Do you remember Vasili Alexeyev, the Russian Olympic Lifter who reigned in the super heavyweight class from the late 1960's till the late 1970's?  I was in college around that time and was taking a course in Russian History.  My professor used Alexeyev to as an example of Russian ingenuity.  In the Soviet system, all athletes were amateurs, since the concept of a professional sportsman was evil capitalism. However, the Soviets did reward athletes with monetary awards if the athlete broke a world record.  Our professor pointed out that in practice sessions, Alexeyev would often shatter the existing records by several kilograms, but during an official event, he would break the record by the smallest allowable margin.  The reason was simple.  If Alexeyev broke the record once by ten kilograms, he would get one bonus, but if he broke it ten times, at one kilogram per event, he would receive ten times the bonus. In this way, Alexeyev was more of a businessman than an athlete. Sports was only a means to an end, and that was cash, not fitness.   

In the USA, we’ve managed to do a similar thing with medical care with a perverted use of Yankee ingenuity.  Our doctors are paid by the procedure.  There is no money to be made with healthy patients.  Our hospitals make money by filling beds and running expensive tests with exotic equipment.  Studies have proven, time and again, that areas with a dense population of hospitals and testing labs have higher medical costs but no better health of the citizens that areas with fewer hospitals and testing labs.  It stands to reason that when a hospital buys a ten million dollar machine, it expects a decent ROI, in the year end report to the stockholders  Our pharmaceutical companies are run on a business model of pushing product out the door, or meeting sales goals, or  hitting Wall Street expectations. I’ve read the mission statements of some Big Pharma companies and laughed out loud, especially when I hear them try to tell me that their mission is to help Americans lead healthy, productive lives.  Yeah, right.  Do they really expect me to believe that when a sales rep for their company is being evaluated for a raise or promotion, they track how many lives were improved?  Please, spare me the bullshit.  Big sales numbers bring promotions and higher earnings.  Nothing else matters.  That’s the way it is with Ford Mustangs, Vegematics, Jell-O Pudding, and Bextra.  You remember Bextra?  Pfizer paid the largest criminal fine in U.S. history: $1.19 billion for illegal marketing of this drug.  But Pfizer sold a lot of Bextra with the illegal marketing and the fine was not enough to offset the exta profit, so Pfizer complied with it's real mission statement: sell more product.

Of course, all this contributes to health care costs.  All the television ads for prescription drugs you watch, all the hospital billboards you  see, all the insurance company brochures you get in the mail, and all the lavish “educational” meetings provided by drug companies to doctors and other health care professionals in places like Bermuda, Las Vegas, and Miami all contribute to the high cost of health care in America. 

It's amazing, isn't it?  In America, we’ve managed to do what no other Western industrialized nation on earth has done, and that is make medical care a business.  In the USA medical care is just a means to an end, and that is cash, not wellness.