the writer.

  10. Not sure that I get what you are saying Scott. Using the analogy of your car I would agree because the mechanic can choose to not fix your car when it breaks down if you cannot pay. The Emergency Room however cannot refuse not to fix you. But maybe I am missing something? Maybe you feel that the ER should not be obligated to fix you if you are unable to pay.

  11. Many of the people that oppose universal healthcare, do so because they don't NEED it. Likewise, if their children aren't in school, they don't want to pay tax to support public education. If they are employed, they don't want to pay tax to provide unemployment benefits. If they don't camp in a state or national park, they don't want to pay tax to maintain the park. If they have healthcare insurance or don't need it, they don't want to pay tax to provide healthcare to those who can't afford it.

    The only pain some people feel is their own. They can excuse their attitude anyway they want and I'll still call it what it is.

  12. Well put Joe. I know that I have changed my opinions about issues after I saw the other side of the coin.

  13. I don't disagree with the Top 5 reasons. I think they make some excellent points. But, just because we can't fix everything doesn't mean we should sit on our hands and do nothing. I say do what we can now and continue to work on the rest.

    The incentives in our health care system are all screwy. No doubt about it. But, to fix those would require major overhaul of the profit motive in healthcare (or the elimination of the profit motive). That's something that would take a real change of heart for most Americans because it's too much like the "s" word (socialism). Healthcare is run like any other industry right now paying for "production" rather than outcomes.


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