Chapter 498 - 232: Addictive Dose
Throughout the long history of human civilization, medicine has always been a sacred art, one of life and death, compassion and redemption.
Hippocrates penned his oath, pledging to place the interests of the patient above all else.
In the monasteries of the Middle Ages, monks distributed herbal remedies to the poor free of charge.
However, on this land called the United States, the story took a different turn.
When the first Puritans arrived at Plymouth aboard the Mayflower, they brought with them a devotion to God, but also a nearly paranoid emphasis on individual liberty and property rights.
In this new world, community mutual aid existed, but it was a fragile bond based on shared faith and common peril.
Once the crisis passed, once the wilderness was tamed, a more powerful force would take its place.
That force was individualism and the commercial spirit.
In this land, a doctor was no longer just a healer; he was, first and foremost, a businessman.
His clinic was his business, his medical skill his commodity.
If the poor fell ill, they had to rely on the charity of the church or wait at home to die.
This cruel logic of the free market persisted until the Second World War.
To curb wartime inflation, the Federal Government froze wages.
Clever employers, competing for scarce labor, came up with a brilliant idea to circumvent the regulations.
If they couldn’t raise workers’ wages, they would buy them insurance instead.
Health insurance, this infant born initially as a "benefit," was seen as a benevolent innovation in that war-torn era.
But no one could have imagined that decades later, this infant would grow into a rapacious monster.
In this country, health was no longer an inalienable human right, but an extremely expensive commodity with a clear price tag.
A life-saving pill that costs just 5 US Dollars from the pharmaceutical company could brazenly appear on a New York hospital bill for 500 US Dollars.
The 495-dollar difference flowed into the pockets of K Street Lobbying Groups in Washington, hedge funds in Manhattan skyscrapers, and insurance executives who studied how to deny treatment.
This is the medical-industrial complex.
It is composed of three great mountains: insurance companies, pharmaceutical giants, and hospital groups.
They are intricately intertwined, two sides of the same coin.
Insurance companies, through complex policy designs, decide who lives and who dies.
Pharmaceutical giants, through patent monopolies, turn the hope for life into a bargaining chip for extortion.
Hospital groups, through constant mergers, eliminate competition, turning places of healing into venues for collecting rent.
Every year, they pour vast sums of money into lobbying in Washington.
They bought congressmen, they bought laws, and they bought the power to define what constitutes a "disease."
Within this system, humanity is alienated.
Healing is no longer the goal; cost control is.
It is a meat grinder that devours lives every second of every minute in exchange for profit.
It is so vast as to inspire despair, so solid as to be suffocating.
It seemed no force could stop its gears from turning.
Until today.
On the interstate to Harrisburg, a black Lincoln sedan cruised at seventy miles per hour.
The windshield wipers swung frantically, trying to clear away the blurry curtain of rain.
The tires kicked up muddy water as the engine let out a low roar, like a knight charging at a windmill.
Inside the sedan, a driver was at the wheel while Leo Wallace sat in the back, a copy of the "Pennsylvania Medicine Benefits Transparency and Fairness Bill (Draft)" resting on his lap.
He was looking at the draft, but his mind wasn’t on the words between the lines.
His thoughts drifted back several months, to the night the idea had first sprouted.
Back then, he had been sitting in his office in Pittsburgh City Hall, his mind consumed with the fervent desire to overturn the entire system.
He wanted to get his hands on every part of the medical process—from hospitalization and surgery to check-ups and prescriptions—to establish a completely independent kingdom for Pittsburgh.
"Mr. President."
Leo had asked in his memory, his tone laced with an ambition that sought to devour everything.
"Since we’re doing this, why not go all the way?"
"Why don’t we just create a fully licensed insurance business? Why limit ourselves to a mutual aid fund for pharmaceuticals?"
"Medical services, hospitalization, surgery—that’s where the real money is. If we can control the entire chain, we can bring the costs down completely."
"Don’t bite off more than you can chew, Leo."
Roosevelt’s voice had grown serious.
"What do you think insurance companies make their money from? Denying claims? Squeezing patients?"
"Yes, but not entirely."
"Those are just the means, not the core of their business model."
"The Affordable Care Act mandates that for every hundred dollars an insurance company collects in premiums, 80 to 85 of those dollars must be used for actual medical payouts or to improve the quality of care."
"This means the amount they can use for administrative costs, salaries, and profit is firmly capped at 15 to 20 percent."
"It’s a straitjacket."
"On the surface, this limits the insurance companies’ exorbitant profits. If they want to make more money, they have to make the pie infinitely larger."
"But there’s another key factor: time."
"Time?" Leo had asked, confused.
"Yes, time."
Roosevelt continued.
"From the day the insurance company receives the premium to the day the patient actually gets sick, sees a doctor, the hospital sends the bill, and the insurance company approves and finally makes the payment."