The dark side of things. . .

Let me begin by saying I believe capitalism is the best of the options before us but it is ripe with flaws when sin steals the framework of morality from the raw pursuit of profit.  Nowhere is this more true than in the radical reshaping of medicine from a healing art to a commodity to be bought and sold with little regard for truth or good.  The once noble healing professions have been turned into mere technicians and sales people hawking the last goods from big pharma.  Insurance gurus from Medicare to Blue Cross call the shots about what gets treated and how without ever having a medical degree -- they do it by assigning a dollar figure to the affliction and its remedy.  Patients have become health care consumers who do their own research and are guided by ads that sell medicines they cannot purchase without a prescription.  The problem is who pays.  People cannot afford it, businesses do not want to shoulder the cost, and government is ripe to intervene because, well, government always knows best, right?

The days of community or religious hospitals in which mercy was the chief value have long ago given way to big corporate medicine in which the patient care and medical standards are balanced by the need to generate profits.  The days when physicians were free to practice as they felt best for the patient have been replaced by the need to see dozens of patients each day and to depend upon technology to know who it is they are seeing.  I am not blaming the hospitals and medical centers who sold out or the doctors who practice within the large corporate practices (often with more employees in billing than in patient care).  What I am blaming is that we set aside values for the sake of an investment in technology that we presumed would improve everything.  We began to care less about the morality of it all than its profitability or its efficiency.  This is true of a nation and society and not simply of those in the medical professions.  We sold our souls to the rule of the dollar.

In my own family's experience I have found hidden charges and surprise bills, claims denied or delayed because they were trying to cost shift from my insurance carrier to somebody else, threats of sending my bill to a collection agency because the insurance was taking too long, and the use of technology in an obnoxious way (like 17 text messages in a week about a very small outstanding balance).  I have "good" insurance and my wife has had a career in critical care nursing from floor to management.  I have it better than most but I still spend hours and hours on the phone trying to figure out why this is covered and that is not or why this was paid but that was not or why these hoops are required of us before we get to that treatment.  The health care industry has become a marvel of business, money making, and oversight but could it be at the expense of the medical care?  Furthermore, it seems that when capitalism is applied without the values of mercy and the sacred character of life, it becomes indistinguishable from any other industry and even, perhaps, less focused on people and even more focused on profits, liability, efficiency, and technology as ends more than means.

The truth is I long for the days when care was focused on the patient, when dollars did not rule the day, when nuns ran the hospitals near my home and Lutherans ran one in Ft. Wayne where my wife grew up.  I long for the days when the health care providers either knew you or tried to know you as much as they knew the right diagnosis codes or reimbursement formulas or copays for your visit.  I long for the days when values drove the dollars and not the other way around.  It is my lament for many areas of life but especially for medicine.  Honestly, I feel like Amazon is more concerned about me than the health care providers I rely on.  Further, a good urgent care center sometimes is more responsive than the monolithic corporate structure that tells my primary care doctor what to do, how many minutes to spend with me, and how to farm off every possible thing to a specialist (except for the vaccines, of course, which some think is the cure to every ill of life!).   I have not even begun to complain about the maze of apps you must have to negotiate the path through it all.  What has your experience been?