Your browser version is outdated. We recommend that you update your browser to the latest version.

In reflection on Dr. Walter Henze’s humoristic shoe store analogy in his guest editorial about funding of the needed upgrade of the North Valley Hospital in Tonasket WA, I trust the community appreciates Dr. Walter Henze’s writing, because democracy depends on understanding, produced by research, a free flow of information, a free press, and a vigorous discussion in the community.  This is of course why constitutional laws in the US and other democratic mixed economies guarantee freedom of expression, of assembly, of religion, and most importantly, the freedom of the press.
Dr. Henze and Editor Gary DeVon of the Gazette-Tribune, have a responsibility to their profession and to their businesses, but the guest editorial prove, that their overriding responsibility is to the society they serve. 
Using analogies and humor is often the best and only way to address serious issues in our society to build a bridge of dialogue between people about issues facing society, such as the healthcare system. 
Dr. Henze’s writing, and Editor DeVon represent democracy at its best, and hopefully will spur vigorous discussion in society about the US healthcare system at large, and about cause and symptoms. Treating symptoms can mask, but does not cure disease.  
The funding problem of North Valley Hospital in Tonasket is a symptomatic example of an underlying disease in the US healthcare system and hence the US economy, causing excess consumption of healthcare at the expense of investment in the factors that are needed to create good health, - healthcare that contradicts it own purpose.   
The problem of course is that resources can only be used in one direction at the expense of other needs in society.  The reality is that lasting social satisfaction, good somatic and mental health, and a sound ecology, entirely depends on investment in sustainable economic production in business that distributes wealth in local economies such as Tonasket and Oroville (not in China) via better paid employment - rather than on welfare or crime.
Hence, excess consumption and spending in healthcare can only be at the expense of investment in the factors that create good public health, such as research, finding new ways to use fewer resources, education, infrastructure and keeping levies, dykes and bridges from collapsing.  In a mixed economy such as the US, the private sector’s role is to invest in economic production in business. Government’s role is to provide those services the private sector fails to provide, including identifying issues and intervening in the economy before problems escalate into social, economic and ecological adversity.  Just as safe air travel depends on the FAA and air traffic control; a healthy society depends on government to meet its fundamental task in a mixed economy.
Consider that the approximate average per capita spending on health care in the OECD countries is $2,550; Sweden spends $2,925, Canada $3,165, both with high quality government funded universal healthcare. The US spends $6,600 per capita, $2,900 more than Canada, and $3,275 more than Sweden.  Even with this spending, 47 plus million Americans have no access to adequate healthcare, (causing havoc in emergency room), and hospitals such as North Valley Hospital are scrambling for funding.  The insurance cost; somewhere between $10,000 and $13,000 per family is a damaging burden for US industry and families, and a hence a disadvantage for the US economy.  Applying Sweden’s consumption rate to the US would mean the US would consume roughly 1 trillion (twelve zeros) less in healthcare, which could in principle, be spent in other directions that create good health, research, education, housing, and infrastructure. To put some perspective on the 1 trillion, the federal Department of Education’s budget for 2008 is 87 billion, defense spending roughly 500 billion, NASA 17 billion, and the National Science Foundation only a sordid 6 billion, 1 trillion would buy              5.7 million houses at a $195,000, not to consider how many could go through college and university.       
Indeed, comparable consumption and spending statistics between different economies doesn’t present all facts, and the scientific rule is; that there may always be other explanations and more research and understanding needed.  However, the reality is that Canada and Sweden is example of economies that consume significantly less in healthcare but still via a “single payer” government system ensure everyone, despite income and social status, access to advanced healthcare.  Also realizing, whether provided by private sector or via government through taxes, it is a nation’s industry and economic production that ultimately must carry the cost of healthcare in competition with other economies.  What often seem to be forgotten is that the higher consumption of healthcare in the US than in other economies makes US industry less competitive in the global market place, therefore US loses jobs to other economies.
For example General Motors, Ford and Chrysler in the US are at a disadvantage compared with industries in economies where consumption of healthcare and therefore cost is lower.  US workers are at a disadvantage compared with a workforce such as in Sweden that can change jobs and move without losing healthcare benefits, and risking facing despair because of illness.  So where do we search for the causes - rather than treating the symptoms masking the disease? Don’t look to the private healthcare and insurance industry; they are doing exactly what the private sector is supposed to do – investing,  in pursuit of profit.  Look to the government. In a mixed economy it is government’s obligation to intervene and address that which the private sector is unable or will not provide.  It is reasonable to conclude that failure in the US healthcare system is an example of government’s failure in a democratic governed mixed economy or systemic failure.  “When the ‘air traffic control’ fails, the passengers are in danger.” To be clear, Canada and Sweden are used as references, and are far from flawless and nothing is - not even I.  Political and guild patronage, excess consumption, waste, trivially sick treated at the expense of the real sick, and far too little invested in preventative healthcare and in research, is a huge problem.  It is a matter of degrees of imperfection.  In pursuit of profit, the private sector is now lobbying hard to convince government and the public in Canada and Sweden to privatize healthcare.    
Eventually, problems and solution in any healthcare system is to be found in government, not in the private sector.  Eventually it is the voters that put fellow members in government, and hold them accountable.  Hence, not to forget, that the behavior in government reflects the level of understanding and the moral and ethical values in society. Ultimately, social conditions and essential services such as healthcare, research and education, eventually is a matter for the voters, and must be part of a fundamental discussion in society about what kind of society it wants to become. Dr. Henze’s writing should spur such discussions.  It is my analysis that US’s excess consumption of healthcare is creating disparities, and leaving fellow Americans without access to adequate healthcare, encouraging greater reliance on welfare, and promoting a higher incidence of crime.  That only weakens the US – a sort of democratic failure.
In an unprecedented and increasingly unstable world, I am concerned for a healthcare system and other factors in the US economy that weakens US standing and respect in the world.  For me it is a personal concern, because if it wasn’t for the intervention of the US in the Second World War, I would not have been able to write this.  President Eisenhower warned of the effect of the ‘Industrial Military complex’, likely today he would also have warned for the ‘Health Insurance Industry Complex’. New thinking, leadership, increased understanding and vigorous discussion is needed. Dr. Henze and Gary DeVon should spur such discussion in good democratic order. Use it or lose it; eventually democracy and good health depends on voters’ understanding and involvement. The US and the world depend on it!      

Kelowna October 9, 2007

Kell Petersen