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Why the American Medical System Is Broken

Why the American Medical System Is Broken

Anyone who’s recently visited a hospital in America knows the system is broken. Prices are outrageous, answers are slim, and insurance companies are insufferable. Each time I think about how the medical system in America is terrible, one of the only small comforts is that Canada’s healthcare situation is worse.

Still, we didn’t arrive here without a string of bad decisions leading to an overpriced, unhelpful, and increasingly woke medical system. So how did we get here?

Big Pharma, Carnegie, and Rockefeller

One gripe many have with the modern medical system is the rejection of diet, exercise, and natural medicine in favor of big pharma and a palmful of pills. But it wasn’t always this way.

Today’s medical system began in the early 1900s with the Flexner Report. This report was written by Abraham Flexner, published by the Carnegie Foundation for the Advancement of Teaching, and funded by the Rockefeller and Carnegie Foundations. It advocated for sweeping reforms to the medical system. Flexner viewed natural remedies, taught by many medical schools at the time, as opposed to science.

The Flexner Report resulted in many complementary and alternative medicine programs and colleges closing. And more broadly, one estimate says that about 80 percent of the natural medicine institutions from the Flexner Report (everything from physical therapy to osteopathy to chiropractic treatments) closed.

Flexner’s proposed reforms included altering the structure of the medical education system, and his description is a striking mirror to the current medical university structure. And while his sweeping changes have undoubtedly been beneficial in some ways, they also created modern big pharma.

With natural medicine on the outs, modern pharmaceuticals have taken over. And it’s no wonder why: Pharmaceuticals can be protected by intellectual property laws, driving profit. There’s nothing wrong with a company wanting to be profitable, and modern medication can and does help many people. But in today’s environment of big pharma, many cure and treatment options are pushed out of the doctor’s office.

All of this is, of course, related to the big pharma lobby. In 2022, the industry that spent the most on lobbying in the U.S. was pharmaceuticals and health products. From 1999 to 2018, this industry spent $4.7 billion to lobby the U.S. federal government, and this number doesn’t even include money spent to fund political candidates.

Pharma doesn’t make money off your doctor telling you to go on a diet, exercise more, prioritize sleep, or get fresh air. But these companies can make money if obese children take medication, as the American Academy of Pediatrics recently recommended in its updated guidelines on childhood obesity.

Woke Medicine

In addition to big pharma, another group involved in the current state of medicine is the American Medical Association (AMA). The AMA is the professional organization for physicians in the U.S., and among other things, it lobbies the government and helps create guidelines for medical schools. But like many other institutions, the AMA is embracing left-wing ideology. For instance, in a 2021 guide, the AMA says:

Narratives grounded in white supremacy and sustaining structural racism, for example, perpetuate cumulative disadvantage for some populations and cumulative advantage for white people, and especially white men. … Narratives that uncritically center meritocracy and individualism render invisible the very real constraints generated and reinforced by poverty, discrimination and ultimately exclusion.

At the same time, the Association of American Medical Colleges is actively promoting this same narrative to up-and-coming doctors, and they partnered with the AMA on the above guide. Similarly, medical schools are looking for candidates who espouse leftist propaganda.

And the grip that medical schools and these organizations have on the industry means that professionals who do not agree with this progressive ideology are in a difficult position. It would not be surprising if the next step were revoking doctors’ licenses for wrongthink: California has come dangerously close to this with a law that would punish doctors for spreading COVID misinformation, though it does not precisely define what COVID misinformation is; this law was only stopped because it was blocked by a federal judge. It’s similar to what’s happening to Jordan Peterson in Canada with his psychology license. And it’s insane.

Government Regulation

Any discussion of what’s wrong with the medical system would be incomplete without mention of government regulation. You can’t read the news these days without some politician talking about healthcare or health insurance. But will more bureaucracy really fix everything?

The foundation that has led to this structure of political rhetoric on healthcare was built about 50 years ago with the advent of Medicare and Medicaid. These programs made government the primary source of revenue for hospitals, and thus, the government suddenly had more power to tell hospitals what they could and couldn’t do. As a result, major decisions about healthcare are made for political reasons as much as medical or economic ones.

And since the 1960s, the iron fist of regulation has only tightened. The so-called Affordable Care Act (Obamacare) has done no favors for our medical system either. Obamacare has made it so no one can opt out of health insurance and so the government tightly regulates insurance companies, rather than letting market forces (and consumers) reign.

On top of all that, getting competition into the medical market is tough. Opening a hospital in the U.S. is a nightmare:

  • Doctors can’t own hospitals.
  • In order to open a hospital in most states, the businessman has to prove to the government that the area needs a hospital and obtain a certificate of need (CON).
  • Obtaining a CON can take months or years and can cost upward of $100,000.
  • In most CON states, competitors to the proposed new hospital can object to the CON application.

In other words, in order to open a hospital in many states, a businessman has to prove to the government there’s a need for a hospital in the area, pay the government an exorbitant fee, wait months or years, and pray a competitor doesn’t say there’s no need for the hospital.

In short, in an environment like this, it’s no wonder that prices are so high: It’s nearly impossible to have any competition to drive them down.

Is There a Solution?

Perhaps the best thing for the healthcare system would be to get the government out of it. While we can obviously support politicians who will repeal regulations and oppose big pharma, this won’t bring immediate change.

In the meantime, as I wrote a few months ago:

We live in a golden age of information when many medical sources and journals are publicly accessible. Many of the sources that doctors are reading are available for you to critically assess. … While I don’t doubt there are fantastic doctors out there, they seem to be increasingly few and far between. It’s up to us to be informed participants in our healthcare decisions, ready and willing to advocate for ourselves.

While healthcare has advanced in leaps and bounds since the early 1900s, the natural medicine that was once relied upon remains available to us. Diet and exercise are still potent remedies, though they cannot cure broken bones.

And as the expression goes, knowledge is power. Understanding how and why the medical system is utterly broken gives us a starting place to repair it.

Image credit: Pexels-Sandy Torchon



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  • Avatar
    February 2, 2023, 1:38 am


  • Avatar
    Rodrigo Silveira
    February 2, 2023, 2:22 am

    What we require a constitutional amendment to limit the powers of the federal government, including all health agencies who pass rules affecting all Americans without representation or accountability. These Federal Officials act like King George, robbing us of our natural and constitutional rights..

    • Avatar
      Tionico@Rodrigo Silveira
      February 2, 2023, 5:24 am

      READ your copy of the US Constitiution. NOWHERE in there are FedGov given the responsibility ofer medicne health care, etc. So they are already operating wildly outside of their assigned "lanes".

  • Avatar
    February 2, 2023, 5:19 am

    For forty years I was "self-insured", nad NO medical insurance or plan whatever. My TOTAL costs over that period ran a bit nder $400. Yes, fourzero zero dollars. A pesky UTI and an "object in eye". I did suffer a workplace injury, a serious one, requireong ext4ensive surgery, but te wormnen's compensation programme covered it.. until tney decided they were done, which was before the final surgery needed done. This has left e a mess, but I slog on.
    I have educated myself on diet, regular exercise, good life habits. My annual birthday bike ride (at LeAST one mile for each trip I've taken round the sun) las t summer had me ride 78 miles in five and a half hours. I still wear the same size clothing I did when I graduated high school decades back, and I was a skinny kid then. I almost never take time off because of illness, and then for maybe one day.
    Friend of mine five weeks younger is a total wreck, badly overwight, takes tonnes of pills, can;t do much, aches and pains everywhere, gets winded sauntring across the lawn and VERY slow n steps. He is constantly taking expensive meds and seeing doctors. My local community health care gummit outfit is wanting me toschedule an "in home wellness visit". I said no thanks. I'm still workiing full time, active, strong, healthy. No medicones beyond normal supplements and I could probably drop most of those.
    And they want me to throw yself onto the current medical care system? No thanks.

    • Avatar
      February 2, 2023, 2:54 pm

      Good on you, Tionico. You're an inspiration. I only wish I hadn't wasted the money I have on premiums through the years. I've needed next to no "expert" care for several decades, and had those premiums been invested, I'd already be retired. I think your idea of a mile-a-year bike ride is awesome; might start that myself this year, since cycling is a hobby. (62 miles would be this year's ride – but in February in Wisconsin? Think I'll wait til summer)

  • Avatar
    Rudy Baga
    February 2, 2023, 9:30 am

    Provocative article. Of course there are a lot of issues with our current health care system. But is it broken? Your opening system sets the tone for your article. "Anyone who’s recently visited a hospital in America knows the system is broken." That is simply an outrageous statement. If we accept your opening broadside the rest falls in place. But in fact it is not true as a blanket statement and that is where this article loses its way. There are many thousands of people who are helped by the system. Despite its problems.

    Each of the areas you pick and the examples you choose to point out have merit and some truth. But they are not monolithic and some are clearly misleading. I will not and have no interest in dissecting this article point by point. No one really cares what I think. Nor do you.

    But let's start with your, and you are not alone, indictment of the latest guidelines on treatment of childhood obesity. We can agree that it is an horrific "epidemic." But if you actually read the full guidelines instead on picking on what seems to be the more salacious and nefarious pharmacologic and surgical interventions you would see that these are not, NOT, the emphasis.

    Much time and thought is put into diet, exercise, family and parental involvement. This basic lifestyle guidance pervades the undergirding approach they are presenting. But, given the morbidity associated with the most obese of the obese there are considerations given to beginning the discussion of these other interventions. The ones you point out. The emphasis is on beginning the discussion when needed. Of course we can debate these. And of course the pharmaceutical industry has their foot in the door here. Maybe more than a foot? But this is not the core emphasis of the guidelines as you misrepresent them.

    Each of your points have validity in that these influences are present and have poisoned the waters. But this has not ruined nor broken the system. Despite woke and leftist/progressive influences many practitioners, probably the majority, do not fall lockstep behind them.

    I must add that one of the core tenants of Western medicine is the randomized clinical trial. Placebos or sham interventions are tried against potentially new therapies. This weeds out anecdotal treatments that are harmful and all too often nonsensical. The so called natural therapies have become a billion$ dollars industry all its own. With no oversight aside from public opinion and advertising this mega-industry rivals "BIG PHARMA" for dominance. I would submit that these OTC, naturopathic, and related therapies are as big a threat to actual health care as what you submit.

    I openly will close with transparency. I have been involved in health care for 50 years. I've seen the good the bad and the ugly. I hear and see the problems. I also on a regular basis hear from patients about their woes as well as their therapeutic successes. I suggest that a major part of the problem is not the system but our desire to live forever, to have a pain free existence, to do what we please, when we please, regardless of consequences and implications.

  • Avatar
    February 2, 2023, 2:18 pm

    Corporations owning “healthcare” have turned medical attention into a product. “Patient centered” (the customer is always right) business strategies have turned the practice of medicine into a menu driven service. Government has made it all a human ‘right’ that government uses to care for society free of ‘charge’ and free from personal responsibility-so long as you relinquish some liberty.

    • Avatar
      February 2, 2023, 3:03 pm

      Yup. "Do whatever you want, and if there are bad consequences, we've got a pill to treat the symptom." (Not the cause, mind you, because then how could we profit off of you?)


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