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Sick Man Lookin’ for a Doctor’s Cure
A preface for CommonDreams readers: We can reduce the time any of us will invest posting or reading comments on this essay if I explain its purpose and field position before you begin. There is nothing in the sixteen hundred words following that you do not already know. I expect general agreement with my opinion and similar disgust with the conditions and persons I describe.
But you and I are liberals or progressives or socialists or worse. Most of our neighbors are those magnificent moderates every politician courts. Many, even contrary to their own interests, are passionate self-described conservatives. It is to these persons I address my columns. Before arriving at this website my essays are published on the editorial page of The Wiscasset Newspaper, a very small paper in a state that ought properly be part of maritime Canada. After almost eleven years I still marvel that my editor lets me do this. I feel a great obligation to use my prominent space to promote ideas and ways of thinking that I believe to be right but which are seldom granted an honest hearing in such inherently cautious journals.
If this essay seems shallow and obvious to you it might nevertheless seem radical and dangerous to someone you know. Perhaps even to your senator or congressman. Use the time you might spend complaining on CommonDreams to plant some doubts and suspicions in those persons' minds.
I know you'd like me to tell you this business will work out all right. I'd like to tell you it will be fine. I imagine it would feel very nice to be flushed with optimism. And probably I'd be more popular and subject to less eye-rolling, head-shaking, wincing, grimacing and disgusted, dismissive looks. But since 1935 at least, when Fats Waller first apprised us of the truth, we've all known it's a sin to tell a lie.
None of the clowns and conspirators presently pontificating over and pawing at the putrid edges of our corrupt, cruel and wasteful health care funding system down in Washington, D.C. has any intention toward replacing this business as usual with anything that will do any good for those of us who will become sick, injured or old and who will need to hire doctors or hospitals or pharmacists sometime before we die.
I wish we could just blame the Republicans. You know, the same patriotic, God-addled, small-minded, small-business lovers who did such a magnificent job of running our country into ruin for the last eight years with unnecessary wars, domestic spying, torturing, catering to financiers, jacking up the national debt, poisoning rivers, alienating allies, lying as a matter of policy and personal preference, forcing a brain-dead Florida woman to linger as living dead and turning Dick Cheney loose on an elderly judge with a shotgun.
And they would, for sure, keep your costs high and your receipt of useful services low if they were in charge, but since last January, you know, they haven't been. Now in the minority in Congress and having alienated all but their craziest, most ignorant, most violent followers, the Republicans are our great national joke party. Except perhaps to Senator Reid who is still scared of them since they made him promise never to use the filibuster against them a few years ago, and President Obama who frequently claims a burning urge to create a bastard child called Bipartisanship with them, what good purpose this hideous hybrid might serve never being made clear.
You might think, if you watch television or read the newspapers, the obstacle in the way of reform is those Blue Dog Democrats. A body of pseudo-Democrats, principally from districts in the southern and western states that would vote Republican if the Republicans could raise a candidate who was not under indictment, in jail or in bed with a boy, the guardians of our collective wealth worry that any money spent to keep poor persons from suffering and dying would be too great a price for our millionaires and our corporations to pay. But they could, some of them, be whacked into shape if the chairmen of several committees (Democrats), leaders of both houses (Democrats) and their president (a Democrat with a recent landslide victory and high popularity numbers among the public and the press) cared to discipline them.
We can't fault President Obama, can we? He's no George Bush. And almost everybody you talk to will remind you how eloquent he is. When he was a candidate he was unequivocal in his support for the only system that can assure quality medical care for every citizen -- government-funded care known euphemistically, unnecessarily, annoyingly as Single Payer. Well he was but now he isn't. Not practical. Off the table. Fuggedaboutit.
President Obama likes compromise. He likes it so much it seems that he makes it his opening gambit, rather than a last resort. Meet with the giant insurance companies and they promise to be more reasonable in the future in exchange for only token changes now. Meet with the big hospitals and they say they'll keep costs in line. Chat up the boys at the AMA; cross-check the big players with your campaign donors list; and you're a convert from bold reform to marginal tinkering.
You know -- practical stuff. Things Congress will pass because none of the moneyed interests will be hurt. Something that doesn't challenge the system that has given us the worst coverage at the greatest expense anywhere in the developed world and second-rate even by the standards of the more reasonable developing nations.
See, they're all in this together: Democrats, Republicans, Obama and the millionaires and billionaires who have been living fat off the combination of high premiums and denial of services that leave millions with no coverage and the majority in a constant struggle to keep afloat by buying a bigger deductible or praying for a job with better coverage.
And what does getting sick and getting well have to do with employment? Nothing. It's just a holdover from the early post-war years when it was cheaper for big companies to throw a few benefits to the unions than to increase wages. So now we debate whether to make individuals buy insurance they can't afford and how small a company will be exempt from mandatory insurance provision and how many years of subsidy of insurance a trillion dollars of public dollars will supply. But every bit of the debate has been about insurance, not about health care. And that's just the way your senator and representative and president like it.
And for all I know, so do you. If your employer pays a hundred per cent of your insurance premium and ninety per cent of your family members' premiums, you think this system works quite well. Unless you have a high co-pay. Or a high deductible. Or a raft of exemptions and uncovered conditions. Or you get really sick and are old enough and the gnomes and elves and computers at the insurance company scrutinize your policy and tell you your particular combination of needs and treatments is not medically necessary, by which they mean to say it will be cheaper for them if you just die. And so you will.
Or you could lose your job. Some have in recent months, you know. No job, no insurance, no luck.
But we don't want the damn government messing in our health care, do we? No. That would be socialism. Ask any Blue Dog, any Republican, any insurance company CEO. The government cannot compete with the private sector.
Unless of course you're over 65: Medicare. Or a veteran: VA doctors and hospitals. Or very poor and meet certain specific requirements: Medicaid. Or a member of Congress: "Fix it, Doc, and send the bill to The People!"
All but a very few members of that latter body are bought and owned by insurance and drug companies. You can look it up. And President Obama achieved his office also with the financial assistance of those civic-minded bodies who knew, somehow, that "Change we can believe in" would not threaten their profit margins. So if it's left to the people fooling around with our lives in D.C. to do right by us we can expect more of what they've been providing. Thousands more of us each day will become uninsured. Those with coverage will pay more and get less. When things get really bad for the really sick the policy will spring a loophole as often as not.
Congress will not change its ways. Only a few men and women there will fight for a public-financed system (as opposed to the useless and counter-productive "public option" amendment to the status quo that a few more will support.) Any bill that passes, any bill the president signs will only continue the torture we now enjoy.
But it could be otherwise. Lyndon Johnson had his flaws. But he was no Bill Clinton, no Barack Obama, no feel-your-pain-compromise-away-your-rights milquetoast. When that fat son of a bitch thought something was right he fought for it. Thus: Medicare. Don't like government health care? Don't sign up for it, citizens; repeal old age health insurance, you simple-minded legislators.
Suppose we had a president who did what he believed in. What if he twisted arms and bashed heads together and called in favors and crowded people into uncomfortable corners and used the great good will and support of the hopeful, desperate people whose votes put him in office in an unrelenting campaign to demand that the giant insurance companies find some other way to keep their executives in private jets and shiny suits and waterfront second homes. Or go out of business, if they prefer. What if he told us he would accept nothing less than a revolution in the way we fund health care so that there was no middleman, no profit taken out, no financiers between you and a cure, pain relief, well-being, good health and personal dignity.
All he would have to do is to say, "Single Payer." Then tell us all that single payer means government payer, not government-as-doctor. He would have to talk about health care reform, not insurance reform. I've got fire insurance and car insurance and liability insurance. I've got all the insurances right there I can afford. Give me a plan where I go to the doctor and the doctor gets paid by somebody who doesn't skim twenty or thirty per cent off the top, doesn't drown me or my doctor in paperwork, and gets the wherewithal to keep the system running with a broad-based, progressive tax on everyone.
Call it Single Payer if you like. But don't expect that or anything like it until we've tweaked the present mess to the satisfaction of all the big players and let it run another eight or ten years so we can see how much suffering that will cause.
I'm five years from Medicare. My health care plan until then is to pray to somebody's god to keep me whole and halfway healthy. I don't expect that will be very efficient, but there's no paperwork, clear expectations and an affordable premium.