The American Health Care System ꟷ Enabled by a Disempowered Public

“Capitalism is the legitimate racket of the ruling class.” - Al Capone

Dr. White is correct (Universal Access to Basic health Care --- The System) ꟷ it is past time to speak up and enable access to health care in these fine United States.  Much needs to be said.  I appreciate this opportunity to contribute to the dialogue…

Adolf Hitler once remarked, as Nazi Germany was beginning to lose the war: “It is fortunate for leaders that the people do not think.”  This quote, though disturbing, highlights the vulnerability of a society that lacks critical thinking skills ꟷ an issue that has troubling parallels in the modern American context.

The Founding Fathers of the United States were, to some extent, wary of direct democracy.  They feared that the general populace, if inadequately informed, might struggle to make sound decisions when electing public officials.  In the early years of the republic, presidents were not chosen directly by the people but by electors selected through more indirect means.  Today, the challenges facing the nation ꟷ particularly in health care — are deeply rooted in a longstanding neglect of public education and civic awareness.

The public unrest of the 1960s and early 1970s, catalyzed by opposition to the Vietnam War and the fight for civil rights, revealed to those in power the potential of an educated and engaged citizenry.  In response, some powerful interests recognized that controlling access to education would be an effective way to suppress dissent.  When people are deprived of education, their ability to engage in analytical thinking and discern truth from propaganda is diminished.  Moreover, a chronically ill population is less likely to mobilize against systemic injustice.

President Richard Nixon began the erosion of public knowledge by cutting federal support for public libraries.  However, it was during the 1980s that public education faced its most aggressive dismantling.  Under President Ronald Reagan, federal funding for education and social programs was significantly reduced, under the banner of promoting individual responsibility and minimizing government intervention.  While this allowed for tax cuts favoring the wealthiest Americans, the long-term consequences were severe ꟷ degrading public education and undermining public health.

Reagan-era policies disproportionately affected under-resourced communities, leading to widespread declines in educational quality.  Numerous studies have shown that lower levels of education correlate strongly with poorer health outcomes.  Individuals with limited education often secure lower-paying jobs that provide minimal access to health care, leading to increased stress, substandard living conditions, and a higher incidence of chronic diseases such as obesity, cardiovascular illness, and diabetes.  Preventative health education is not a priority in our health system since it is not as profitable as allowing the development of chronic disease which will generate corporate income until the patient dies.  Even college-educated professionals are not immune: many are burdened by significant student loan debt, creating a modern form of economic servitude.

Concurrently, the 1980s marked the acceleration of corporate influence and privatization across many sectors ꟷ  including health care. This trajectory has continued into the present, culminating in what many describe as a corporate takeover of the American health care system.  Despite advances in medical technology and training, the quality of patient care has suffered.  Health care professionals face unsustainable workloads and excessive administrative burdens, driving many nurses and physicians out of hospital settings.  This has led to staffing shortages, burnout, and compromised care.

Pharmaceutical prices in the United States remain the highest in the world, driven largely by the pharmaceutical industry's outsized political influence.  Ultimately, meaningful reform is unlikely as long as private corporate interests remain entrenched in health care.  A system driven by profit rather than public well-being can only lead to further deterioration.  Without significant structural change ꟷ including the removal of corporate dominance ꟷ American health care will continue to decline, and the broader public will remain disempowered and underserved.

Respectfully submitted,

Jay Stearns MD

Dr Stearns retired after 39 years of clinical practice. He worked internationally and nationally as a locum tenens hospitalist.  He served the Indian Health Service on the Pine Ridge Reservation in that capacity.  Living in Vermont, he enjoys spending time with wife, Dr. Pilar Stearns, and their family and working as a certified personal trainer.  He regularly serves as a guest lecturer at his medical school alma mater when visiting friends and family in Mexico.