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Why our health care system promotes disease maintenance

Marya Zilberberg, MD, MPH
Social media
September 25, 2009
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When I was growing up in the 1970s, news was different, and this is not just the everything-was-better-in-my-day nostalgia. News was about news. News was not sexy. What has changed? Robert Reich’s Supercapitalism, makes the answer obvious: competition.

Interestingly, according to economic theories, competition is good for the consumer – it drives quality up and prices down. That may be true for toilet paper, but it has not panned out for such consumables as news and health care. Instead, these markets in their entirety have moved in the same direction, applying the same strategies to maximizing profits. By definition, a high bottom line comes from only two sources: low expenditures or high returns, and preferably both. Since commercial news channels are supported through advertising, their market share of our eyeball and ear time are critical for investor value. Thus, the slippery slope to the lowest common denominator.

With the advent of constant news the competition for market share became far stiffer than we had imagined. To differentiate one Constant Chatter Channel from another, marketing ideas were applied. Today’s anchors, young, pretty, kid-next-doorish, keep us glued to the screen with a constant barrage of headlines and sound bites designed to tantalize, terrify, titillate, and sell products: soda, cars, hospitals, alarm systems, keeping us wrapped in a cocoon of deceptive comfort and ignorance.

Our health care system fits into this context as well. A mammoth enterprise generating staggering returns for many involved, it has not promoted health, but disease maintenance. Why? Simply put, health does not generate income, disease does. And what of the economic consequences of cleaning up such disease causes as tobacco, pollution, food? Think of the financial and political muscle behind these industries, a Goliath easily stamping out any grass-root efforts at a disease prevention agenda. Add into the mix the at-once frightened and phlegmatic populace, and how we got here becomes obvious. Less obvious is how we move on.

Because I do not believe that pure unmitigated human evil is common, I have to conclude that our slide into this morass is the result of chaos, of too much money and self-interest at stake. The health care system has been like a symphony orchestra without a conductor – each musician producing beautiful music, with painful cacophony the end-result. If you buy my theory, then you must agree that it is disingenuous to keep the government out of this discussion: our elected officials represent precisely the interests of the people, and thus must balance out all of the other loud voices at the table.

I do not hold out much hope for the business of news – after all, keeping us informed is the job of a handful of serious news outlets. And since they are still widely accessible, I personally do not care what others do – these are the choices that we still have in America. As for the health care system, we must hold our politicians responsible for representing our interests and stopping this disease juggernaut in favor of promoting a healthy society.

Marya Zilberberg is founder and CEO of EviMed Research Group and blogs at Healthcare, etc.

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