We Need a New Word, a New Way
Incessant Public Health policy whiplash and Harm-for-Profit in the United States | By Kimberly J. Soenen November 24, 2024
(Unhoused person, Chicago, Winter, 2020. Photo by Kimberly J. Soenen.)
Advocates for Universal Healthcare across the United States—from business owners, to unionizing medical residents to frustrated physicians and patients are fighting to minimize risk and increase access to medical care without barriers—are asking: Now what?
On November 21st, the New York Times published an Op-ed by Jeneen Interlandi about the status of health, healthcare and Public Health in the United States. By every metric, measurement and economic indicator—both clinical and qualitative—Americans are the least healthy society in what some call “the Western World.” The title of her Op-ed is: “We Tire Very Quickly of Being Told That Everything Is on Fire,” and boy, is it ever.
Interlandi writes:
“Further crisis-proofing will require officials to start distinguishing between what the former C.D.C. director William Foege has called the immediate and the important. That means paying as much attention to the roots of a given problem as to the hair-on-fire consequences. Want to conquer lung cancer? Focus on curbing cigarette consumption. Alcohol abuse? Look at the policies that govern alcohol sales. Chronic health conditions? Confront the original sin of employer-based health insurance and find a way to make health care itself universal.”
Interlandi covered many of the medical conditions that plague Americans and deepen wealth disparity. She wisely encourages readers to examine the root causes of poor health. Most of the conditions she highlights are the byproducts of an unhealthy society, including addiction, obesity, loneliness, depression, chronic illness, alcoholism, suicide, heart disease and violence. Add to that a society that largely favors religion over science and a dollop of health illiteracy and, well, kaboom, here we are.
On the issue of calling for Universal Healthcare, she is very much on point: Enacting National Improved Medicare for All / Senate Bill 1655—if oversight of the legislation were to be placed in the hands of moral and ethical persons—would afford Americans access to lifelong health maintenance without disruption. After signing the legislation, Single Payer reform would be implemented within four years. However, after more than 40 years of cries for Universal Healthcare by patients and ethical medical professionals, that is not the direction the United States is moving.
In fact, the Universal Healthcare movement in the United States of America began more than 150 years ago, long before Managed Care architected Denial of Care Harm-for-Profit. Health, healthcare and Public Health policy will shift very aggressively in 2025 to removing antitrust oversight of hospital Mergers and Acquisitions; augmenting vertical integration between Commercial Health Insurance companies and pharmacies; removing public safety requirements for the pharmaceutical industry; increasing the velocity of Denial of Care; and increasing consolidation of power and wealth across corporate healthcare by greenlighting Private Equity to further insert.
In this piece however—which is the pattern across the American healthcare policy and public health debate—Interlandi fails to address the most damaging element perpetuating the United States Public Health crisis: unchecked greed and the legality of Harm-for-Profit business models at any and all cost.
Healthcare in the United States is a for-profit, transactional venture dominated by many insidious bad actors who are protected both by the lobbyists who draft laws to protect the bad actors, and Congressional members and senators who accept campaign-finance monies to implement policies that perpetuate Harm-for-Profit.
The private sector in the healthcare space will incentive harm when given the green light to do so by government. As writer Mike Lewis said to CBS News / 60 Minutes about The Big Short and all the film embodied, “If you incentivize an individual to impose Harm-for-Profit, she will. It’s just that simple.”
“That means paying as much attention to the roots of a given problem as to the hair-on-fire consequences. Want to conquer lung cancer? Focus on curbing cigarette consumption. Alcohol abuse? Look at the policies that govern alcohol sales. Chronic health conditions? Confront the original sin of employer-based health insurance and find a way to make health care itself universal.”
—Jeneen Interlandi
Because it is individuals who propel Systemness forward, individuals often deny their role in perpetuating Harm-for-Profit. Whether it’s covering up the scope and scale of Chronic Traumatic Encephalopathy (CTE) by the National Football League; supporting the junk food industry; allowing the sale of nicotine and ammonia-laced tobacco delivery products; normalizing alcohol abuse; ignoring gun violence data; promoting white sugar and cancer-causing elements; allowing the privatization of water; publicizing online gambling (Lewis’ current Public Health investigation) or Denial of Care by the Commercial Health Insurance industry, it’s all Harm-for-Profit. And, select individuals willfully choose to partake and support it in an array of ways—as employees, senators, parents, Attorneys General, business owners, and of course, shareholders.
(Unhoused person, Chicago, Spring 2020. Photo by Kimberly J. Soenen.)
Possibly it is not that Americans are tired of being in “crisis” mode. Possibly, American mistrust and poor health is rooted in fatigue born of greed and profit at any cost being rewarded while millions and millions of persons struggle financially, emotionally and physically.
The private sector—in the context of health, healthcare and Public Health—has proven its priority is not to serve The Patient or the ethical healthcare professional, the priority is to generate wealth for shareholders precisely by siphoning resources from The Patient.
Exhibit A) The Commercial Health Insurance industry’s business model is Denial of Care.
If we are to reduce comorbidities, chronic illness, obesity, despair, violence, and disregard for senior citizens, disabled persons and veterans, would a good place to begin be enacting non-privatized Single Payer Universal Healthcare? This would allow Americans to access lifelong health maintenance without barriers, bias or Denial of Care. It would also reduce Maternal Mortality, The Death Gap and bankruptcies from hyper-inflated, hyper-irrational medical bills.
When the United States Surgeon General and others speak about the layers of “crises” —all man made it’s worth noting—they cannot im good faith offer up prescriptive care while at once knowing most Americans, even while ‘insured,’ cannot afford or access medical care. Deductibles, premiums and actual medical care are all cost prohibitive.
In addition, because Denial of Care is the Commercial Health Insurance industry business model, millions of denied claims occur hourly. The Surgeon General is often on tour offering advice assuming that every American has access to healthcare, which is not the case. And yet still, despite 40 years of data and evidence about the Denial of Care business model, the Surgeon General will not make a public call to enact Universal Healthcare.
“Our current roster of apparent public health crises is both sprawling and haphazard. Mass shootings make the list, but everyday gun violence seldom does. Adolescent angst and parental well-being have been elevated to five-alarm fires, but serious mental illness and the enduring lack of resources to treat it have not been. Obesity is a crisis, but heart disease, which is a far greater cause of preventable death, seems not to be. Last year, the United States surgeon general described loneliness as a crisis so dire, it threatens to ‘rip our country apart. But neither he nor any other federal health official has raised comparable alarm about the two million or so people across the country who don’t have reliable access to clean drinking water, or the 47 million who regularly go to bed hungry. All of these issues deserve attention and resources, to be sure. But when it comes to discussing their relative urgency and import, we need either a new way or a new word.”
-Jeneen Interlandia
Even the CEOs of major global companies are now asking the Commercial Health Insurance industry why premiums continue to increase year-after-year-after-year, and business leaders are seriously reconsidering how Senate Bill 1655 would improve the lives of their employees. Small businesses and large companies alike would be leveraged. Even they recognize that without checks and balances, this fantasy of “ever-expanding financial growth” will continue to devalue, rather than leverage, the health of their employees.
Until Universal Healthcare is enacted, Americans will continue reaching for the Coca-Cola, beer, Fruit Loops, weed, NFL tickets, Ozempic, Oxy, Dunkin’ Donuts, the metaphorical Twinkies…because cheap food, instant pain relief and infotainment are rodeo clowns that give Americans a hit, a fix, an immediate high. These distractions allow persons to avoid doing the real work that’s required to pass lasting legislative changes that would improve Public Health and the economy.
The “new way” forward that Interlandi summons will require new wiring of the electorate’s hard-wired brain. Americans know it’s much easier to take a quick hit or get a quick fix than it is to build consensus and enact legislation that is in the best non-partisan interest of society. Americans are sprinters by nature, not known worldwide for being invested in the long game.
(Gary, Indiana. Spring 2021. Photo by Kimberly J. Soenen.)
As of this writing, the United States government and private sector continues to permit and endorse an approach to healthcare where Denial of Care as a business model remains legal.
Interlandi writes: “All of these issues deserve attention and resources, to be sure. But when it comes to discussing their relative urgency and import, we need either a new way or a new word.”
The new way?
Possibly we should stop teaching, celebrating, encouraging, perpetuating and rewarding greed and Harm-for-Profit.
As for the new word, should Americans try: “integrity?”