Towards A Successful Society - Healthcare And Capitalist Evangelism

The success of any society is ultimately				compelling motive for insurance corporations to
determined by how well its population lives and				cover individuals susceptible to high healthcare
dies. Within this paradigm of "successful population"				costs (i.e., those with catastrophic physical illness;
are two fundamental elements - individual and				mental illness; the frail elderly; new mothers and
collective wellness. A successful society therefore				infants), period. The outcome of such a system
embodies the notion that both individuals and the				would be to spiral into category 1 - No healthcare
overall population are well, and these two				programs - (mediated by a very few insurance
measures are reasonable assessments of the				companies) wherein the richest segments of
wellness, and hence the success of any given				society would be able to access services. The
society.				irony is, the richest citizenry often require much
In other words, the success of a society can be				less healthcare than others. The upshot is this:
assessed, characterized, and understood through				there is an increasing disparity in the number of
these two main measures. To break it down,				people who are able to access healthcare in the
individual wellness consists of answering the				face of age and cost escalations. One needs to
question: does the society reasonably allow and				question the current and future success of these
encourage individuals to be well? Secondly, does				social systems.
the society allow and encourage wellness for the				4. Combinations of Above: Combinations of the
entire population from birth to death? To the				above become extremely complex and difficult to
latter question, the most important component of				assess. There are certainly advantages and
population wellness and hence, societal success, is				disadvantages, as well as incentives and
the degree to which the sum of individual wellness				disincentives for a hybrid of the above systems.
creates collective wellness. The single-most				Each of these advantages and incentives (or lack
important component of population wellness is a				of) are inextricably connected to the
high level of population health, measured by the				socioeconomic class you and your family belong
numbers of individuals who are well or have				to or are transitioning into as well as a host of
reasonable access to being well.				external and internal factors. A government
The four scenarios below represent a summary				funded universal system provides healthcare to
snapshot of healthcare systems currently in				everyone, including those who are disadvantaged
existence in the Western Hemisphere. The				and could not possibly access care without
scenarios are predicated on the reality that the				subsidization. It also provides care to those who
cost of healthcare is (next to purchasing a home)				are charged by some who would abuse care
the most expensive cost one will experience				(though unclear who this group might be as people
during his or her lifetime and that these costs are				do not consume unlimited healthcare once they
expected to continue to escalate over time as				are well). Alternatively, the system dominated by
new technology, treatments, and pharmaceuticals				large insurance companies provides very high
continue to drive costs. These four main				quality, responsive care to individuals who can pay
approaches to healthcare are:				or who are insured by corporations who in turn
1. No healthcare programs (other than free				can pay. This system works well where individuals
market)				insured are reasonably healthy and young. A
2. Universally funded programs				problem occurs when the population of employees
3. Insurance company funded programs				becomes older and insurance premiums are either
4. Combinations of the above				hiked to cover extraordinarily high costs (insurers
These four healthcare approaches are				will only cover healthcare costs where the profits
summarized below with respect to how well they				of covering healthcare costs actuarially calculated
represent the ability to create a successful				costs) or removed entirely. Countries in which no
society. Remember, a successful society is one				healthcare programs exist (presuming healthcare
that encourages, promotes, and allows for both				is available) results in costly but accessible services
individual and collective wellness, as measured by				for the very few. There is no need to get into
population health.				the obvious personal suffering and strife in this
1. No Healthcare Programs: Countries which have				latter healthcare system.
no healthcare programs generally have lower than				To summarize the four systems discussed:
average population health. While some members				1. The richest members of society will continue to
of the population in these societies (namely the				receive care regardless of the system in place.
very rich) who are able to afford healthcare may				2. The poor will suffer the most in instances
be healthy indeed, the overall population health is				where there is either no system in place or
often quite low. It is important to note that				where insurance corporations are the primary
socioeconomic status is generally a good predictor				arbiters of healthcare delivery.
of population health. In countries where no				3. The government funded universal system
healthcare programs exist, and the reason for				provides care to the greatest number of
these lack of programs is lack of finances, then				individuals in society, despite any shortcomings.
population health is usually comparatively low.				4. Profit motive and linkages to incentive to
Using our definitions of societal success, the				constrain services and limit accessibility becomes
success of these societies would be low, or				increasingly prevalent as the workforce ages (and
unsuccessful.				healthcare benefits supplied by employers become
2. Government Sponsored Programs: Countries				accessed more frequently).
with government sponsored and funded universal				5. Societal Success = providing the opportunity for
healthcare programs generally have a collectively				wellness for the greatest number of people that
higher level of healthcare than other countries.				make up the society.
Again, if the one applies the definition of success				In conclusion, the success of a society is
of the entire population as the sum total of the				correlated with the individual and collective
wellness of all individuals within that system, then				wellness of that society. Wellness of the society is
countries which offer healthcare programs that				inextricably linked to the overall health of the
collectively confer benefits on the highest number				population within that society.
of individuals are, by definition, successful. Since				Societies that provide healthcare to the highest
one cannot be more than well, there is no				number of individuals to an established floor (as
incentive for individuals to access more services				opposed to ceiling) level of care (inclusive of the
than are required in order to be well. Leaving aside				most downtrodden and indigent) are successful. A
preventative programs and social marketing costs				ceiling level of care is redundant when referring to
as key aspects of overall population health, health				healthcare, since, with the exception of only an
and wellness can be accessed within government				extremely rare and unusual incidence, people only
sponsored programs up to a certain level				access healthcare up to the amount which will
depending on the aggregate overall need of the				result in wellness. For instance, unlike other goods
population. Therefore, by definition, and in spite of				or services (e.g., Ferraris, Rolex watches,
incentives and disincentives within the system, the				massages, Gucci handbags), obtaining healthcare in
societies that employ these systems are				excess amounts is both redundant and ridiculous
successful.				and counterintuitive to human nature.
3. Insurance Company: Healthcare programs				It is therefore reasonable to suggest that a
sponsored by insurance corporations can work				system of care which provides for the greatest
well, provided that the insurance coverage				number in society (e.g., everyone), the most
provides all members of society with at least				vulnerable in society; as well as those at the
basic coverage and coverage through catastrophic				highest rungs of the socioeconomic ladder and
illness. Nobody plans on getting leukemia, or ALS,				everyone in between could reasonably be argued
or meningitis, or lupus, for instance. If you are				as the most effective. To those who would
well-educated and have a position with health				charge or decry a system that would benefit
benefits with a corporation or you have been				everyone as inefficient or unaccountable and
successful in your career or business, then it is				therefore untenable, it is important to ask where
likely you will be able to afford the costs of				they, themselves, fit into the
healthcare. However, since healthcare and				healthcare-socioeconomic landscape. Secondly, are
profit-motive are mixed within the same crucible,				they interested in the societal success, will their
there is a strong incentive to cheat or to create				approach move the society toward success, or
environments where profit supersedes care if the				are their own parochial interests - however they
two vie for supremacy - much as suggested in				are justified - masquerading as societal success.
Michael Moore's movie, Sicko. The active removal				You be the judge.
or denial of healthcare is a logical and inevitable				In essence, evangelizing capitalism to the exclusion
outcome of a for-profit, insurance corporation				or minimization of societal success as measured
controlled system of care delivery - particularly				by population health is tantamount to "cutting off
where the population is aging. Also, there is no				your nose to spite your face".

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Towards A Successful Society - Healthcare And Capitalist Evangelism