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It might surprise you to know that the word pharmaceutical comes from the Greek word "pharmakon" which has the dichotomous meaning of both "cure" and "poison." If you've seen a prescription ad on television, with it's rapid-read list of deadly side effects, than you'd agree that pharmakon is the perfect root for big Pharma.
It's the perfect word for Dr. David Gratzer's prescription on how to "cure" America's health care dilemma. In fact, that's the very title of the book: "The Cure: How Capitalism Can Save American Health Care" Though it comes with a 2006 Copyright date, Dr. David Gratzer's book could easily find its way in the hands of many Americans who are following the progress (or lack thereof) of Obamas plans to insure most of America. The book could also mislead many of such readers.
Grazter brings a lot of intellectual weight to the debate. The combination of his doctoral status and the hard data he presents in this book would probably be enough to give credence to his arguments for most people. Gratzer wants a free-market health-care economy so that premiums can be driven down and service quality be driven up. He knows the arguments against this – the affordability of insurance under this model – and so he takes aim at it. Because he wants our government to take a "hands-off" approach, he also takes aim at that as well. His fifth chapter "Insuring America" is where he gives considerable attention on disclaiming the points put forward by his opposition. It is this chapter that I found the most troubling.
Grazter knows that when you get into the trenches of "Uninsured America" the pictures aren't pretty, which is why he avoids them and takes the approach of looking at this population through the lens of numbers and statistics. This approach, of course, makes it easier to emotionally detach ourselves from the scenarios he presents. It also makes it easier to rearrange numbers to satisfy his case.
His first target is what he calls "Myth 1: The Number of the Uninsured is Spiraling Up". He uses percentage ratios to show that the increase in those who are uninsured remains constant with the overall population increase. His conclusion then is that the increase is actually a plateau of uninsured Americans. Yes, if we're looking at ratios. However, a perspective-shift back to raw numbers (not percentages) allows us to also conclude that the because of the population increase in the US the volume of people without insurance continues to escalate with it. So which number-perspective do we rely on to truly diagnose the health-care climate in the US? Percentages or Raw Numbers? If the agenda is to suggest that there is no crises at all but rather a "stabilized problem" then we go for the percentages. If the agenda is to present an argument for an increasing crises then we focus on the actual body-count, which went up by 3,000,000 people over a period of seven years.
This example sums up a major part of my dilemma with Gratzer's book: How objective are his numbers? Or rather how objective is he being while exploiting the numbers? Too often the book feels like propaganda masquerading as objective data. Like Deborah Tanner described in her excellent book "The Argument Culture", Gratzer spins data to make his oppositions arguments seem baseless. While this strategy is common in most debates, such spin-strategies over a topic as important as this one seems inappropriate.
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Another example can be found in Gratzer's debunking of "Myth 3: The Uninsured are a relatively homogeneous group – poor". It is interesting that he uses the word "relatively" in his heading because a few paragraphs later, he forgets the term when he makes the statement that "$50,000 may not be an enormous sum of money; but the income level is certainly far above the poverty line." His case here is that 1/3 of the uninsured make upwards of $50K a year and are therefore uninsured by choice since, in his opinion, this is enough to afford health insurance. What Gratzer selectively forgets is that "poverty-level" is also relative term, and that many people who bring in a "middle-income" still live under subsistent conditions.
Gratzer wants to use hard-data as a crunch, but data such as demographics are isolated and static and do not reflect the dynamic quantitative or qualitative variables. These variables change from person to person and therefore makes it difficult to conclude whether a person earning $50K a year is uninsured by choice or because financial concerns eliminates the choice. For instance, does this person have a child? How many and what ages? Expenses for children increase and decrease according to the age of the child or children. Where does the person live? What State? What City? What neighborhood? What is the cost of living in a given city, and, in a given neighborhood? In other words, what is that person paying in Rent or Mortgage now? And what will that person pay if they move to a different neighborhood? Does the person live in a region where heating costs are high during winter periods? All these factors and others can convert a middle-income into subsistent living. The effects then being even more dramatic as the income decreases.
Finally, there are times when Gratzer's penchant for "spin" results in shameless deception. For example on page 156 under "Safer Drugs" he writes the following: "Here's the FDA's dirty little secret: clinical trials involve a relatively homogenous group of healthy individuals who collectively are totally unrepresentative of the people who actually take pharmaceuticals." Uh, wouldn't that be the "dirty secret" of pharmaceutical companies and the CRO's employed to conduct clinical trials? This type of shabby spin, coupled with the sensationalist language, seems, quite frankly, suspicious since this is a Doctor who should know better.
Seeing as how this is Gratzer's prescription for a healthier America, then just to be on the safe side I better warn you of some of the side-effects of this book. The excessive spin in this book could result in dizziness. Readers may experience acute nausea and vomiting. If you experience any of these symptoms talk to your doctor... just not this one. |
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