The Weakness of Private Enterprise

Let me start out by saying that age is creeping up on me and my perspective on this issue is changing accordingly. In the last few years I lost my mother to an accident but not before a long fight and stay in intensive care. I have had two good friends be diagnosed with terminal cancer and watched them fight both our system and the disease with equal determination. I have some very minor health issues associated with aging that I am currently dealing with as well. I have another close friend whose wife spent the last six months bouncing from one surgery to the next and is now permanently disabled at a very young age because of a total lack of accurate diagnosis and control of prescription drugs. She was basically poisoned by taking prescription medicine prescribed by two different doctors for two different ailments; no one seemed to catch the fact that they were poisoning her because no one was in charge of her overall care to the point of comparing notes from all doctors involved. None of this makes me an expert on medical care but it does give me a lot of insight into our current system and it absolutely stinks.

My mother became a victim of a hospital so wrapped up in profit making that it has absolutely lost sight of taking care of the health of its patients. Don't get me wrong, I met many nurses, and a couple of doctors who were both dedicated and skilled at what they do and did literally everything in their power to help her. However, the system as a whole which is the deciding power in medical treatment, is so fragmented and splintered into specialized areas that the patient as a whole is not the prime consideration. What is a primary consideration is the maximization of profits that can be made from understanding and manipulating medicare payments. After a visit with a senior care lawyer we came to realize how to fight this tendency but it is widespread and pervasive and I would highly encourage anyone going down this road that they first consult with such a lawyer to understand their rights. I am not exaggerating when I say their life as well as their financial security depends on it.

As is my tendency, I have spent a lot of time lately trying to understand problems that I find in front of me. After doing a lot of research reading books, white papers, and research studies on Cancer two things have become clear to me. Cancer is another age related disease. It is becoming more prevalent because we are living longer, which is a testament to improved health care in general. Also, we are concentrating on the profitable part of treating cancer instead of the unprofitable policy of curing cancer. In fairness, doctors for a long time attacked Cancer with the tools they had at hand.

Surgery was the first option as removing the Cancer before it spreads is still a viable opportunity. Unfortunately, what we didn't understand was what Cancer was or how it spread so the early attempts treated it like an infection. Removing Cancer and all surrounding healthy tissue became the norm for many years and had some success if caught early enough. The problem is that it is not an infection that spreads to surrounding tissue. It is a DNA replication mutation and it spreads on a cellular level through the bodies numerous circulatory systems.

Oncology is the practice of using chemicals or radiation to kill the Cancer cells. Again, this practice works if done early enough although the damage to healthy tissue is also massive and largely uncontrollable. The delicate balance between killing the Cancer and allowing the patient to survive is at the heart of all Oncology and has been a delicate balancing act for many years. It is also a horrendous and brutally exquisite torture. Again, it was practiced for many years before we even understood what Cancer is or how it spreads. It is worth noting that the two main catalysts for cell mutation (which we now understand is the basis of all Cancer) is exacerbated and often CAUSED by the introduction of chemicals and radiation. In other words, the cure is also the cause of future Cancer in many cases.

All of this is almost the natural progression of how science works. Theory is followed by experimentation which produces a new theory followed by more experimentation. However, and this is a key point in my mind, eventually we have to understand a cause before we can develop an effective treatment. In the case of Cancer we did not concentrate on cause as much as we concentrated on treatment of symptoms. There are two reasons for this, doctors had patients who needed treatment immediately and the only way they could do that was with the tools they had at hand. The immediacy of the need for treatment outweighed the need for taking the time to understand the cause. The second reason is less noble and more discouraging. There is no profit in research for understanding cause without a payoff at the other end with a profitable cure.

Right now, in our current profit based system there is a large and growing profit in treating the symptoms of Cancer. There is a small and less effective amount of research into cause which is why we now understand it is a DNA replication problem to begin with. However, over the last century of research 95% of the effort and financial support in Cancer research has been put into treating symptoms. Five percent has been toward researching cause. There is a great struggle right now to put more emphasis on the gene research needed to change the DNA replication problems that cause Cancer but it is a slow and complicated process. There have been great discoveries wherein a methodology of how to attack the root problem with substances that alter the DNA structure itself have been developed. Unfortunately, the Cancers this has been successful in treating often evolve in such a way that a new substance is needed fairly quickly. In other words, it is an expensive and complicated process without a large financial payoff down the road. Drug companies have little or no interest in developing gene structure manipulation that is soon ineffective. The expense is in the research and not manufacture or marketing of the substance itself. Add to that the fact that the cancer cell often evolves so that the treatment is no longer effective and we begin to see why drug companies are reluctant to invest in such research. In other words, it is not profitable.

In a system that is built around profit, we have little hope of actually financing the research needed to cure Cancer. Therefore, for the immediate future we will continue to treat its symptoms. Private industry does many things well but it has never and will never do things well that are not profitable. Perhaps one day we will realize this. That idea at its core is why I believe we need to change our basic idea about health care in this country.