"The system is a labyrinth of bureaucratic red tape and mismanagement and seems wholly indifferent to the suffering of the sick. The plague of HMOs and PPOs has cut the heart out of what used to be known as healthcare and critically wounded the doctor patient relationship."

It's a done deal. Massachusetts has become the first state in the U.S. to provide universal healthcare for its residents. Part of the deal is a totalitarian mandate that requires all residents to purchase health insurance or suffer crippling tax penalties. For those who can't afford insurance, their healthcare will be free. The people in the middle, the working poor, will receive subsidized insurance.

Much of the focus has been on how this plan will be funded and implemented. Two important points, to be sure, but there is a third issue that has received little consideration and that is whether the effort and billions spent on this initiative is really going to be worth it. That is, rather than promoting sickness as normal and working to add more people to the ranks of the insured, shouldn't we be trying to reduce the need for health insurance by aggressively funding and promoting health?

Of course, cost can't be ignored as the Massachusetts initiative promises to be an expensive and complicated plan to implement. Not surprisingly, two of the chief talking points of the plan are that it will be both affordable and provide value for the uninsured. The first claim sounds like wishful thinking while the second is highly doubtful given the current state of healthcare in America.

Money to cover the uninsured has to come from somewhere. Somehow, some way, taxpayers either in-state or at the federal level will have to dig deep to come up with the additional taxes to make this plan viable.

Most people above the age of ten instinctively know to hide their wallets whenever government promises more for less. This well-known principle of public spending is known as the *Inverse Cost/Benefit Axiom (ICBA). Based on Newton's First Law, it states that "Spending, once begun, tends to increase in perpetuity, while projected benefits tend to decrease inversely to rising costs." In other words, according to the ICBA, the cost of the Massachusetts plan will increase as quality of care decreases.

You don't need a crystal ball to determine whether this projection will turn out to be true. A history book will do just fine. It was during the Reagan Administration that managed care, that alphabet soup of acronyms, became a reality for insured America. This newfangled approach to healthcare was supposed to manage costs and provide better quality care to a broader audience. It has mostly been a failure. Healthcare is far more expensive today than most people expected and those rising costs have far outstripped the earning potential of the working class.

The system is a labyrinth of bureaucratic red tape and mismanagement and seems wholly indifferent to the suffering of the sick. The plague of HMOs and PPOs has cut the heart out of what used to be known as healthcare and critically wounded the doctor patient relationship. Some doctors have opted out of the system altogether and have returned to accepting cash for services rendered.

Meanwhile, industry, fed up with its role as health insurance sugar daddy, has gradually shifted the cost of insurance from the corporate coffer to the labor force. Even people with so-called 'good jobs' and platinum insurance plans are being forced to choose between stratospheric deductibles and stripped down coverage just so they can maintain some semblance of civilized middle class life.

When healthcare goes awry
A 1999 study released by the Institute of Medicine put the number of preventable deaths, due to medical error, at between 44,000 and 98,000. These numbers were subsequently disputed by the American College of Physicians. A second, 2004 study by HealthGrades Inc., put the number at an astounding 195,000! In 2005, the Medical Error Database law went into effect. It created a new system that allowed clinicians to report medical errors anonymously. The fact that such a system was even necessary suggests that there is a serious problem within the medical industry and that perhaps, the "death-by-doctor" statistics are closer to accurate than any of us care to think.

Consider the abysmal statistics that put two-thirds of Americans in either the overweight or obese categories. Throw in the medical industry's addiction to prescription drugs. Add increases in diabetes, osteoporosis in children, heart disease and cancer and you have a diagnosis that suggests that medical care in this country is critically, irrevocably ill.

America leads in the development of bleeding edge medical technology and produces some of the best and brightest clinicians to use it. We have the ability to provide healthcare that is unequaled anywhere in the world. That said, modern healthcare in this country is a fiscal and functional disaster. We are transitioning from a nation of producers to a nation of patients that is increasingly dependent on revenue generated by the sick business.

A better treatment plan
The Massachusetts plan is a good sign that government does have a conscious and can be a positive force in the lives of everyday citizens, but will insuring more people really make a difference in a system gasping on life support? Perhaps the answer, as suggested at the beginning of this article, is in the idea that we should be trying to reduce dependence on healthcare rather than increase it. How do we do this?

To start, let's have some real healthcare reform. Let's spend some of those billions on educating people on how not to get sick in the first place. Let the medical industry do what it does best and that is, focus on acute care issues, while we relearn how to make our own day-to-day health decisions. Let's preserve our historical independence and prevent multinational companies from taking over the food supply. Let's make a real effort to clean up our environment and hold companies accountable for the products they produce. Let's do what's necessary to prevent industry from poisoning us. Let's clean house in Washington and let God and the courts sort'em out. Let's put an end to our addiction to prescription drugs and finally, let's start with real education about real food.

Doing this will take guts. It will mean telling the truth about some sectors of the food, pharmaceutical, manufacturing and medical industries. It will mean that Washington D.C. will have to turn its back on the millions of dollars in legal bribery and influence peddling that it has become accustomed to. In short, it means funding a second revolution that is once again, of the people, for the people and by the people.

Healthcare is as much about education and advocacy as it is about drinking your milk and getting plenty of exercise. When we rediscover our ability to take care of ourselves, we'll have something far more valuable than universal healthcare, we'll realize universal health.