Fixing U.S. Healthcare – Annual Summary & Review 2021

2022.01.03 Caduceus-Flag-Map

Fixing U.S. Healthcare blog each year posts an annual review.

This blog’s year can be summarized in two sentences:

  • Along with many other writers, this blog has recognized that President Biden’s handling of the coronavirus pandemic is a test – of deliberate governing versus laissez-faire, of Big Government versus anti-institutionalism, of individualist freedom versus shared sacrifice for the common good.
  • Healthcare reform is, simply put, political reform, civic reform, and social reform, and can proceed only as a component of and by-product of those three basic reforms.

Here are highlights of the most-read posts this year:

Guest contributor Michael Stehney M.D., M.P.H. wrote: In order to do good, empathy, like knowledge, is necessary but not sufficient. We know perfectly well what a more effective, efficient, and equitable health system looks like. . . Augustine, a Neoplatonist before coming to Jesus, tells us in Confessions that the will must be brought to bear as well. But the will, he says, is divided between old habits we want to cling to, and new ones we wish to have. In the case of healthcare in the United States, entrenched interests are perfectly happy with the ‘old habits . . . So people of good will must keep working to enlist us all to make the changes necessary for a more just and free society. From that will follow a healthcare system that is efficient, effective, equitable, and affordable. Not before.

This post was a response to a challenge by fellow bloggers at Academic Masters blogsite to develop a proposal for healthcare reform. Fixing compiled elements of past posts to analyze the problem. It made the point that reform has two components. First is the “routine” component, which is standard system process improvement based on Walter Shewhart’s model, now used in every industry. That’s the straightforward part. The harder part is political, civic, and social reform (See Pointing Fingers, below).

This post reviewed the “racial” argument that inferior races don’t deserve healthcare, and that providing it to them would “take away” an equivalent amount from the deserving (superior white) race, or at least tarnish its value as a (white) mark of privilege. This post briefly summarized Historian Heather Cox Richardson’s book tracing post-Civil-War perpetuation of racial oppression. And it commented on Economist Health McGhee’s book exposing the fallacy of zero-sum thinking and the dire economic cost of perpetuating all forms of racially based deprivation.

  • Pointing the Finger at Whom to Blame, Part 1 & Part 2 – August 5 & 11

These twin posts examine the underlying maladies in America that block constructive good-faith solutions to accessible, effective, costworthy healthcare. Part 1 addresses the two political evils of imbalance between corporate and citizen power and of the disenfranchisement of key stakeholders in our polity. Part 2 addresses the fracturing of civic society into four rivaling camps.

This blog continues to embrace the goal of examining the inexorable rise in healthcare costs. Healthcare spending is expected to have exceeded $4.2 trillion in 2021 (18% of GDP). Meanwhile, the U.S. healthcare system continues to underperform.

This blog has increasingly seen cost growth and underperformance as symptoms of underlying rifts in our politics and society, bordering on outright social pathology.

Fixing U.S. Healthcare aims to continue providing a clear-eyed view of healthcare reform in all its facets from a variety of perspectives into 2022.

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Image Credits

Title:  Flag-Map 1959

By: DrRandomFactor, CC BY-SA 3.0  via Wikimedia Commons


Title: Caduceus

By: Rama, Public domain, via Wikimedia Commons


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