‘Completely Inadequate’ Mainstream Media Talk on Poor US Health Outcomes Discounts Alternative

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 on Wednesday he felt “frustration and outrage” at how the issue was presented in the Washington, DC-based paper.“On the one hand, it’s good to make the clear connection between inequality and death, and between inequality and high rates of crime and disease, and to basically say the real measure of inequality is not difference in income but difference in life and death. Okay, that’s a pretty strong point. There’s a cynical way to look at that and that is, another in a series of avoidance strategies so that we don’t have to take on the health care industry,” he said.“We can say to the Post here, it’s really the social determinants of health, so-called, like you referenced the seatbelt law, the tobacco tax, that’s really the problem. And they never come out and explicitly say: ‘the health care industry makes money by denying people care and profits after charging a lot of money for insurance and procedures and other aspects of the health care system, and until we take the profit out of the health care system, we’re going to have a country that looks like this,’” Lighty said.He said the grim numbers were “a real indictment of the health care industry in the US,” but noted  “it’s not news: folks who do health policy and look at these issues have known literally for years, if not decades, that Americans have high rates of chronic conditions. I mean, basically by the age of 65 most Americans have two or more chronic conditions. I noticed in the recent Medicare booklet that there are new provisions for accessing preventive care. By the time you’re 65 it’s a little late,” Lighty said.“This is a real indication that we don’t have a health care system of early intervention, we don’t have a health care system of prevention, we have huge disparities in the health care system not only based on income but by geography, race, gender - all sorts of barriers, primarily financial, to accessing care have caused this chronic disease epidemic,” Lighty said. “And yeah, okay, you can say lifestyle, but frankly, if you’re going to the doctor, have access to medical treatment, you’re going to get messages and you’re going to get interventions that do matter.”“And we do have to acknowledge that the Post points toward the fact that people can’t afford good food, they eat badly, they make it seem like it’s a notion of individual choice, and that’s the other problem with the series is they’re talking about essentially social determinants but they never say this is a social, structural problem in the American economy, in American society,” he noted.Lighty also stated the Post never mentions that 7 million people are being kicked off Medicaid as a consequence of the end of the COVID-19 pandemic-era emergency measures. “That’s going to make a huge difference,” he said, emphasizing the state-funded health insurance system for low-income Americans is extremely difficult to sign up for and retain.“‘Gee, why are they making such bad choices when we have such a great health care system? I don’t understand it.’ Then you don’t live in the real world,” Lighty quipped. “Particularly with the cost of groceries, access to good food is even worse. But I do think it comes back to … medical interventions matter, early treatment matters, and if all of sudden you start getting reports that your blood pressure is way-high and your blood sugar is out of control and your weight puts you at risk of these diseases, that gets through to people. I don’t think you could ever address this issue simply by saying ‘eat better.’ You have to have a rigorous and ongoing relationship with medical providers.”Lighty said that when papers like the Post do cover proposed alternatives, such as Medicare for All, that would take the profit-making out of the health industry, they make a point to discuss only the downsides and never the benefits of such a model.“It’s just completely inadequate and it reflects entirely the conventional wisdom in Washington about the political viability of systemic change in health care. Basically, they start from the premise that ‘we can’t really change the system, so these wild-eyed idealists like [US Sen.] Bernie Sanders are really just tilting at windmills and everyone knows it’s not going to happen, so let’s talk about what could happen.’ And then it turns out ‘what could happen’ is ‘we can throw more taxpayer money at the industry so they’ll have more resources to perpetrate the existing model, which doesn’t keep people well.”“So when you have an article about Medicare for All, you don’t actually talk about the savings it will generate. Even the Congressional Budget Office has said those savings are like $650 billion a year. They don’t mention that, they’re always [talking] about the cost. But how can something that costs less be expensive, relative to the existing system?” Lighty said. “Then they’ll trot out the industry talking points: ‘most people like their private health insurance, so these idealists aren’t going to get rid of peoples’ health insurance.’ Well, let’s examine that assumption: first of all, people are desperate to keep whatever they have; second, those who generally like their private health insurance haven’t used it that much; and third, the real problem are the out-of-pocket expenses, the copays, the deductibles, the out-of-network charges - all of that stuff is the real financial barriers to care, if there is even a provider in your area that’s accessible to you.”“And why is that? Because of how we finance health care, we don’t actually ensure that every community is equitably served. We don’t put money into that, we just, if you’re a rural hospital and you can make money, you stay open, if you can’t make money, well, you’ll close and that’s just the way it goes. And that whole model is uniquely American, no other country does it that way and we never heard about that. When does the Post ever report we have the only health care system that is organized as a profit-making industry and here are all the consequences in terms of health outcomes?”

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