We don't have a healthcare problem in America.

When you reach the point where both the haves (read: multinational corporations) and the have-nots (read: everyone else) are both complaining that healthcare will "lead them to bankruptcy," the issue ceases to be a problem and becomes a paradox.

In the ultimate zero-sum game that is our free market economic system, when all sides of the equation are having the same "problem", it usually means the real issue is being missed or ignored.

On the surface it is certainly seems like an economic issue: healthcare costs a lot of money, who is going to pay for it? Is healthcare too expensive? If so, is it because of lawsuits? Shady controls on imported drugs?

Money, however, is neither the problem nor solution here. It can't be. Healthcare is such a large and all-encompassing cost center that, by the nature of a free market economy, no matter who writes the check, we're all going to pay for it anyway.

Stripping economics out of the debate, we're left with the less-discussed question: why are we so sick? I believe this does get us a little closer to the crux of the issue, but it's a position that has its logical flaws as well. Decade by decade we find that pollution declines, dangerous activities like smoking decrease, and life expectancy continues to rise. Yet our "need" for healthcare also rises. Something just doesn't compute.

Thus, I would take the "why" out of the above question and ask: are we really this sick?

We can't possibly be. But we certainly think we are. It is this dichotomy that finally beings to shed light on the real healthcare problem in America. The reasons (unfortunately for those who like simple black-and-white, who-to-blame answers) are complex, ingrained in everything from our cultural attitudes towards illness to the way we approach the marketing of healthcare.

Since each and every one of us were children, our culture has been more and more accepting of illness and the need for care. While this attention we give our health certainly has important benefits (e.g. discovering diseases at an early stage), our obsession over personal care has morphed into the positive reinforcement of being sick in general. Think about it simply: children are taught that with illness comes the unquestioned benefit of not having to go to school for a few days. "Calling in sick" is the predominant way American workers remove themselves from the stresses of the job for awhile.

At the end of the day we've all learned that illness is a safe place for us to be. It may start as completely dishonest, or a slight over-exaggeration, but any psychologist will tell you that if you want to be sick, its not that hard to trick the mind and body into really being sick.

At one time in our history being sick was, quite frankly, a bad thing. Without the benefits of technology we have today, being sick meant crops were not harvested, industrial output was slowed, and basic needs- food, water, clothing and shelter- were in danger of not being met. Now, I am not about to extol the qualities of 19th Century living- I like my cozy life as much as anyone- but I do find it dubious that as Americans gain more and more free time, they tend to fill it with being sick.

Lack of individual responsibility is, I believe, the predominant force behind the healthcare crisis in America. That is not to say, however, that American corporate culture- and its marketing philosophy- is off the hook here. As with any marketing trend, consumers and suppliers work in tandem. An examination of the recent tendencies of pharmaceutical advertising bring to light another element of our real healthcare problem.

Turn on any television show or look at the billboards on any street in America, and you'll see an influx of advertisements for drugs, diets and other such solutions to health problems. Now, there's certainly nothing wrong with the concept of marketing healthcare- the free market is a lot more efficient than any other sector of society, marketing is how we communicate in a free market, and drugs- on the surface- have historically be much more beneficial than dangerous.

The problem comes in the subtleties of the advertising message. If you compare today's drug commercials with those of any other period of time in our culture, there is one distinct difference: the message is no longer about the symptoms in which the said product assists in curing, its now merely about the feeling you, the consumer, will achieve by using the product. Its up to you to backfill in the symptoms.

To boot, many drug advertisements don't even mention the symptom they supposedly treat. "Take the green pill and you'll feel great!" "No, take the beige pill and you'll be refreshed and back in action!" The inquiry of "why" is never answered.

Selling the sizzle over the steak is a long-standing marketing principle. It makes sense for most consumer goods because, frankly, we probably don't actually need them as much as the advertiser needs us to buy them. That's fine, as it's a lot of the reason our economy moves and grows much faster than other types of economies. However, when it comes to drugs and healthcare, this is a very dangerous way to go about business.

As with our positive cultural attitude toward illness, the "call to action" on healthcare marketing requires the consumer to want the symptoms in order to achieve the benefit said marketing offers. For example, The message used to be "If you're depressed, take product XYZ." Now, the message has distorted into "If you want the benefits of product XYZ, maybe you should consider if you're depressed."

So where does this leave us with the debate on healthcare? I'll leave the economic and procedural arguments to the pundits to chew on over the next few years. I'd argue that these points are secondary to the real problems with American healthcare- problems that, unfortunately, may require a lot more effort on everyone's part.

At the core, our cultural attitudes and corporate marketing- in tandem- have created a perilous desire in all of us to be sick. Until we, as a culture, move to a more pragmatic view of how much healthcare we actually need, such collective desires will inevitably bankrupt any healthcare fix we can dream up.