Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

No one is in charge of the free-for-all that is U.S. health care

Steve Adelman, MD
Policy
September 14, 2021
Share
Tweet
Share

During these solemn high holy days of repentance and reckoning, millions of Jews around the world beseech God to stop COVID-19 from spreading and ending lives.  Although it can be soothing and reassuring to believe that the universe is governed by a supreme being who listens and responds to the prayers of sentient human beings, the last 19 months suggest to me that “no one up there is listening or responding.”

Are we any better off if we narrow our focus to the human species on planet Earth?  Probably not.  Although each of us is a citizen of a political entity with a government and a leader, outside the island nation of New Zealand, there is little evidence that heads of state possess the right stuff to conquer our implacable viral adversary.  Success would require them to cooperate effectively with one another, and, in most cases, take risks on the home front that would be politically dangerous.

Tip O’Neill famously stated that “all politics is local,” a misguided perspective in this era of worldwide infectious disease and viral spread.  Humankind is now a global tribe comprised of millions of overlapping and interacting clans.  We are desperately in need of a well-functioning tribal council, on the national as well as the international level.  We have none.

Here in the United States, some of us look to the free market and the so-called health care system for answers.  Our performance, to date, is less than reassuring.

There is no public health system.  Health professionals are dedicated and mission-driven but work for organizations that do not focus on prevention.  Their primary orientation is to cure illness, especially when it is severe, and the afflicted patients are nearing their deaths.  Industrialized medicine, also referred to as “the medical-industrial complex,” is a haphazard, patchwork quilt of government agencies, academic institutions, non-profits, health plans, hospital systems, and corporate entities that develop proprietary products (think: pharma and medical devices).  Health care is the largest sector of our economy, where market share and profitability, not the health of the public, reign supreme. No one is in charge of the free-for-all that is U.S. health care.

A few years ago, three billionaires co-founded Haven, a well-funded venture that aimed to disrupt and reform the health care industry by building a better medical mousetrap for the 1.2 million employees of Amazon, Berkshire Hathaway, and JPMorgan Chase. Earlier this year, Haven was shuttered; Mr. Bezos has moved on to making a splash with stratospheric space shots; and, Dr. Atul Gawande, the brilliant thinker who was tapped to lead Haven as its CEO, now serves the U.S. government as assistant administrator of the Bureau for Global Health.  The U.S. “sick care” system has triumphed.

As a connected and global species, our health, as well as our planet’s viability, would seem to depend on an aspirational model of inspired leadership that does not currently exist.  Rome burned while the fiddlers fiddled.  Can you imagine learning to play a new score on different instruments?

Steve Adelman is a coaching and consulting psychiatrist and can be reached at his self-titled site, AdelMED.

Image credit: Shutterstock.com

Prev

To my fellow physicians who are struggling with suicidal ideation

September 14, 2021 Kevin 1
…
Next

How do we explain the unexplainable? Are there words for the things we’ve experienced?

September 14, 2021 Kevin 2
…

Tagged as: Public Health & Policy

Post navigation

< Previous Post
To my fellow physicians who are struggling with suicidal ideation
Next Post >
How do we explain the unexplainable? Are there words for the things we’ve experienced?

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

More by Steve Adelman, MD

  • Should all health professionals be teetotalers?

    Steve Adelman, MD
  • The horror of darkened hearts

    Steve Adelman, MD
  • I’m covering the practice of a “Dr. Feel Good”

    Steve Adelman, MD

Related Posts

  • How social media can help or hurt your health care career

    Health eCareers
  • Why health care replaced physician care

    Michael Weiss, MD
  • Turn physicians into powerful health care influencers

    Kevin Pho, MD
  • Health care is not a service commodity

    Peter Spence, MD, MBA
  • Why the health care industry must prioritize health equity

    George T. Mathew, MD, MBA
  • Health care workers should not be targets

    Lori E. Johnson

More in Policy

  • How locum tenens work helps physicians and APPs reclaim control

    Brian Sutter
  • Why Medicaid cuts should alarm every doctor

    Ilan Shapiro, MD
  • Why physician voices matter in the fight against anti-LGBTQ+ laws

    BJ Ferguson
  • The silent toll of ICE raids on U.S. patient care

    Carlin Lockwood
  • What Adam Smith would say about America’s for-profit health care

    M. Bennet Broner, PhD
  • The lab behind the lens: Equity begins with diagnosis

    Michael Misialek, MD
  • Most Popular

  • Past Week

    • Why removing fluoride from water is a public health disaster

      Steven J. Katz, DDS | Conditions
    • When did we start treating our lives like trauma?

      Maureen Gibbons, MD | Physician
    • Mastering medical presentations: Elevating your impact

      Harvey Castro, MD, MBA | Physician
    • Why the fear of being forgotten is stronger than the fear of death [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why what doctors say matters more than you think [PODCAST]

      The Podcast by KevinMD | Podcast
    • The hidden incentives driving frivolous malpractice lawsuits

      Howard Smith, MD | Physician
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • The silent toll of ICE raids on U.S. patient care

      Carlin Lockwood | Policy
    • Addressing the physician shortage: How AI can help, not replace

      Amelia Mercado | Tech
    • Why medical students are trading empathy for publications

      Vijay Rajput, MD | Education
    • Bureaucracy over care: How the U.S. health care system lost its way

      Kayvan Haddadan, MD | Physician
  • Recent Posts

    • Why the fear of being forgotten is stronger than the fear of death [PODCAST]

      The Podcast by KevinMD | Podcast
    • How a rainy walk helped an oncologist rediscover joy and bravery

      Dr. Damane Zehra | Physician
    • How inspiration and family stories shape our most meaningful moments

      Arthur Lazarus, MD, MBA | Physician
    • A day in the life of a WHO public health professional in Meghalaya, India

      Dr. Poulami Mazumder | Physician
    • Why women doctors are still mistaken for nurses

      Emma Fenske, DO | Physician
    • How home-based AI can reduce health inequities in underserved communities [PODCAST]

      The Podcast by KevinMD | Podcast

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 3 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Why removing fluoride from water is a public health disaster

      Steven J. Katz, DDS | Conditions
    • When did we start treating our lives like trauma?

      Maureen Gibbons, MD | Physician
    • Mastering medical presentations: Elevating your impact

      Harvey Castro, MD, MBA | Physician
    • Why the fear of being forgotten is stronger than the fear of death [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why what doctors say matters more than you think [PODCAST]

      The Podcast by KevinMD | Podcast
    • The hidden incentives driving frivolous malpractice lawsuits

      Howard Smith, MD | Physician
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • The silent toll of ICE raids on U.S. patient care

      Carlin Lockwood | Policy
    • Addressing the physician shortage: How AI can help, not replace

      Amelia Mercado | Tech
    • Why medical students are trading empathy for publications

      Vijay Rajput, MD | Education
    • Bureaucracy over care: How the U.S. health care system lost its way

      Kayvan Haddadan, MD | Physician
  • Recent Posts

    • Why the fear of being forgotten is stronger than the fear of death [PODCAST]

      The Podcast by KevinMD | Podcast
    • How a rainy walk helped an oncologist rediscover joy and bravery

      Dr. Damane Zehra | Physician
    • How inspiration and family stories shape our most meaningful moments

      Arthur Lazarus, MD, MBA | Physician
    • A day in the life of a WHO public health professional in Meghalaya, India

      Dr. Poulami Mazumder | Physician
    • Why women doctors are still mistaken for nurses

      Emma Fenske, DO | Physician
    • How home-based AI can reduce health inequities in underserved communities [PODCAST]

      The Podcast by KevinMD | Podcast

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

No one is in charge of the free-for-all that is U.S. health care
3 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...