The Health Care Industry

The lawyers are the most hated Paraducer class in America, but coming in a close second is the health care industry. This twisted tale includes some Consumers, Paraducers, and Producers, but the net result is a huge economic penalty to Producers in America.

The Consumer in the equation is anyone who purchases health care products or services. Now these people can be, in the larger picture, strict Consumers (such as store clerks or restaurant help), Producers (such as a factory worker or engineer), or Paraducers (such as an attorney or accountant). But at the foot of the health care throne, we are all Consumers at the mercy of faceless, first-name-only people on the other end of a customer service line in Singapore.

The health care Producers are the doctors and nurses who do the work to make and keep us well. While doctors have a love/hate relationship with the health care industry, their contribution is mainly one of production, whether they do research or family medicine.

The Paraducers are the middlemen in the health care and insurance companies who don’t know an appendix from a vertebra, only the cost to remove or replace them, plus the standard mark-up. Their sole function in life is to maximize quarterly income. Period.

This situation sets up an antagonism that is palpable. Doctors resent the health care and insurance companies and HMOs for quibbling with their diagnoses and suggested treatments. The Paraducers hold the doctor’s opinions of little value because treatment costs money, and cures are expensive. The consuming public is caught between doctors who communicate less than a depressed mime, and plan administrators who communicate not at all, or only with the word ‘no’.

The Paraducers in this situation, the health care and insurance companies, and HMOs, have little interest in quality care or customer service because, simply, it costs money. In fact, as health care providers’ costs increase, they mark up those costs before passing them on to insurers, who mark them up again before passing them on to you and me in the form of outrageous premiums. Health care providers act as if they have no local competition because insurance companies limit consumer choice artificially, driving down service and driving up cost. The doctor gets grief from the patient for not providing proper treatment, so he orders expensive tests to cover his risk in the case of a malpractice suit. And those costs cycle through the system again.

The insurers and health care administrators provide little added value to the doctor/patient relationship, but extract a huge portion of the money that changes hands.

When I was a kid and I fell ill, my family pediatrician would make a house call. My parents wrote her a check and they were square. Today, there are no more house calls, and the office staff at any medical facility looks confused when I whip out my checkbook, they are so unaccustomed to receiving payment for services rendered from anyone but an insurance company.

My family doctor is so fed up with the extra cost burden imposed by the Paraducer insurance companies that he offers a discount of about 50% if I file the claim forms myself. I like that because I don’t file the claim forms anyway, since my family policy has a deductible that does not touch anything less expensive than a lost limb or brain transplant. We generally don’t have enough medical expenses per year to recover any charges from the insurance carrier. And our premiums increase every time one of us has a birthday.

There is another dimension to Paraducerism in health care, and that is the entrenched health care education and treatment approval systems. The doctors, educators and regulators play the role of Paraducer when they resist expansion of medical education to research and validate alternative treatments, and delay the introduction of drugs and methods that have been in safe use in other parts of the world for decades. Patients who have to fight insurers for approval of treatment are subject to stress and the extended ravages of disease, all to benefit the insurer’s bottom line.

This obstructionist behavior deprives the Producers in our society of life saving or life improving drugs and treatments, in order to solidify the medical community’s monopoly position regarding health care. In this situation, a doctor can be a Producer in daily practice, and an interfering Paraducer after hours as he writes articles for the consumption of other doctors and regulators, agitating against anything but traditional medicine. The situation is indeed quite complex.

In a delicious and tragic irony, that doctor is then targeted by the chief Paraducer class, the attorneys, for malpractice litigation. This attack results in the long term in the strengthening of the lawyer-Paraducers by funneling money from doctor-Producers in the form of insurance premiums and direct payouts.

Leeches feeding on leeches. This almost reaches the level of poetic justice, until I realize that I am ultimately paying to send the whole lot of their children to Harvard and Yale, where they earn more degrees in law and medicine, and enter society ready to feed as their parents did.