When health and profit
Meet and clash,
Never bet
Against the cash.

America’s No. 1 growth industry is health care. No one has yet found No. 2. This preeminent role is not due to deadly epidemics, environmental meltdown, or massive public education. It’s due to greed.

Greed drives pharmaceutical companies to finagle with patent laws, doctors, and Congress to maintain their destructively high prices and profits. Greed drives nonprofit insurance executives to convert to for-profit status and thereby snatch up tidy bonuses. Greed drives doctors to open their own testing clinics whereby they can refer patients to themselves. Greed drives hospitals to offer every sort of specialty service, needed or not, so as not to let any patient’s dollars escape to competitors.

Yes, greed is universal, but some other nations deal with it better. All of them in fact, when it comes to health care. Every industrialized country, and some not so industrialized, has a superior system. In some, like Britain, the government is in the business up to its elbows. In others, like Switzerland, the job is left to tightly monitored nonprofits. Only in the United States is health coverage still left to privateers. Otto von Bismarck (an unlikely hero) started the trend toward public health care. Too bad it wasn’t Teddy Roosevelt.

And now, as we try to fix our deeply flawed system, it ain’t easy. President Obama’s original plan, rather than wisely providing Medicare for all, would mostly have provided profits for all. That grab bag attracted more corporate players than a piñata. Big Pharma was so giddy over its expected drug gains that it mailed out glossy campaign flyers praising supportive Democratic congressmen, normally its enemy. Private insurers were thrilled that all those grouchy uninsured healthy people out there would finally be forced to buy from them.

Thus the reform law that would finally cover most Americans would also be a corporate bonanza. How ironic that all those normally Republican corporations were initially thwarted by a Republican Party that this time had a different agenda, namely defeating Obama. As a result, 45 million Americans may yet remain uncovered. Oh well, that’s politics.

The upshot of the possible downfall of health reform is that America may yet continue its Wild West health-care system. Hospitals and clinics still snipe at one another for patients, drug companies still conspire to keep prices up, insurers still jack up premiums and refuse to cover those who are sick, employers still quietly abandon health benefits altogether or hire uncovered part-timers, and doctors still edge over from general practice into more lucrative specialties.

Also, people still suffer. Recent free one-day clinics in New Orleans, Houston, and Hartford each drew over 1,000 uninsureds, and those were just the lucky ones who heard about it. To others without available clinics, treatment is a dream, a mirage like the “single-payer” (Medicare-for-All) system enjoyed by our Canadian brethren. Only Hawaii, with its long nonprofit tradition and its emphasis on preventive medicine, comes close.

Without reform we will continue to muddle along with too many insurers, too many drugs, too many specialized doctors, too many administrators, and too many lobbyists. And now with the Supreme Court granting even more political clout to corporations, we’d all better stock up on milk, fruit, and Wheaties. If reform ultimately fails, real health care will cost too much for many of us.