MOSES LAKE — Moses Lake pharmacist Shawn Needham has worked in the healthcare industry since he graduated from the University of Washington in 1994, and in the ensuing decades, he’s witnessed what he sees as a breakdown in the system.

Industry-wide, costs increased, services diminished and patients were failing to get the healthcare they needed, an issue that was only exacerbated over time, Needham said.

He quickly decided upon the culprit: the federal government and the modern health insurance system it created. For decades he explored the issue, jotting down notes and statistics, until in 2015 he felt it was time to make his case.

Finally, five years in the making, Needham does so in his new book, “Sickened: How the Government Ruined Healthcare and How to Fix It,” which landed digitally in the Amazon Kindle Store just a week before the end of 2019.

In that book, Needham investigates how the government has gradually involved itself more and more in the American health care system over almost a century. He points to the 1930s, with the Roosevelt presidency and the passage of Social Security, as the first step on a long road that Needham said led ultimately to the Affordable Care Act, also known as Obamacare.

That initial interference with the free market was quickly compounded, Needham said, as the federal government became more comfortable getting involved with more sectors. Fast forward 30 years later to the 1960s when the Medicare Act was passed.

“And that’s when government became the major payer of healthcare,” Needham said. “When they did that, and you can see this in my book, the price of healthcare went up astronomically.”

The price of some services inflated 700 percent within several years, Needham said.

Meanwhile, utilization of many services also skyrocketed. Needham points to the number of patients entering nursing homes, for example, which he said increased exponentially in short order. When patients no longer had to pay the total costs for medical services, they were more likely to utilize services they didn’t need, he said.

“Healthcare is the only industry I can think of where the consumer receiving the benefit is not the one paying the bill, and when that happens, costs go up astronomically, because consumers aren’t really the costumer,” Needham said. “They’re not the ones paying the bill.”

Though the title of his book directly calls out the government, Needham isn’t particularly fond of “private” insurance, either. In fact, he demurs from calling it truly private, given the level of government regulation in the industry.

To Needham, employer-based insurance is little better than government-subsidized healthcare, particularly after passage of the Affordable Care Act. But its problematic past starts in the 1940s, Needham added.

Only a decade after passing Social Security, Roosevelt, now a wartime president, supervised a nation racked by labor shortages.

Concerned by wage inflation, the president issued an executive order based on the Stabilization Act of 1942, allowing him to freeze wages and salaries for all of the nation’s workers. But this federal fix caused a national problem: without the ability to offer higher wages, how was a company supposed to be able to retain or attract employees?

Roosevelt’s executive order covered many different types of compensation, but a massive exemption slipped in: employers could offer insurance and pension benefits, which unlike wages were allowed to grow over time.

“Ford needs new employees, and they want to hire some employees working at General Motors right now, they can’t say ‘I can pay you 10 percent more,’ they couldn’t do that. So what they did was offer what was called hospital insurance.”

Thus was the modern form of employer-based health insurance born, though it would take decades yet before this primordial perk for employees would bloat into its current form, largely with further help from Congress and the Executive Branch.

If there was value to the essentially accidental system of health insurance the America adopted in the 20th century, it was severely diminished with the passage of the Affordable Care Act, Needham said. That act placed further mandates on what insurance companies were expected to cover.

“After the ACA, there were less insurance companies, which really created an oligopoly,” Needham said. “Those insurance companies don’t have to give good prices, they don’t have to give good services, because the government protects them with these laws.”

To Needham, the entire healthcare insurance system built up over almost a century should be done away with. He doesn’t just want federal reforms — when it comes to healthcare, he wants the federal government and its insurance schemes out of the picture entirely.

Doing away with insurance doesn’t have to mean higher prices for the individual, Needham said. He points to a number of providers that have moved away from accepting insurance and have managed to provide services at more reasonable prices, such as The Surgery Center of Oklahoma.

Attracted to what he saw as a better alternative, the clinic he co-owns with his wife Janet, Moses Lake Professional Pharmacy, went to a cash-only payment system in 2002, Needham said.

He also believes that patients need to be more responsible for their own health than they have become since the proliferation of health insurance.

“The best health insurance we have is how we take care of our bodies,” Needham said. “Not some policy we can buy.”

While Needham places responsibility for a patient’s healthcare on the patient, he doesn’t suggest that the only way to approach healthcare is to go it alone. Alternatively, he points to innovative models for cost sharing, such as health sharing ministries.

Ultimately, the primary thing Needham said he wants for patients is better education and the understanding needed for them to advocate for themselves. He hosts a live radio show alongside his wife, “Health Solutions with Shawn and Janet Needham,” on KBSN, AM 1470, every Monday from 1-2 p.m., where the Needhams work to educate listeners on the healthcare system and their personal health.

Needham doesn’t expect the health insurance system to flip 180 degrees overnight, and he acknowledges that the changes he recommends are unlikely to happen in the coming years. But, he said, he hopes that through outreach efforts, such as the radio show and the book, those changes may come in his lifetime.