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[Part of a series, this essay looks at some ways people make money in the context of Healing America’s Narratives: the Feminine, the Masculine, & Our Collective National Shadow — Now available]
What could possibly go wrong when the tools and systems of war, violence, injury, medical services, death, and corpse disposal are profit-driven?
Reminder: The elements of the collective national Shadow of the United States we work with in this series include ignorance, arrogance, fear, bigotry, violence, greed, excess, bullying, and untrustworthiness.
Two of America’s most powerful and profitable hybrid industries stand out as exemplars of America’s collective national Shadow. The insurance-pharmaceutical-medical-government-financial-lobbying industry (IPMGFL), euphemistically referred to as health care, fabulously succeeds in providing the most expensive services in the world for the ill or injured, fortified by the intersection of ignorance, arrogance, fear, greed, and excess. Its older cousin, the military-industrial complex, about which President Eisenhower warned us, adds violence to the Shadow element blend. Beyond making profits for defense contractors, it also succeeds in creating new customers — victims of war and violent crime — for the IPMGFL industry.¹
Just to be clear, the above is not an indictment of the dedicated souls who actually provide medical services to us when we’re ill, injured, or otherwise caring for our health and wellness. The majority of them are overworked and underpaid subjects of the IPMGFL. Nor is it an indictment of those who serve in the U.S. military, whose starting salary as an E-1 in 2023 is $1917.63 per month.²
Rather, we are pointing to a system (a set of beliefs, relationships, behaviors, and objects) that allows specific groups of people — corporate officers and shareholders — to profit from the manufacture of weapons of various sizes and types of destruction, to profit from rebuilding the infrastructures destroyed by those weapons, to profit from the mental and physical health services provided to those who are injured by those weapons during both war and the normal everyday violence among Americans, and to profit from the disposal of the corpses of those who are killed by those weapons (and who were fortunate enough to have had someone who cared about them).
Every healthcare system on the planet — including America’s — pays its nurses, doctors, technicians, aides, and others who directly serve patients. Every system pays officers or administrators to lead and manage operations. Every system pays for the infrastructure — buildings, vehicles, supplies, equipment , and research—that modern medicine requires.
America’s for-profit system adds the requirements that top officers of the pharmaceutical, medical, and insurance corporations are paid excessively, and that the shareholders of those pharmaceutical, medical and insurance corporations receive their dividends. When we get our bills — whether for the birth, the appendectomy, the chemo, the hip replacement, the annual physical, or the drugs that might accompany any of these—they include enough so that we collectively cover those C-suite salaries and bonuses and the shareholder dividends.
To borrow and revise another industry’s marketing question, “Is this any way to provide ‘health care’? You bet it’s not.
Again, to be clear, those who run large (or small) organizations — whether not-for-profit or for-profit — and who run them well, should be reasonably and well compensated for their work. Which, of course, begs the questions, “What do ‘reasonably’ and ‘well’ mean, and who gets to decide?” More often than not these questions are answered via market analysis — what are folks in similar positions making — which is useless, since analyzing the market is to use the status quo in order to evaluate the status quo. The status quo is fine — according to the status quo. No problem here.
A more reasonable approach might be to step back and look at the whole system — perhaps the whole of society with all its systems — in its current and historical iterations, and ask something like, “How much money is needed for basic needs, how much for some additional comfort and a vague sense of security, how much for luxurious living and a financially worry-free life, and beyond what amount do money and other asset accumulations become excessive?
While some of these questions point to objective reality — especially initially (what does a family or an individual in a given neighborhood need for food, clothing, shelter, etc.), they become increasingly subjective. What feels luxurious to one may feel basic to another. The problem is further exacerbated by the historical American trajectory that values money and things over people. Think enslavement and Indian removal. Think defense contractors, their D.C. lobbyists, and the physical and mental struggles of many combat veterans.
What could possibly go wrong when the tools and systems of war, violence, injury, medical services, death, and corpse disposal are profit-driven?
Take a look around.
The answers are there.
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- Among many sources: Harvard T.H. Chan School of Public Health, “The most expensive health care system in the world,” 2020, https://www.hsph.harvard.edu/news/hsph-in-the-news/the-most-expensive-health-care-system-in-the-world/; “President Dwight D. Eisenhower’s Farewell Address (1961)” https://www.archives.gov/milestone-documents/president-dwight-d-eisenhowers-farewell-address; Samuel Stebbins and Evan Comen, “Military spending: 20 companies profiting the most from war”, USA Today, February 21, 2019, https://www.usatoday.com/story/money/2019/02/21/military-spending-defense-contractors-profiting-from-war-weapons-sales/39092315/.
- https://www.military.com/benefits/military-pay/charts
Healing America's Narratives 