File: c:/ddc/Angel/Papers/SickHealthcare.txt
Date: Sat Aug 16 19:43:39 2008


Healthcare: a sick business
===========================

Healthcare is a large business in the US: 16% of GDP in 2007.  If that
is gobbledygook for you: roughly one in six workers gets a pay check
as part of the healthcare business.  

The next thing to consider is who are the consumers of the providers
of healthcare?  The rule of thumb is that 20% of the population
consumes 80% of the expenditures.  Lets work these numbers a bit.
Just relax before the numbers are in.  

We will concentrate on those that need extensive care, the 20% of the
population.  This segment uses the services of 12.8% of the workforce.
Thus, we get, roughly, that each salaried person working in healthcare
services 3.1 people that need extensive care.  Still the true paradox
is that in spite of the abundant amount of care the US ranks in the
30-ies in international comparisons.

Other countries are more efficient.  Japan spends only 8% of GDP,
which translates into: 6.2 people are serviced by a salaried care
giver (instead of 3.1) and they have better results.  The excessive
administrative overhead in the US does not explain the difference.
Correcting for the 30% administrative overhead in the US, we still get
only 4.5 patients serviced in the US per salaried care giver.

Lets have a look at the quality.  The clumsiness of the medical
profession is legendary as well as pathetic.  Amputation of the wrong
leg, surgery on the wrong side of the brain, tools that end up inside
of patients after surgery, babies that die due to wrong drugs, nurses
who are numerically challenged and calculate dosages wrongly,
etc. These are well known anecdotes.  We have now more than anecdotes.
The Netherlands reported hard-nosed figures for 2007: 1700 people/year
die due to medical errors.  (The country's population is 16M).  To put
this figure in perspective: the country is up in arms already for
decades about traffic fatalities, which are less than 900/year.  But
the truly strange thing is that the Dutch government simply ignored
the report about the 1700/year medical fatalities.  Even stranger is
that the medical profession is silent about their lack of
professionalism.  A design or manufacturing defect in cars lead
immediately to recalls.  The medical profession is however immune to
accusations of its systematic failures.

The reverse happens as well.  You have chronic pain, you are old, you
have had enough of life and you want to die.  The constant pain makes
existence a hell.  Your physician will tell you that you are
depressed.  Why?  As long as you are alive you are a great source of
revenue.

The relationship between smoking and lung cancer was first documented
in 1929.  Publication after publication reported the same thing.
Thirty-five years later: the Surgeon General of the US recommends:
stop smoking.  One million people still die each year from lung
cancer.  What are the physicians doing about it?  Lobbying to get
tobacco classified as an illegal drug?  No, they keep earning money
from treating their lung cancer patients.

Is your bank still using hand written records of your account?
Electronic medical records have been discussed for decades.  Their
lack off is responsible for endless communication failures and blocks
the usage of power tools for diagnosis, disease management, research,
and is plausibly the key cause of systemic inefficiencies.

Humanity grew from 1.5B people in 1900 to 6B in 2000, an unprecedented
increase in the history of mankind.  Each global problem we have
witnessed since 1900 is directly or indirectly connected with this
cancerous growth.  Did physicians participate in the discourse about
overpopulation?  No, they kept earning money by delivering babies.

Finally, lets not forget that the medical profession has the only
professionals who actively participated in genocide: killing Jews in
Nazi Germany.

So why is the medical establishment getting away with their atrocious
behavior?  It is the flip side of the 80-20 rule; 80% of the people
consume only 20% of the expenditures.  Healthcare is not on the radar
of most people beyond obligatory yearly checkups.  On the other hand,
those that need extensive care are in no position to deal with the
anomalies they encounter.

It is long over due that we - the healthy ones - are taking vigorous
action to clean up the mess in the medical "industry".  And if we may
ask: why are our candidates mum about this greatest boondoggle
humanity ever produced?