The sick and the dead

There is an overwhelming amount of stakeholder interests in this healthcare "debate". I can summarize the main stakeholder groups thusly:

1. Healthcare providers (physicians, other individual providers, hospitals)

2. Manufacturers (Pharma/Biotech, devices, information technology)

3. Payors (Insurance companies, state [Medicaid] and federal [Medicare, Medicaid] governments)

4. Government

Which ones do we as consumers of healthcare trust? Seems like those of us who want to keep the government from expanding its role in healthcare trust the other three more than their elected officials. It is baffling that they should. Ask yourselves, what are the interests of those parties? Manufacturers... Insurance companies... Healthcare providers... While it is heartening to me to think that you may consider your healthcare providers trustworthy, I may be engaging in self-deception there. I know that the public's trust in our venerable profession has eroded dramatically, and I do not need to reinvent the wheel telling you why, since Dr. Gawande has already done it for me, and much more eloquently than I ever could.

Do you really trust the manufacturers to have your best interests at heart? If yes, why? They are a business, and like any other business they are driven by the need to increase investor value by making profit. Where is your interest in this equation? There are , of course, exceptions, but do we want to put all our eggs in that basket? And speaking of the profit motive, what are insurance companies' primary goal, if not to make as much of it as is humanly possible? What? You don't believe me? Why else would they have armies of employees responsible for denying reimbursements for needed services?

So this brings me to the government. Who are these people and why don't we trust them? Well, aside from the fact that we elect them, they seem to be mostly beholden to the special interests that contribute gobs of money to their campaign coffers. And these groups of course are the manufacturers, the payors, and the like. No wonder we do not trust them!

What is peculiar, though, is that the rhetoric opposing healthcare reform is centered around the government intruding in our personal choices, compelling us to do that which we are opposed to doing. Is that not strange? The solution seems to me to be quite simple: clean up the government, make them responsible to the people again, and make them accountable for fulfilling their responsibilities to the citizens. Why are we talking about killing grandmas as if all of the other stake holders are immune from this accusation? Pardon me for my crudeness, but could it be that we understand that a sick patient is more lucrative than a dead one?