Health care in the United States is very very sick. The problem is not Medicare, the insurance companies, the doctors, or the patients. It's all of them and more It reminds me of the old joke, "What's the difference between God and a doctor? God doesn't think he's a doctor." Sadly, that's merely the tip of the problem, though. Medicine is more complex than ever. My primary care physician recently gave up his practice because of his insurance premiums. They actually went down, but so did his liability cap from $3 million to $250,000. He took a job with his brother who owns a grave marker (tomb stone) company. Life is unfair folks. Some of us are going to get sick and die, sometimes very suddenly, sometimes over a very long period of time, and it's generally nobody's fault, even if the treatment doesn't go the way you hoped or planned. Doctors ARE human, and will make mistakes and overlook things. I would say the overwhelming majority of problems with treatment are NOT malpractice, but the results of a doctor being torn between seeing enough patients to make payroll (or a living) and having enough time to get in 9 holes this afternoon. Many factions are to blame. Insurance companies are to blame. Increasingly, they like to collect those premiums, but will use any and every means to NOT pay claims, even legitimate ones. This greed is evident not only in medical insurance, but other forms as well. Even 25 year customers are getting their auto insurance dropped for minor claims! Insurance companies are out of control and need to be regulated. Profitability is fine. Not meeting contractual obligations and hiding behind a team of is not. Lawyers. Ah yes, lawyers They're to blame. Why not sidle up to the trough of greed and gorge yourself on free money? It's a difficult temptation to resist, and it's a rare litigation lawyer who doesn't. The tort system is out of whack when the person who essentially does the paperwork and makes a few arguments can get one-third OR MORE of a settlement. Lawyers' fees should be capped to a reasonable amount, but certainly not a significant percentage of these multi-million dollar settlements. Take away the incentive to inflate judgments beyond reason and they will come down. Patients are to blame, too. Modern medicine is miraculous in its abilities, but it cannot cure every ill in every instance. Not even close. Some diseases are beyond our reach right now, and like I said before, some doctors will make mistakes. If we have a pain, we go to the doctor to get a pill. Pills are easy to prescribe and easy to take, so we get our pills and the symptom is gone. Never mind the new chemicals introduced into your body, and that they may cause new problems. And forget about the fact that the underlying cause hasn't been addressed, either by you or your doctor. As long as you are symptom free, you're healthy, right? Patients have forgotten that they are also part of the health care equation and need to take charge of their health destinies rather than accepting substandard care. Blame the doctors Sure, they want to make money. I would, too! Doctors have a huge investment in education, so they're entitled to go for the big bucks if that's what they want. Unfortunately, their time is as limited as ours 24 hours in a day. In order to make enough money (after paying employees' salaries, office rent, etc.) to support the Benz, the big house, the kids in college, they have to overbook their appointments and only see us for a few minutes, and generally throw some pills at us to squelch our symptoms and complaints. The underlying problems causing the symptoms are often difficult to address, and some patients simply refuse to take control of their health. Pills solve the symptoms, and there seems to be a pill for everything these days. Doctors are also under enormous pressure from the drug companies to prescribe the latest (profitable) pill for patients. Heck, the nice drug companies will even lure doctors with junkets, golf clubs, and other nice bonuses just for listening to their spiel! The theory of any care is better than no care it all seems to prevail. Removing symptoms takes precedence over treating the whole person. Blame the drug companies Profit is a good thing. More profit must be a really good thing! The chemicals that drug companies produce seem like they can cure anything. Taking a pill is a lot easier than living a healthy lifestyle and much less invasive than an operation or other surgical procedure. Sure, there are a lot of good drugs out there, but the drug companies are running unfettered, giving us incredibly strong chemicals delivered through a supply chain that is intentionally set up to favor them the entire way. They control the approval process, seduce the doctors and advertise to the patients, all with very little control. Patents, the gold mine of pharmaceuticals, are being extended for minor things like double coatings, so the extreme profitability of drugs can be continues nearly indefinitely. Combine this with many people going to several doctors, often having several prescriptions, and it creates and often-deadly and frequently harmful unique brew of chemicals for many patients! Yikes. I am highly suspicious of any drug that I should take as a preventative or one that I am given a permanent prescription for. Except in unusual circumstances, there are no drugs that normally healthy people with a reasonable lifestyle will need in order to live day to day. NONE! The drug companies would have us believe otherwise. Blame the medical schools Teach some theory. Let the drug companies get to the young minds. Teach a little care. Throw the kids into the antiquated, cruel internship system, and give 'em an MD. Oh yeah, remind them about that Hippo-, er, Hypo, um, oath thingie. Don't forget to make sure they're in about $200,000 of debt when they get out so that they'll have to suckle any financial teat they can. Blame the government Medicare is only one part of it the government's failure in medical care. Medicare limits what the doctors can charge. Under that kind of pressure, frauds will happen, or worse, substandard care. The shame is that we CAN afford good health care in this country. And we can afford it for everyone. But it will come at the expense of long established and entrenched systems of care, billing, and treatment. I guess legislative ignorance and hands off is the way to regulate medicine in this country. I don't suspect maliciousness or laziness on the part of our leaders so much as I do a constant and concerted effort on the part of those who profit the most from keeping the status quo. Lobbyists (and through them their employers, the insurance companies, drug companies, etc.) are much more to blame than those being lobbied. Soft money is everywhere. The interests of those who can afford to have their voices heard are being met. Those who do not form a voice, or who do not hire lobbyists do not have the attention their representatives. We may elect Congress, but the special interests buy it. Day in. Day out. We need to wrest control of the legislative process form those currently strangling this country and making us unhealthy and tell our leaders that we want a pragmatic approach to medicine based on wellness not on profits and taking pills. The guilty will fall Many of the greedy companies, insurance, HMO, and even drug companies will perish before the system turns around. Many will flourish as well. It won't happen overnight, or even in a few years. A concerted effort on the part of everyone who is a part of the system is necessary. So is a lot of sacrifice, and, sadly, we're not a country that does that any more. Health care is broken. The way it is delivered is broken. The way it is financed is broken. Our expectations of it are broken. With all that said, how do we go about fixing it?