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Political Animal

Addicted to Health

By Brian Morton | Posted 1/2/2008

"Well," the ophthalmologist said as I watched him writing through my dilated eyes, "your eyes are fine. You know, you should probably come in here and get checked every year."

I said nothing at the time, but I recalled the late columnist Molly Ivins, back in the 1990s, writing about one of the first giveaways from the newly elected Republican congressional majority--it was to eye doctors and the ophthalmology industry. Before, when you accidentally sat on your glasses and had to get a new pair, you could just tell your doctor to use your old prescription. Suddenly, if that prescription was more than two years old, you had to go and get a new one, which put money in the hands of ophthalmologists, eyeglass companies, and whoever owns shares of America's Best, For Eyes, and the like.

Now here was my eye doctor telling me that it's a good idea for me to come in and hand him money every year, as opposed to every other year, which his lobby cleverly paid for back in those heady "Contract on America" days.

Same goes for my regular doctor. I have no problem going in for the annual checkup and physical--I'm in decent enough health, albeit with the hypertension that runs in my family, just as it does in millions of other African-American families. I'm on medication and under control, and yet my doctor purposefully writes prescriptions that last for only six months, in order to get me back into his office to tell me all is well, eat more vegetables, and see you again in six months.

I don't see my dentist as often as I should. The last visit was a year or so ago, when a hairline crack in a veneer on a front tooth finally opened up and fell off, making me look like something out of the West Virginia hills, only without the complicated family marital history. While he gently laid on the guilt trip for not coming back more often, he also offered an extensive selection of cosmetic options such as teeth-whitening--vanity-appealing and wholly unnecessary--I might want to try in the future.

It's been a decade or more since the pharmaceutical industry realized that there was more money to be made marketing directly to our inner hypochondriacs than to hospitals and doctors--not that they've let up on those campaigns. You'll notice every time you step into a waiting room, nearly every clipboard, pen, magazine rack, and key fob has been thankfully provided by the good people at Merck, Pfizer, GlaxoSmithKline, or AstraZeneca. The evening news is sponsored almost in whole by Big Pharma, with most ads for the new drugs that command the highest profit margins.

I'm no expert about the general health of the average American citizen, but it appears to me that the health-care industry is suffering from a serious and chronic addiction to money. What's more, the problems with the U.S. health-care system will never be solved until two things happen, one likely and the other not as much.

First, businesses need to realize that the employer-based health-care system is not the answer. A single-payer system, or one based on the Medicare model, is better for all concerned. As it starts to see the general explosion in health-care costs, Big Business is slowly coming around to this way of thinking, despite its intransigence at Hillary Clinton's failed efforts to remake the system in the early years of her husband's administration.

The second, and more unlikely, thing is the need to wean the big health-care concerns off their addiction to massive profits, which is the giant, rampaging white elephant in the room whenever reform is discussed. Nobody lets go of money or power easily, and you can be sure they will bully their way to a place at the table during the next administration, should a Democrat be elected to the White House with an eye on reform. Just as an example, a Wikipedia search shows that 12 of the top 20 pharmaceutical industries, by 2006 revenues, are U.S.-based. If you think they'll willingly get cut out of the equation, I've got some prime K Street property I'd like to sell you.

On top of that, there are still the die-hards, the fiscal conservatives (and it's not accidental that I left off "compassionate"), who believe that, given access to affordable health care for all, the masses will simply "abuse" it. This is the Wall Street Journal "lucky duckies" view of consumers, from those who think that health care should be rationed out like holiday bonuses, with the best going to those who can afford it, such as themselves. This is why Dick Cheney was offended by that nurses union ad that said if he had health care like you do, he'd be dead now.

We may get health-care reform under the next president, but it will be like fighting an addict for his fix. It won't be pretty.

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