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TechnoratiThe Big, Bad Joke of Healthcare Reform
The healthcare reform effort underway in Washington, DC, sounds a lot like a really bad annual benefits meeting to me. Healthcare policy discussions and formal hearings are not filled with the sounds of crafting policies to guarantee what candidate Barack Obama termed a human right. Formal discussions center instead around all sorts of heady and wonky words and phrases, like "benefit connectors" and "cost containment" or "reinsurance" and "tiered benefits" or "payment incentives and physician bonus opportunities." There are very few people walking the healthcare-is-a-human-right talk.
I've heard all this sort of pitching many times before as insurance agents and intermediaries peddled their wares in conference rooms and break rooms for employers I've worked for over the years.
Truly. It feels like those mandatory meetings employers call when the insurance benefit year is about to turn over and the company has had to renegotiate plans for the umpteenth time in recent years. The meetings feature a rundown of plans made available - and in recent years the options grow ever more expensive, ever less comprehensive and ever more complex. That's the talk in the Senate finance committee and the Senate health committee and some of the caucuses in the House.
My head spins, my eyes glaze over and the for-profit insurance companies are taking it all in and waiting in arrogant anticipation of the signing of the final national contract - or our healthcare reform legislation, as the politicians turned insurance sales reps and benefits administrators will sell it soon.
Listen to the talk about healthcare. We've come a long way from candidate Obama's calm and assured response to a debate question. In the fall, Obama confidently asserted for the world to hear that healthcare is a human right - even in his America. He did not attach any benefit exclusion clauses to that comment or ask us to begin thinking about which tier of benefit plans our family would purchase. It would have been odd to try to explain why some families belong in the bronze level human rights plan, others are silver plan human rights member while the best and brightest can afford gold level human rights, wouldn't it? Yet that's the garbage we're now hearing here as healthcare reform.
But now, we have to suffer the long and excruciating benefits drill on a national level - and if the U.S. Senate has its way, you and I and every other American will be able to purchase the human right to healthcare based on our financial stations in life. If we're middle class (shrinking though our ranks may be), we'll choose what fits in the family budget - not necessarily what protects our families. And if we're not doing so well, well then we'll get to go through demeaning and embarrassing needs testing by government bureaucrats (actually working on our dime for the insurance industry) who will determine if we get a subsidy to purchase the same lousy and flawed benefits.
Oh, yes, they'll force (wink, wink - handshake under the table) the insurance industry to cover all who can purchase their plans. What a big, bad joke on all of us. What a shameful way to pretend we believe healthcare is a human right.
But what are the alternatives now? Can this President who lost his mom to cancer as she fought with the bills and insurance company and who proclaimed healthcare to be a human right in this nation - our nation - show the political courage it will now take to actually back that talk? I think he can - but I am less sure if he wants to. He's got some front folks doing some pretty smooth talking right now, only this time, he isn't quite getting it that Americans are dying and suffering as he guides the talk towards the biggest, most complex and convoluted healthcare policy this nation has ever imagined.
We "lucky" insured Americans, are still sitting in those conference rooms, Xerox machines humming and spewing warm air into the room and clutching our latest employer benefit contract booklets upon which we'll be asked to gamble our families' futures and our own lives as we choose from for-profit, private insurance plans meant to make us feel secure while not actually protecting us from physical and financial ruin. And then we'll exclaim our relief at being able to "keep what we've got" and go back to our cubes or our desks or our work stations calculating the latest dent to our take-home pay but grateful to have a job and any coverage at all.
Especially during times of recession, many of us with jobs and benefits feel a sort of survivors' guilt and we wait for a time when our neighbors and friends will have jobs again and won't suffer so much. Those suffering often do so quietly - like my family did - embarrassed and ashamed and using every ounce of energy just to stay afloat as past due notices, collection agency bills and disconnect notices from the utility companies stack up on kitchen table reminding us that this recession will hurt us a whole lot more than the government leaders we have so generously funded with our votes and our taxes.
Is any of this the talk of human rights? No. Not even for one moment. Even the talk of a healthcare public option for purchase is little more right now than a nod to those fighting for sanity and common sense in developing a publicly financed, privately delivered healthcare system. Placating the human rights folks while enriching the market babies doesn't fool anyone - it's a scam. Even if we "insure" kids first through S-CHIP, we still haven't grasped the concept - come on now, how many new customers are the American people supposed to pay for in this insurance industry bail-out?
You see, I'd even like to hear them (the Congress or the President) be honest about giving us the same healthcare security they have at our expense. Every one of them has access to a doctor - always and without a co-pay or deductible - in special taxpayer funded medical offices should they ever need care. Not one of them needs to think about an emergency room bill or lost work time if they get sick. That's what a human right looks like and feels like. Care given when care is needed. Period.
If this President and this Congress choose to create a huge bureaucracy and huge expense simply to administer a horribly and unnecessarily complex benefit plan for all Americans at the hands of the private, for-profit insurance industry, I think we'll need to rise up and demand they give up all taxpayer-funded medical services and insurance plans and live in the healthcare world where the rest of us live until they get it. Oh, and they ought to lose pay and status for every day they miss working for me in my Congress and my White House. Until they get it.
On the other hand, when they get serious about healthcare as a human right, the hearings will include all voices and all realities in this broken system and all the clear and concise solutions available for this mess. When they get honest, they won't need to stack the deck with industry darlings who stay on message - they'll embrace solutions that grant a human right not slam through decisions that profit an already bloated and abusive system.
Until I get the healthcare as human right status my President said he supported, no one who serves at the pleasure of my vote and lives well on the income I provide should live without regard for my suffering and worry. This isn't supposed to be a bad benefits meeting being held to protect an already wildly profitable industry - we're supposed to be reforming healthcare. And it's the stuff of human rights. Adjourn the bad benefits meeting, Mr. President. Remember your mom's struggle and honor your nation with the tough stuff of making sure human rights are finally recognized and protected in healthcare policy. Anything less dishonors us all and maybe moms with cancer most of all.
37 Comments so far
Show AllDonna will be on my radio show this Sunday 2-3 (pst)
www.Green960.c0m (live stream)
The entire show will be devoted to Single-payer health care.
Love & Peace
Cindy
"There are a thousand hacking at the branches of evil to every one striking at the root" HD Thoreau
Good article.
It said "the company has had to renegotiate plans for the umpteenth time in recent years. The meetings feature a rundown of plans made available - and in recent years the options grow ever more expensive, ever less comprehensive and ever more complex". Exactly true.
Furthermore in practice the insurance companies can and do change which doctors, procedures and drugs they cover on an ongoing basis even after you sign up. Doctors can and do decide to drop certain insurances when rules are changed, reimbursements are lowered and burdensome requirements are put in place. (pre-approval for everything, arbitrary and routine denials, phone never answered etc.) A patient can be in the post-op stage and find their surgeon has been dropped by the insurer (Happened to me). And this is for people lucky enough to be working and to have a plan at work.
This is why we need single payer, organized along the lines of Medicare or Veterans' Administration, but better run.
The idea that we can solve the problems of providing medical care through computerization is just not true. That idea comes from a computerized systems salesperson's PowerPoint presentation and sweet talk. Believe me there are also a lot of IT heads at hospitals who see funding for computerization as a big opportunity for $$$$ contracts and to increase their salaries. People will gloss over the truth when they see the possibility of cash.
You cannot efficiently computerize chaos. I can say this with some authority, having worked for years in on computers in medical settings. Business computing works well with fairly rational or stable situations.
Currently, in the medical field you need an army of analysts constantly reading the daily incoming orders from hundreds of different insurance companies and an army of programmers marching to the orders.
You have to deal with many patients who lie in order to get care - they may use their sister's medical insurance or Medicaid card, so there is contradictory and incorrect historical information on the medical records.
Sharing of relevant medical information between rival commercial entities (or even departments within an institution) is hampered, not so much by requirements of patient privacy but by territoriality between competitors and doctors' fears of second-guessing.
My experiences were at a top urban medical center complex with medical school. I can only imagine how it is working in other places, such as tmullins' Eastern Tennessee area.
Single payer and universal coverage are the stabilizing pre-conditions for computerization.
Free routine and preventive care by nurse practitioners and midwives and cost / benefit analysis based on public health concerns, not on a desperate grab for revenue, will help address the poor outcomes and high costs we pay relative to the rest of the world.
Joe
Phil Bredesen would be a disastrous pick to head HHS. See what is deemed, defended and supported as THE ACCEPTABLE STANDARDS OF HEALTH CARE in Tennessee.
http://www.wisecountyissues.com In East Tennessee, Profit Care comes before Patient Care and he doesn't give a shit...
frances
Thank you for this "from the inside" post. Those who like to tinker with miniscule reforms often create a bigger mess.
We have a hangover from the big anti-government binge that started in the 80s. Apparently, life is not an Ayn Rand novel, and businessmen are not the super-race.
Are there any representatives at the national level that have indicated support for a single payer system?
Yes, of course. Dennis Kucinich, for one.
you will have healthcare reform if you divide it in two and give the republicans the other half to die with it
edweg
Bill Walz
What does it take to get health care recognized not only as a human right, but a societal responsibility? Capitalism has no business in health care - or pensions, for that matter. It looks like it is going to take citizens demanding that we adopt a national health and pension plan like exisits in some form in every Western European country. There is no sign that Obama is going to do it without a national groundswell. We have been a people in the service of our economy too long. We need an economy in the service of the people. Beginning with health care. 100% coverage of 100% of the people. NOW! Not through insurance companies who are only interested in their profits, but by OUR government, who damn well better have our interests first, and not the corporate thieves who have ruined this country. The whole idea of a "medical industry" is an abomination. Medicine's responsibility is to "first do no harm" and then heal. Well, the American people have been harmed pleanty, and too many cannot find the healing they need. Single Payer, Medicaid for all - NOW! HR676. Write your congresspersons and Obama. Demand it.
Then - Nationalize the banks, and cap all salaries at $500k, while putting in a national living wage or pension for every citizen who can't work or is retired of no less than $25k. Maybe we'll start to look like a civilized country then and not USA,Inc. Maybe we can end this culture of insatiable materialism and start being a real society that cares about a quality future for our children and grandchildren and generations to come. This capitalism madness has got to end.
for those of you who haven't seen michael moore's sicko, you should.
the reality is that we will never have health care reform until the thinning of the legal herd first occurs. physicians will not buy into any sort of reform as long as they have to pay exorbitant malpractice insurance just to cover their asses from the greedy ass lawyers filling up the yellow pages (and back covers) of any and all phone books. first things first.
Sicko did an excellent job of showing the problems with the insurance companies, but didn't address the dangers of conventional medicine and the drug companies. True reform would address these problems, but I haven't read anything about that yet.
Don't blame the lawyers for high malpractice premiums, look to the bond market. We'd be in worse shape if no one was looking out for the patients in our current system.
A couple weeks ago I saw Chris Hayes of The Nation on Countdown with Keith Olbermann.
During the course of the interview he uttered the words "SINGLE PAYER".
I can't remember when I last heard those words being said on a mass media program.
When Dennis Kucinich was running for President he was excluded from the AARP sponsored Democratic Presidential "debate".
The insurance companies are so terrified of SINGLE PAYER they censor anyone who may dare to mention it.
Restore the Fairness Doctrine. Return the airwaves to the people.
Give SINGLE PAYER advocates equal airtime time to explain it to the country.
It wouldn't be long before support was overwhelming, loud and unstoppable.
They know this, which is why they must resort to censorship.
This is why policy is being crafted by a bunch of corporate know-nothings in a back room hidden from the public.
Because they can.
------------------------------------
Whoever controls the media controls the country. Period.
The sad truth is that health care is only an issue for those of us either without any or with health care that is lousy and expensive to boot. The folks with great public service jobs and great health care don't care and the rich don't have to worry either.
The disappearance of Tom Daschle from the health care scene was a great relief to those of us who have been working for single-payer health care (H.R. 676) His ties to the for-profit health care industry were all too evident in his proposals;
his "reform" plans were simply a health insurance company bailout plan with some cosmetic changes around the edges. And, his community forums were just a cover for the bailout plan. People interested in discussing single-payer options were frozen out of the discussions.
H.R. 676 is by far the fairest, most efficient, and easiest to establish of all the proposals. Health insurance companies are not in business to provide health care, but to make a profit. Now that they are in trouble (their pool funds invested in a tanking market and client list shrinking because jobs and businesses are disappearing), they are insisting that government monies be funneled to them under the guise of health care reform.
This MUST NOT BE ALLOWED. I beg everyone interested in the subject to read John Conyers' H.R. 676 proposal, and get on the Health Care Now list for phone-ins, letter-writing, e-mailing, and doing whatever possible to stop another corporate ripoff.
Our problem is that Obama has been programmed by the established order.
Show me one Ivy Leaguer who is representing the true interests for the common
good of the citizens..
Ralph Nader is with us, but they keep trying to destroy him..Why didn't they
allow him to debate in the past election?
Preach on, Donna. Wonderful article. Thank you.
We need a cure for health care in America. http://www.wisecountyissues.com It's time for the politicians and profit machines to get out of medicine.
Unfortunately, a Raygunesque "stimulus" package to keep the wealth flowing upwards is more important to Obama than single payer healthcare. Besides, Washington is just like those self-righteous rightwing assholes who stick their fingers in their ears and sing a-la-la-la no matter what you try to tell them. I guess it's back to hitting the pols locally before we can penetrate Washington.
Obama has a big problem. We can't underestimate the power of the health care Mafia and their allies. The binding referendum is the only way to get his programs enacted and stay alive.
The only problem is the Democrats. And this time there are no exuses.
Maybe we should "push" Obama for an HHS Secretary who's actually in favor of single-payer.
Any ideas?
Add my thanks to Donna Smith for her excellent piece.
As she says, the solution to the crisis in health care cost escalation and access is absolutely straightforward. It is also ethically unassailable. The politicians' insistence that it is "not politically feasible" proves, beyond doubt, their abject corruption and betrayal of any notion of this country as a community. If the current brinksmanship over the stimulus package is any indication, health care reform is already DOA.
I believe it will take a massive campaign of civil disobedience to wrest control of the health care system from the insurance, pharmaceutical and medical technology interests.
I refuse to participate in the current system, at the risk of my health and, if it comes to it, my life.
If I should fall ill, I will refuse emergency admission to hospital, refuse to sign any consent or billing agreement or assignment, refuse to be examined by a doctor.
If health care "reform" comes to include a mandate to purchase private health insurance, I will refuse to do so, and will refuse to cooperate with any taxing authorities which try to enforce such a mandate.
Sioux Rose
DRHOL: I feel the same way, but I'm not sure I'd want to be jailed over it. I wonder if they'll work out some nifty agreement where if your family can't pay, upon death or near death (or if the market requires it) you give up one of the following: 1. a working kidney 2. bone marrow 3. eggs (women) 4. an arm?
Trafic in human organs DOES go on in other nations. Is it inconceivable here? Could "a pound of flesh" gain currency on the health care market if insurers remain in the game as theirs becomes a diminished tidepool of well-paid/covered workers?
Well look at it this way. If you don't have mandatory insurance what will they do? Not treat you? We already have that. If they put you in jail at least you would have medical care. It is actually true that some people do try to get arrested just to get treated. What a sorry state of affairs...
Yep, that is indeed the irony ... go to jail in order to get health care.
I will refuse care there, as well.
You're better off refusing that (prison) care, which in California, and no doubt in most states, is absolutely abominable. Getting arrested to get treatment is no solution at all.
Are we there yet?
Is it time to get out the pots and pans and hit the streets and not stop until all the collaborators are out of government?
That will make two of us!
Hi Donna:
Thank you, THANK YOU, for continuing to keep beating the drum on this critical issue. I've spent nearly 40 years in healthcare, but am arriving comparatively late to the single payor issue. So, I could use a little coaching from CD'rs:
is HR 676, as just recently listed on change.org, the way to get there? Or, are we wasting our time on this? Is there some other path we can take to make single payor a reality?
http://www.change.org/healthcarenow
To a relatively uninformed person like me, it looks like this org (HealthCare-NOW) is gaining steam on HR 676. Is it real? Should I sign on here??
Gaining steam is a great way to put it -- yes, yes, wherever we have the opportunity to weigh in, do so. HR676 is very much alive -- despite what some may wish to have be the reality.
The long arc of history bends towards justice -- we just do not know exactly we are on that arc right now, but we are moving in the right direction with our support and work on HR676.
Thank you for the comment.
Donna Smith, American SiCKO
Let me add my thanks to his and PLEASE keep up the excellent work.And please keep the articles coming with information.
We are all in this battle together -- I deeply appreciate the support as it pushes me to keep the information coming upon which others can build and push.
Donna Smith, American SiCKO
The idea of putting for profit corporations in charge of rationing healthcare is insane because their raison detre' for existence is to make a profit for their owners. The only ways any such an enterprise can accomplish their "job one" is to either raise their premiums or to increasingly deny coverage to policy holders.
Meanwhile, American employers are made less competitive by virtue of havig to provide healthcare as a benefit of employment and their employees are made less secure by virtue of losing their healthcare coverage until they find new employment in cases of firing or layoff.
About the only thing I disagee with Donna on in the article above is the suggestion that we need the same healthcare coverage as the Congress, Senate, President, and his administration receive.
This is backwards--they need to have the same healthcare coverage the average Wal-Mart or McDonald's employee has--that just might increase their learning curve about the healthcare crisis and motivate them to do something about this awful mess.
Poet
Great article!
Poet-it is not just a problem with "for profit" providers/insurance. My area, all hospitals are "non-profit" but you still see the same problems with sky high exec pay and inadequate services for the "indigent", etc., even tho they pay no taxes. One is chartered to specifically provide those services and gets partial taxpayer funding to do so.
"I think we'll need to rise up and demand they give up all taxpayer-funded medical services and insurance plans and live in the healthcare world where the rest of us live until they get it. Oh, and they ought to lose pay and status for every day they miss working for me in my Congress and my White House. Until they get it."
Precisely. This should apply to local and state govs too. I had to give up my health insurance cuz I couldn't afford to pay it anymore (went from $200/mo to $500mo in 3 yrs.). Even if I could afford it, cuz of pre-existing conditions, I couldn't get it anyway. Yet, I get to pay everyone elses, including for other peoples children (S Chip). A little galling since I knew I couldn't afford to have children and didn't, so now I get to subsidize people who pop out all these children THEY can't afford either. Or maybe could, if they weren't paying for everyone elses health care too.
And with the new bill just passed you get to pay for the children of folks making more than a hundred thousand dollars a year and for children that aren't even Americans. This is really going to cost.
Excellent post. Excellent points. I would suggest though that the only "rights" humans have are the ones that their society give them.
Poet, you took my thoughts out of my keyboard - but probably expressed them better.
Just think folks - one of the main reasons jobs have been lost here in the US is the lack of universal healthcare here. This is why our companies have off-shored production. They can't be competitive when they pay for healthcare. Elsewhere, companies are free of this obligation.
2 statistics cited by the former head of the CDC:
American healthcare per capita cost is 1/3(not sure of exact %) higher than anywhere else.
The U.S. is ranked 72nd in health of its citizens - less than many developing countries as well as less than all the rest of the industrialized nations. This measurement includes such stats as longevity, childhood death rates, etc.
Think about it.
According to no less an authority than the CIA fact book, Cuba has a lower infant mortality rate and longer average life expectancy than they US. Very poor and economically persecuted Cuba has better healthcare statistics than the US--truly there are none so blind as those who will not see.
Poet