Our Healthcare System will Change (Like it or Not)


Submitted by John Hooker

In reply to a recent laudable post “Drug Prices: How Pharma Games the System,” I have this to add.

To gather momentum to change our system we should be relentless in emphasizing the cost that affects patients directly.

There is one major fallacy of our healthcare system. We chose to link healthcare insurance to employment in the years following World War II. In contrast, at that same time, Europeans chose to provide health care as a right for all (Universal Healthcare). Their countries chose different systems (some public and some private), but the underlying intent was always to insure everyone in the country, because that is how a successful insurance system works.

Healthcare obtained through your employer was our original sin. It never insured more than 70% of the population, and it actually took over our rights to choose and in stead put our employers in charge.

As per “Drug Prices: How Pharma Games the System,” Medicare is not allowed to negotiate prices. Pharmaceutical prices are still unregulated. Worse, Medicare is hamstrung by administrative rules that tend to increase fraud or waste. As we all know, that led to claims that anything government puts “its hands on” cannot work.

But the reality is that Medicare was engineered to be inefficient and to maximize profits for our private health care industry.

However, recent talk about healthcare is raising factual awareness and creating a platform for campaigns. Excessive patenting to extend branded product life, as described in “Drug Prices: How Pharma Games the System,” is only one aspect of the problem.

Most important is to remind ourselves that American pharmaceutical companies are free to charge whatever they want, whether the product is on or off-patent! Even if the drug is 30+ years old! That is outrageous.

Another point related to messaging: We should stop reminding the younger generations that health care costs are rising and implying they are being made to pay the bill for the costly care of older Americans via higher healthcare premiums. What no one seems to get, is that this is how insurance works! If you are a very careful car driver and never have an accident you are still paying insurance and this “covers” the expenses of the insurance company when others submit claims. In contrast to auto-insurance where higher premiums due to accident prone driving make some sense, health issues are often unrelated to negligent behavior. Even if you think that those who smoke, drink, or have unprotected sex with multiple partners, should be made to pay higher healthcare premiums, consider this. In our immediate future, say in 10-20 years, everyone will get a full sequence of their genetic profile. This means that you, your doctors and perhaps even your health insurance, will know the details of which diseases you are prone to get in the future.

Will you get a heart attack with 10% chance or with a 90% chance? Will you get hypertension? Will you have a stroke? Will you have diabetes? Will you get any number of different cancers? Thanks to Angelina Jolie and other celebrities, everyone already knows about BRCA gene mutations and the high risk for breast cancer and ovarian cancer that they impart. Within a few decades there will be thousands of such cancer genes. You can bet that private for-profit health insurance companies would love to get your genetic profile and charge you insurance rates accordingly.

The ONLY way to “overcome the inequity of nature” is to adopt the widest healthcare insurance pool possible, distribute the risk, and lower premiums for everyone.

It is time to debunk healthcare insurance through employment. It increases the lack of transparency. It decreases control for the individual. It is unmanageable in its current form and it is getting worse.

Experts predict that the expanded use of genomics will eventually afford predictability of disease for the entire population. This is the “holy grail” for healthcare providers. It is also the right time to dramatically change our healthcare insurance system.

If not politics, science may compel us to accept Medicare for all.

Let’s simplify and make good.


John Hooker is an International Medical Communications Consultant with 36 years of experience working with Big Pharma.

About D. Posnett MD

Emeritus Prof. of Medicine, Weill Cornell Medical College
This entry was posted in ACA, Health Care, Medicaid, medicare, Uncategorized and tagged , , , , , . Bookmark the permalink.

1 Response to Our Healthcare System will Change (Like it or Not)

  1. James Ewing says:

    Fascinating John. Thanks.

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