Health care is a boondoggle. Ever since Nixon put his slimy stamp of approval (and lack of oversight) on "Edgar Kaiser's Permanente thing" back in 1971, the system has moved continuously towards prizing profit margin over all else.
Kaiser was my father's company's primary competitor. Once the HMO thing was created by Kaiser/Nixon (my grandmother knew Nixon, grew up in the same neighborhood), everyone wanted in and my dad's hospital management company dumped all their hospitals (13 of 'em) and started an HMO shortly before 1980. They all saw the hospital biz as going down the tubes at the time, with HMO's the obvious way to go and since Kaiser already had a massive head start and was raking in the profits they made it look like a gravy train you merely had to join and making a fortune would be guaranteed.
It's what happens when people trained and licensed as accountants get to be in charge of medicine (my dad was a CPA). In all his discussions of the business I heard, none involved any patients, er, "clients." After all, what do patients have to do with for-profit healthcare besides drag down profits?
But don't worry, he and folks like him got their Karmic rewards as we all eventually do; I'm one of the few children among the folks running that scene who isn't totally fucked up, in rehab, in prison, or dead (or even worse, part of the next generation of douchebags; thanks magic mushrooms!). It's probably because one day I just split and started my life over from scratch, dead broke and living in a tent in the woods with my unusually hardy girlfriend (and I've lacked access to any healthcare since 1995, ironically). My gf was hardier than I was, frankly (she being born and raised in rural Germany, I from a SoCal suburban Hellscape) but she did manage to whip me into shape after a while.
I walked away from it all back in 1995 and have been following my Vision/passion/bliss ever since, but only now in 2011 do I think I'm finally on the cusp of building something real and lasting and that might get me some health coverage, lol. It was harder than I ever thought I could endure, but I guess in my own way I'm an example of the American Dream still working out, more or less. Once you spend a year living in a tent in a subtropical environment (meaning "constantly wet") most other things start to seem relatively easy to handle. I can't recommend it to anyone though since it was so intensely harsh for so long. I did my time working total shit jobs (even literally crushing rocks for $4.25/hr in '95; if you need a job in the next 45 minutes, it's an option) so I was off and running on the "get rich slow" track, lol.
Oh, and for a real potent dose of irony, how's this: When still in business, my dad shelled out lots of money to lobbyists to get legislation passed in CA that placed limits on punitive damages for malpractice cases. It passed, and such damages are now by law kept rather low. Stock prices for CA HMO's rallied! Cha-ching! Fast forward 20 years, former CEO of the HMO needs a kidney transplant; gets a couple (first one didn't take), but second hospital nearly kills him with demonstrable gross negligence. He needs to relearn how to walk and all that (slight brain damage from too-low blood pressure after surgery) and has a solid malpractice lawsuit. He talks to lawyers who agree his suit is valid and a sure winner but caution him that the actual damages he can recover are capped by law. Guess who helped get that law passed? Isn't life just amazing sometimes?
So, maybe the American Dream is the chance to make our lives the way we want them to be, but there's no guarantee that we'll succeed or that what we want won't ultimately be what does us in. The American Dream, then, is the right to succeed or fail in our own way. I demand
the right to fail!
If life is a minefield (and it most certainly is, plus we're all walking through it blindfolded), then the American Dream exemplifies at least a (relatively) wide-open minefield that allows us to go in any direction that attracts us whereas most others try to to force people to stay on a path arbitrarily chosen by those in positions of power or as a function of the social class one is born into. It sucks to take the chance and lose, but it's better than never being allowed to take a chance at all.
As it says in that most Holy of Holy Books (The Book of the Subgenius), If I can't whup it, I'll go down!