Arm Waving and Obfuscation

"Pay no attention to the curtain!" "Do not look behind the curtain!"

There are two areas in which it seems necessary to ignore the Wizard. One is in the nature of "healthcare" itself. Most spell checkers refuse to recognize healthcare as a valid word, suggesting "health care" instead.

Clearly, spell checkers have not been sensitized to the politics involved. Since the dawn of the HMO nearly 30 years ago, health care has gradually given way to healthcare. What does that mean for you and me? I don't know if you've noticed, but even the physicians have been shifting attention away from their own role toward the insurance end.

More than 15 years ago, I attended a software engineering conference in Chicago at which [former] Surgeon General C. Everett Koop was a keynote speaker. I became disturbed during his speech when he made comments seeming to grant insurance companies a gate-keeping role in health care. When I got back home, I wrote him a letter mentioning my impressions and asking whether that was his intent. Some weeks later I received an envelope with Dr. Koop's return address and which contained my letter. My "gatekeeper" question was circled (red pencil) and "NO!" was written (large) in the margin.

Today, physician leaders don't even blush when they tell us that the solution to our healthcare problem is better access to [insurance] coverage.

Health care can be linked to medicine. Healthcare is a business, pure and simple. When people are talking about money and where it will come from, they aren't talking about health care.

I do not question the motives of individual physicians in health care, but I question everyone's motives in healthcare unless they are talking about profits. Even the insurance companies are being edged out for control. Today, healthcare cost is controlled by third-party (neither doctor nor patient) vendors of everything from pharmaceuticals, to technology--especially technology. This isn't necessarily a bad situation--it all depends on what the goals are. Pick your favorite goal from this list (or suggest another):

• Profit
• return on investment
• market dominance
• a healthy populace
• access to medical care
• control
• benevolence/compassion
• giving back
• ???

If you are a person who has a need for (or interest in) health care, you really do need to peek behind the curtain of healthcare to avoid wasting your time, money and energies.