Real Leaders

The Future Architects of Healthcare Will Be Women

The first principle of classical ethics is that no human being should willfully cause other human beings to suffer. The second principle is if you have the ability to prevent or alleviate human suffering you should. Obviously, those principles are violated constantly.

When philosopher Adam Smith wrote about the benefits of capitalism, he did not promote the misguided notion that all human provided services would be better if driven by the profit motive. There is a distinct difference between commercial markets needed community services. Whenever people misuse the profit motive to serve essential human needs, whoever has the least amount of money will get the least benefit. That’s why Benjamin Franklin founded our country’s first community fire departments. If only wealthy individuals could afford to pay to protect their houses with private fire departments, entire cities would’ve burned to the ground because the widespread devastation of fires can’t be contained.

So what about our health?

The fact is, that unless every American citizen is in one 330 million-shared risk pool, the only way profit-making insurance companies can make money is restricting coverage for the truly sick and gouging the healthy. Therefore, one all-inclusive pool is the only way we can harness the law of averages to keep healthcare remotely affordable.  And that’s only the beginning.

The problem we face is profit-driven health care requires so much regulation to avoid profiteering and exploitation that all we can create is a bureaucratic mess. That’s what politics is doing to healthcare. And it’s creating needless human suffering.

Why Women Must Take the Lead in Healthcare

I have little confidence in our male political leaders to do anything creative or collaborative to solve the healthcare cost crisis. So, it’s time to get female candidates ready for 2018. The answer: we must elect many more women to Congress.

Here’s why women need to take the lead in solving this problem:

  1. Women are more likely than men to need medical services. They need to visit doctors more frequently and as a result, have to pay a greater proportion of their income for healthcare.
  2. Women earn less than men, and are more likely to live in poverty. So they’re less likely to afford medical care. As a result, uninsured women are nearly 20% more likely to have trouble obtaining health care.
  3. Young women, rural women, Latinas, and African American women all face severe obstacles to obtaining medical care. Cost and access to competent care is much more limited for these women.
  4. Because women are more likely to work part-time jobs, they’re less likely to have employment-offered health insurance.
  5. Women are economically disadvantaged because they now spend nearly 1/3 of their lives caring for their children, and for relatives who are sick, disabled, or elderly.
  6. Women are much more vulnerable to losing healthcare coverage because of divorce than men.
  7. Reductions in Medicaid disproportionately harm women because more women live beneath the poverty line.

(All of these statistics come from Dr. Susan Sered; Suffolk University Boston.)

The Answer to Healthcare is Unlikely to Arise from Males

The answer to these problems is unlikely to be addressed by blue-brained males who mistakenly believe that marketplace competition creates quality and efficiency in all cases. The concept of limited government is appealing but quickly loses its practical value in the face of virtually unlimited, powerful, supersized corporations. When the size and power of our institutions become imbalanced, power becomes concentrated for a few at the expense of the many.

The conservative Heritage Foundation promotes a severely limited government. They espouse a fundamentalist belief that taxes rob the worthy wealthy of their just rewards for their hard work and give it to unworthy lazy people who are either poor or sick because they have brought it on themselves. This sincerely held belief is cloaked in the costume of personal responsibility, as if every struggling, abused, or single mother has brought her suffering on herself.

Although that might seem far-fetched, it’s not.

The roots of William F. Buckley’s 1950’s arguments for modern conservative values, are deep in the soil of New England Calvinism. Calvinists believed that whether you were going to heaven or hell was pre-destined. Worthy people who are pre-selected to go to heaven were born to good families, who could afford to give them good educations and opportunities. Unchosen people were usually born to poor families or slaves, where they lived out there pre-destiny of suffering both in this life and the next. Moreover, many of these fundamentalists believed that trying to empower the poor or the unchosen was against the divine will. They believed people got what they deserved.

These misguided 17th-Century beliefs are so buried deep within conservative dogma, that they would never be openly acknowledged.

Yet, you clearly saw this kind of thinking when Congressman Jason Chaffetz told a journalist last week that people “are just going to have to choose between a new iPhone or their healthcare.” He is simply representing the self-righteous condemnation of the poor and the disadvantaged, as if they have only themselves to blame.

 As this kind of thinking creates a binary society of winners and losers, of the deserving and the undeserving, we lose the reality of our new level of interconnectedness. We lose the aspiration of creating a society that honors both personal responsibility and our common good.

Often Conservatives plead that they’re just being practical.  They argue we can’t afford what is necessary to create a more ideal society. That is simply not true. It is a matter of priorities.  And priorities are guided by whatever your inner story is. Countries on the rise invest their taxes in the capacity and well being of their citizens. If we taxed investment gains in exactly the same way we tax wages we could create a 21st Century country. The only reason we don’t is we choose not to.

Why is the value of money made by high-speed stock trading more valuable and taxed less than money earned by hard-working nurses? For instance, if we were willing to tax the first $125,000 of investment gains at the same rate we deduct Social Security and Medicare taxes from wages those programs would have ample money.

Investing in a Level Playing Field

The research is clear; we know what to invest in. There are five conditions that create a level playing field that actually empower people’s self-reliance, discipline, and vision to elevate themselves. The five are universal access to:

  1. quality education,
  2. healthcare,
  3. capital,
  4. justice,
  5. and infrastructure from transportation to high-speed internet.

Countries that provide free education, healthcare, justice, low cost capital and life leveling infrastructure have the highest rates of social mobility. That means were you start in life doesn’t determine where you end. That was once the American dream but is now more likely to be found in countries like Canada and New Zealand.

My concern is that as long we have authoritarian, highly-competitive males determining how citizens can access healthcare, we will only come up with costly answers that cause unnecessary suffering and lack of access by the people who need healthcare the most—especially  women.

I don’t believe the answers will be found on the Right or Left. I don’t believe government run healthcare will be the best and most efficient. And I am certain that healthcare rationed by a few highly profitable insurance companies, obscenely profiteering drug companies, and a competitive swirl of hospitals and doctors, will never sort itself out into something remotely effective or fair for all.

The answer?

We already have some well-established models that rely on collaboration and commitment to provide the best care for the most people. They’re called Accountability Care Organizations (ACO’s).  They are collaborative, non-profits that invest surpluses in new technologies, thus eliminating waste and breakthroughs like tele-medicine. The best governance model, to scale these organizations to serve every American, is the medical cooperative.

Medical cooperatives are run for the primary benefit of every member they serve.  They’re governed by citizens not bureaucrats. The promise of citizen-led organizations with proper rules of governance and a clear and narrow guiding mandate will provide innovative choices of how to provide high-quality services, that every citizen needs, without the bureaucracy, corruption, and greed that clog our path to the future.

The architects of Citizen Healthcare will be Women. Because women are the force of civilization.

Women have always wanted a future that is better, safer and fairer for their children, their community’s children, and the world’s children.

We need something new. We need it  now.


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