Dear President Obama,
I recently wrote to raise the question, Why are my health insurance premiums under The Affordable Care Act nearly twice what they were, before the Act was passed?
A conversation with a representative of Blue Cross/Blue Shield answered that question (having to do with covering the previously uninsured and the ban on "pre-existing condition" exclusions, the added costs being passed along to the rest of us) -- and raised another issue.
Allowing how difficult it was to get that act passed under today's obstructionist Congress, it nonetheless appears that the Act didn't go far enough.
It should be understood that the Act was not one of health care reform, but of health payment reform. Health care has not been reformed, and the relevant question is, Why is medicine so expensive?
We are not talking about HEALTH care reform, but of ILLNESS care reform.
Current medicine does scant little to care for health; it predominantly cares for those whose health has failed -- and its strength lies in care of acute illness, not of more costly chronic illness.
That's where the scope of the problem becomes evident.
As long as ILLNESS care remains the emphasis of our medical system, it remains sick.
It's more than choice of diet -- difficult enough to regulate or to self-regulate, enough among those intent on the matter.
It's also about quality of diet. In particular, current day agriculture may generate quantity, but has continued to degenerate in the area of quality (I'm talking about nutritional content, not cosmetic appearance). Petrochemical agriculture has failed to regenerate soil quality, and food quality shows it. It's common lore that food doesn't taste as good as it used to. The reason: it doesn't contain the nutritional value that it used to. Taste reveals chemical content; loss of taste reveals loss of nutritional content. Soils are depleted of the mineral content and, with the use of herbicides, even of healthy organic content. Herbicides kill the soil, and the loss of topsoil due to loss of the binding organic life of the soil is a well-acknowledged fact.
Current petrochemical agriculture is approaching nutritional bankruptcy.
A short jump of reasoning draws the link between agriculture and public health, between agriculture and health care costs.
The dominance of pharmaceutical medicine is another gigantic problem. Pharmaceuticals largely counter or hide the effects of declining health; it doesn't produce health or lead to health. It's, at best, a stop-gap measure. As long as pharmaceutical companies control the game, medical costs will likely continue to stay high or escalate, given the other factors. Consider: the root of the word, pharmaceutical, is the same as that of the word, "harm"; pharmaceuticals are poisons (consider side-effects and the meaning of anti-biotic -- "against life"). The dominance of pharmaceutical medicine largely answers the question, "Why is medical care so expensive?"
As long as The Dollar remains the primary measure of appropriateness (or excusability) of action, these problems may continue to worsen. Only if populations and their governments undergo a shift of values and of methodology are these problems likely to be corrected.
The Health Care System is grossly out of balance, which is to say, sick.
As I said, The Affordable Care Act didn't go far enough. Drive it home.
Something like President Kennedy's Council on Physical Fitness may be in order.
Evidently, the problems are far more massive than payment for health care. It may not be up to you to finish the job, but I think it is up to you to continue to work on it. That would be a legacy worth leaving.