Rebuttal to John Mackey’s Wall Street Journal Op-Ed
“The Whole Foods Alternative to ‘ObamaCare’”
John Mackey’s editorial in the Wall Street Journal is merely a continuation of the myths propagated by the for-profit health insurance and pharmaceutical industries and the right-wing think tanks they fund. His suggestions would take us farther in the direction that has already failed.
For this rebuttal I’ll focus on the following points:
- Healthcare IS a right in other countries. So, what does our Constitution “guarantee?” The European Union’s Constitution includes Health Care as a Right. The U.S. Supreme Court ruled in 1936 that Article II Section 8’s “Promote the General Welfare” applied to Social Security. Medicare falls under this ruling. Though not binding, the Universal Declaration of Human Rights, signed by the United States, includes medical care as a right. (Details and references)
- Does health reform mean a “government take-over?” Ridiculous question but NO! Free markets do not work without rules and an independent arbiter. All Bills before Congress maintain the private sector for delivery of health care, both hospitals and doctors; but include regulations such as protection from arbitrary loss of health insurance and greater transparency. (Details and references)
- Repealing mandates on what insurance must cover & state laws which prevent insurance companies from competing across state lines. Without some minimum national regulations and means of enforcement, companies will incorporate in states with the least regulations and enforcement, leaving consumers vulnerable. In addition, administrative costs for doctor’s offices and hospitals will increase. (Details and references)
- Health Savings Accounts – Why they don’t work. 80% of health care costs for individuals in the U.S. exceed $2,500 and 73% exceed $5,000, so people would rapidly exhaust their health savings accounts. Sick and injured people trust their doctors to make appropriate decisions and neither have the skills for making the decisions nor the availability of data to base such decisions on. High deductibles leads to reductions in both appropriate and inappropriate care, e.g. blood pressure monitoring. (Details and references)
- Medicare reform and finances – Why we will not allow Medicare to go bankrupt. Medicare has done a better job than private insurance companies in keeping costs down. Medicare covers the costliest sector of our population, altogether over 43 million Americans. Private insurance would either be denied due to pre-existing conditions or prohibitively expensive. Medicare pays for all specialty residencies and subsidizes hospitals with a high proportion on uninsured. Without Medicare, besides the human tragedy of seeing our loved ones experience both reduced quality and length of life, emergency rooms will collapse under the additional strain, hospitals will close, and many doctors will go out of business. Medicare’s cost cannot be separated from a health care system whose current projectory is unsustainable. (Details and references)
- Wait times here and abroad (including emergencies) – Mackey’s misleading statistics. Wait times in Canada are far better than reports given here and they are investing vast sums in improving both quality and timeliness of care. Wait times in many other nations with non-profit universal health care are actually quite good. And wait times in the U.S., especially for the un- and underinsured are worse than in many other countries and, even for those with insurance, wait times exist and are deteriorating. (Details and references)
- Medical Liability/Tort Reform – why this won’t solve the healthcare crisis. Malpractice costs are an infinitesimal portion of total health care costs. Up to 100,000 Americans die from preventable medical errors. Just five percent of all doctors are responsible for approximately 40% of malpractice suits. Truly bad doctors seldom lose their licenses. Only about 1/10th of all medical errors that cause death or serious disability lead to malpractice suits. So-called “defensive medicine” is often just an income generator for physicians who own or are invested in labs and radiology facilities. (Details and references)
- Healthy life styles are good but don’t save us enough. Many factors affect health, including genetics, air and water pollution, infectious diseases, commercial food interests targeting children, even in our schools, availability of recreational facilities, physical education in our schools, and longer and longer working hours. Healthy life styles are important; but almost everyone will sometime in their lives need health care. A healthy life-style can often delay the onset of chronic diseases and/or if ill or injured contribute to a more rapid recovery; but it is naïve to believe that healthy life styles can solve our health care system problems. (Details and references)
CONCLUSION: John Mackey doesn’t know what he is talking about. In essence, he is just parroting the myths and propaganda created by the for-profit insurance and pharmaceutical industry together with their well-funded right-wing think tanks.
I don’t wish to support a platform of policies that allow private insurance companies to continue to take undue advantage of average citizens for profit, much less make it easier for them by adopting any of Mackey’s ideas. I am joining thousands of former Whole Foods loyalists to redirect my dollars to support organic co-ops and local farmers’ markets. I hope you will join me.
Joel A. Harrison, PhD, MPH, lives in San Diego, where he does consulting in epidemiology and research design. He has worked in the areas of preventive medicine, infectious diseases, medical outcomes research, and evidence-based clinical practice guidelines. He has lived and studied in both Canada and Sweden. Dr. Harrison is a long time advocate for a single-payer plan. For those interested in learning more go to Physicians for a National Health Program’s website at www.pnhp.org
Dr. Harrison is a Fan of the Whole Foods Boycott Action Page on Facebook.
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September 8, 2009 at 7:14 pm
Can y’all put a share button on this? Would like to post to FB friends, who are about 50/50 on the boycott. They don’t see the harm of Mackey’s position, or the deeper issues (local, local, local; union-busting, etc.)
September 8, 2009 at 9:19 pm
Dr. Harrison, thank you so much for all your research and truth pertaining to Mackey’s editorial in the Wall Street Journal…………….all of us as Americans need to know the truth about health care reform and get past the current scare tactics and misinformation being used to mislead the American people.
September 9, 2009 at 6:47 pm
I’m from the UK and it boggles my mind to see people saying health care is not a right.
Governments protect their people in different ways, some by sending armies off to war, others by treating the people so they can keep their jobs and keep on paying the taxes that help treat everyone. Can’t America do both?
September 12, 2009 at 9:55 pm
Healthcare is NOT a right! It does not have to be provided by any government OR employer for that matter. As far as this wacko president is concerned he wants to provide healthcare for Americans….AT WHAT COST! to further push this country into the ground. We have to be talking about healthcare NOW?? when this country is ready to fall apart..wear are the priorities?
September 27, 2009 at 5:29 pm
Thank you Joel for your insightful analysis.
Willy’s comment is interesting but he does not rebut Joel’s citations supporting health care as a right. Even so, I believe it is the moral and ethical duty of a community to provide coverage to all its citizens. If we have to pay for health care with taxes, then I am quite willing so long as the system is not unduly wasteful. Would Willy want poor people dying in the gutter from treatable diseases?
Republican politicians claim that life is inviolable (until it pops out of the womb). If it is so sacred, then protecting it is a duty which we fulfill even after it is born and even if it costs money.
October 16, 2009 at 11:34 am
I think health care is a right because the sick have a moral claim on us, and because the laws guarantee healthcare in emergencies. What else does a “right” mean?
We’re already paying for lots of other people’s healthcare, through Medicare, the VA, hospital and ambulance company and fire department mandates, etc. It costs us much more than other countries, because our “hybrid” system has accountants and patients and regulators and nurses all working at cross purposes.
October 28, 2009 at 10:59 pm
I will rebut this article. Free markets work. But when you have an arbiter and rules, you end up with corporatism and the current recession. The writer points out that most health costs exceed $2,500. Want to know why? Pharmaceutical patents give drug companies monopolies on certain drugs and they can charge whatever they want. He also points out the longer waiting times for patients in the US. Again, we have government to thank for that. Back in the 1950’s the government gave the AMA complete control over licensing doctors. Because of this, they have created an artificial shortage of doctors in the country by putting a cap on the number they license each year. If the cost of medical procedures and drugs goes down and licensing of doctors is privatized as it was before the 50’s, more people would be eligible for insurance and health care costs would go down.
November 1, 2009 at 2:54 pm
In Response to WonsanUnited:
It is absolutely absurd to believe that any system can function without rules and arbiters of the rules. Without laws and a court system, who should one turn to if ones coverage is dropped arbitrarily and/or delays and denials? Actually, the very concept of a free market is a myth (e.g. James K. Galbraith, “The Predator State”). The AMA does not limit medical licenses. However, foreign doctors to become board certified as specialists have to complete residencies in the U.S., not determined by the AMA; but by the individual specialty groups. On the other hand, we don’t need more specialists and do need far more family practioners. In addition, we have approximately the same number of doctors per capita as many other countries. Unfortunately, our doctors spend hours each week dealing with the numerous private insurance companies, whereas doctors in countries with universal non-profit systems of health care actually have more autonomy and, thus, can devote more of their time to actual patient care. Regardless of how costly doctors and/or drugs are, our private fragmented healthcare system will require doctors offices and hospitals to maintain excess staff to deal with multiple negotiations, billings, etc., costing about 10% of gross billings and the insurance companies will each have their own negotiators, actuaries, advertising, hotlines, staff to pay bills, overpaid executives, and, of course, dividends to share holders, altogether taking a minimum of 15%. Thus, reduce the costs of doctors, hospitals, and drugs, and still 25% or more of every health care dollar will go to an unnecessary fragmented system that neither improves the quality, access, or timeliness of health care, just takes their cut.
Health care does not function as a market commodity. Even using the abstracted concepts of a free-market only work when appropriately applied. An excellent, but pricey book is Thomas Rice, “The Economics of Health Reconsidered (3rd Edition), available through Amazon, etc. Rice goes through all the traditional assumptions underlying a market model and shows how they do not apply to health care.
What is fascinating is that people continue to try to push a market approach to healthcare while completely ignoring how other countries with various approaches to universal non-profit health care have developed systems that cost less, cover everyone, and supply high quality health care. Of course vested interests try to frighten us with lies, distortions, etc. concerning waiting lists, etc. However, anyone who actually takes the time to study all the available data would discover that health care is quite good elsewhere. Even the claims that cancer survival is longer for certain types of cancer in the U.S. are false. Because we do far more screening, we discover more cases of “cell dysplasias (pre-cancerous states),” Most of these “malformed cells” die out rather than go on to become cancers. Some cancers do not advance. Just to make it simple, if 40% of dysplasia’s found from pap smears would just die without advancing to cancer; but all were removed, then those who were alive five years hence would have been alive regardless (e.g. Laura Esserman et al, “Rethinking Screening for Breast Cancer and Prostate Cancer,” JAMA 2009, 302(15): 1685-1692).
Canada, Sweden, Germany, France and other countries with various forms of universal non-profit health care have as high or higher rates of literacy than the U.S., are vibrant democracies with higher voter turnout than in the U.S., have strong economies; yet many Americans believe that all these people with different cultures, histories, languages, etc. all choose to continuously support health care systems that subject themselves and their loved ones to substandard delayed care. Does anyone really believe that all these and other countries are that masochistic and/or plain stupid? It is impossible to believe that they are not aware of the American system of healthcare and how it works. So why don’t they simply vote for systems more similar to ours? Maybe because they know their systems are better than ours despite the propaganda pushed by vested interests in this country. Besides having lived in Canada and Sweden, I have spent over 25 years studying health care. We rank high on medical errors, hospital-based infections, overcrowded emergency rooms, etc. In addition, counting the uninsured, the underinsured, and those who temporarily between jobs lack insurance and at least 1 in 3 Americans at some time during a year does not have adequate coverage. Finally, at least 65% of all health care costs in the U.S. are funded directly and indirectly through taxes. It is absurd to believe that any system is free market when subsidized by 65% or more.
The author is partly correct on one thing, our patent laws and procedures for approving drugs is flawed. The drug companies grossly exaggerate the costs of bringing new drugs to market. In addition, much of what they claim as research is market research and, finally, far more me-to drugs are marketed than new ones (e.g.
Public Citizen. “Rx R&D Myths: The Case Against the Drug Industry’s R&D ‘Scare Card,’” July 2001. http://www.citizen.org/documents/ACFDC.PDF )