American Health Care Is Wealth Care

Covid-19 is exposing the American health care system’s greatest weakness: its focus on wealth rather than health

W.J. Astore

As millions of Americans lose their jobs due to Covid-19 disruptions, they also lose their health care, which is tied to their jobs.  Only in America is health care contingent on employment.  Efforts to create a national, single-payer, health care system have failed since the Truman administration in the late 1940s.  Americans have been sold on the idea that health care is best administered by “the free market,” which of course is neither free nor much of a market.

The American health care system puts profit over people; in short, it’s wealth care, not health care.  This is simply fact.  Health insurers, pharmaceutical companies, hospitals, are motivated by money.  Indeed, health insurers make money by denying you coverage, not providing it.  They raise co-pays and deductibles to unbearable limits.  Meanwhile, they spend liberally on lobbyists to keep Congress in their pockets, as well as on advertising to persuade Americans that health insurers are always on your side.  Until you file a claim, that is, or need expensive treatment.

Health care should be about health, not wealth, and people, not profit.  Back in 2013, I wrote the following article on health care for Huffington Post.  Of course, the system has only grown worse.  America faces a crisis today, driven by a deadly pandemic.  Isn’t it time to embrace single-payer health care for all?


Americans generally, and politicians in particular, proudly proclaim that we live in “the greatest” country. But how should we measure the greatness of a country? I’d suggest that quality of life should be a vitally important measure.

And what is more fundamental to quality of life than ready access to health care? When you’re sick or suffering, you should be able to see a medical specialist. And those costs should be — wait for it — free to you. Because health care is a fundamental human right that transcends money. Put succinctly, the common health is the commonwealth. And we should use the common wealth to pay for the common health.

Here’s the truth: We all face the reality of confiscatory taxation. If you’re like me, you pay all sorts of taxes. Federal, state, and local income taxes. Property taxes. School taxes. Social security. State lotteries are a regressive tax aimed at the poor and the gullible. We pay these taxes, and of course some for health care as well (Medicare/Medicaid), amounting to roughly 30 percent of our income (or higher, depending on your tax bracket, unless you’re super-rich and your money comes from dividends and capital gains, then you pay 15 percent or lower: see Romney, Mitt).

Yet despite this tax burden, medical care for most of us remains costly and is usually connected somehow to employment (assuming you have a good job that provides health care benefits). Even if you have health care through your job, there’s usually a substantial deductible or percentage that you have to pay out-of-pocket.

America, land of the free! But not free health care. Pay up, you moocher! And if you should lose your job or if you’re one of the millions of so-called underinsured … bankruptcy.

Health care is a moral issue, but our leaders see it through a business/free market lens. And this lens leads to enormous moral blind spots. One example: Our colleges and universities are supposed to be enlightened centers of learning. They educate our youth and help to create our future. Higher Ed suggests a higher purpose, one that has a moral center — somewhere.

But can you guess the response of colleges and universities to Obamacare? They’re doing their level best to limit adjunct professors’ hours to fewer than thirty per week. Why? So they won’t be obligated by law to provide health care benefits to these adjuncts.

Adjuncts are already underpaid; some are lucky to make $3000 for each course they teach. Now colleges and universities are basically telling them, “Tough luck, Adjunct John Galt. If you want medical benefits, pay for health insurance yourself. And we’re limiting your hours to ensure that you have to.”

So, if Adjunct John Galt teaches 10 courses a year (probably at two or three institutions of “higher” learning) and makes $30,000, he then faces the sobering reality of dedicating one-third of this sum to purchasing private health insurance. If that isn’t a sign of American greatness, I don’t know what is.

I groan as much as the next guy when I pay my taxes. But I’d groan a lot less if I knew my money was funding free health care for all (including me and mine). Commonwealth for the common health. With no death panels in sight.

A healthy republic that prides itself on “greatness” should place the health of its citizens first. That we don’t is a cause for weeping — and it should be a cause for national soul-searching.

10 thoughts on “American Health Care Is Wealth Care

  1. Excellent post. As a retired psychiatrist, 40 years of practice ( 28 years in a non-profit
    medical institution, 7 years in private practice, 5 years with Seattle VA outpatient service-
    I was a Navy Medical Corps/Marine 1/3/5 Battalion Surgeon 1969-70) I and many of my colleagues in Mental Health medicine, Primary Care/Family Care medicine, medical/clinical psychology, psychiatric social work/therapy supported and worked for the implementation of a Canadian-like single-payer healthcare system. I have been a Physicians for National Health program (PNHP) member for years, was a Medicare/Medicaid physician for my entire practice; now I’m on Medicare/Social Security and my monthly Medicare premium for parts A,B, C and D are about $350, with almost no copays or surcharges for surgical procedures.
    My point in telling you all this is that there is very much a class-based divide in both for-profit and non-profit medicine–Those of us cited above were, and are, historically the lowest-paid, lowest insurance-reimbursed practitioners in American medicine, were viewed as money-losing clinicians by large multidisciplinary clinics.
    Mental health doctoral-level (MD, PhD) and Master’s level (ARNP, MSW) practitioners had essentially no Insurance coverage until recent years; people paid out of pocket and many didn’t want to see a mental health doc or therapist anyway. The other class-based division
    in American medicine grew out of the employer-provided, for-profit medical insurance corporations’ financial reimbursement for any and all surgical/interventional/pharmacologic procedures at multiple (up to 10X or more)
    what they would pay for a primary care doc or mental health specialist to diagnose,
    examine, and treat/care for outpatients. There are some classic insurance ideology
    reasons cited for this of course having to do with medical-technical procedures being much more easily, physically verified as having been done, and the accompanying reluctance to pay for a series of office visits where “only” an interview took place consisting of taking a history, maybe a brief hands-on or neuropsychiatric exam, and variable time counseling, educating, writing prescriptions. Interesting to me is that these activities are so much less
    valued, by medical and insurance institutions, than getting a hip replacement, and that we primary care/mental health practitioners are the ones most in favor of a federally funded
    and managed national healthcare system.

    Liked by 1 person

  2. Your post is even darker in view of the fact that the likely Presidential nominee of the supposedly for-the-people Democratic party has vowed to veto any Medicare-for-all legislation that crosses his desk. For years, Dems have been villifying the evil GOP for its meanness and lack of concern for the common man, but the annointed Dem uber-spokesperson is every bit as much in the pockets of the health insurance industry as any Rethuglican. Meaning that even if Trump is ousted, we the people won’t be any better off when it comes to treatment for illness and accidents.

    Liked by 1 person

    1. Tuning in to the Jimmy Dore Show for April 26, 2020, I caught this excellent interview: How Bernie & Squad Actually Support Corporate State. w/Chris Hedges. At about the fifty-minute mark, I caught this:

      [49:49] Chris Hedges: “It’s over. Anyone who thinks we live in a functioning democracy should turn off Rachel Maddow and start reading Sheldon Wolin. . . . Which led to this:

      A Pair of Petrarchan Polemics

      “The Russians did [whatever].” Maddow said it.
      Americans must have someone to blame.
      Excuses they require, both weak and lame.
      Just start a rumor, then proceed to spread it.
      [Whatever] bad, give Vladimir the credit.
      In Cable-TV World, it’s all the same:
      The Villain has a Russian-sounding name.
      (Have Rachel make it up. No need to edit.)
      Or Trump. His tweets. His speeches (Himself-centered)
      A product and a symptom of our fate.
      The infantile career, by Bannon mentored.
      Once more we hear the Nixon suffix “-gate”
      Pursue the White House occupant who entered
      Then on the nation’s nerves began to grate.

      Our “leaders” want submission, not our thanks.
      They tell us where to go and where to stick it.
      A billionaire’s behind? They say to lick it.
      Obama’s government, chose by some banks.
      Now Biden: lost, confused, and drawing blanks.
      “Not Trump And Not Quite Dead” seems just the ticket.
      The Democrats’ new plan? A chirping cricket,
      But billions more for missiles, planes, and tanks.
      Some books have told us all about this racket.
      An Oligarchy with Free Money swollen
      To benefit the topmost income bracket.
      Along the way, Democracy was stolen
      By some fool posing in a bomber jacket.
      To understand, start reading Sheldon Wolin.

      Michael Murry, “The Misfortune Teller,” Copyright © 2020


  3. But, but…”we” don’t want to be like Cuba, right?!? [imagine insanely-guffawing emoji here] Enough of our population buys the health insurance industry propaganda to not want to rise up and demand real change. Enough of our population–in what proved to be the decisive states re: Electoral College–believed Donald J. Trump would make a swell president. Coincidence??


  4. Most Americans support Medicare for All. Too bad the politicians and powerbrokers love things just the way they are. They have good health care, but why should other Americans, especially the poor?


Comments are closed.