hearts and minds

December 15, 2009


Filed under: Class warfare,Health care crisis — Hearts & Minds @ 5:30 pm

I’m not his only friend, by a long shot. Skip is respected and well liked by a whole lot of people. He was a fellow seaman and a millwright, a member of the Masters, Mates and Pilots Union, the Carpenter’s Union, an organizer for justice and human rights and the IWW. He loved family and friends, and he valued and respected life and people.

He was working as a millwright when he got sick, and the illness and treatment made him unable to continue working, which, of course, cost him the health insurance coverage he had at the time he became ill. Months of recuperation and healing followed, but when he experienced symptoms that caused him to again seek medical help, he was turned down flat due to his lack of private wealth and the lack of health insurance, which was caused by his lack of current employment, which was caused by his previous illness and treatment. This left him a healthcare “choice” between realizing that he was at the end of his rope, or hanging on to “Hope”. Any “Hope” he had might have been based partly on the fact that he was just months away from becoming eligible for Medicare.

On the day he became eligible, Skip showed up at the hospital, which immediately admitted him, considering his signs, symptoms, and history. He was soon released from the hospital. But that wasn’t good news. There was nothing the doctors and nurses and technicians could do for him, because the delay in getting “eligibility” to receive health care had been too long. So he died soon afterward. A couple weeks ago.

I campaigned one day at the Ozaukee County Fair during the summer of 2008. (I ran as an Independent in 2008 for the state senate against a career politician Republican incumbent who had never before faced an opponent in a general election, despite his notorious voting record.) I approached a family that was just getting up from a picnic table and cleaning up after brats and a soda, and introduced myself. “What do you think is the most important issue in this election?”, the young father asked me. “I guess I’d have to say the health care crisis”, I replied. “We know something about that”, he said. And he (and his wife) proceeded to tell me what they knew, with their ten year old daughter quietly and carefully listening.

He was a machinist by trade. His family was covered by health insurance that was the “choice” of his employer. The fine print written in the policy was the “choice” of the insurance company. Co-pays and deductibles, coupled with the cost of providing for a family and preparing for future educational expenses, encouraged him to make the usual “choice” to forgo comprehensive regular physical exams and preventive care, since he felt fine and healthy as usual, until the day came that he felt he had no “choice” but to see a doctor. The news was not good, and the treatment necessary was extensive and expensive due to the late diagnosis.

The insurance policy exemptions and co-pays and “reviews” resulted in substantial cost not being covered by insurance, and in the family quickly depleting all savings and credit. (The treatment was such that the father could not continue working, and since they, like virtually all working families in similar circumstances, could not afford to “choose” to make COBRA payments, the family no longer had health insurance.) They were informed by the hospital administrators that in order to continue the treatment plan, they would have to “choose” to sign a payment plan. Well, a payment plan does not even have the slim legal protections that remain for personal bankruptcy. A payment plan is whatever you agree to. And the administrators wanted everything this family owned in order to continue with the treatment plan.

You may be surprised that the husband and father actually had to think it over. The treatment, after all, was not an elective option – it was a life or death “choice”. But despite this, he was unable to immediately sign the papers, although his life was clearly at stake. Could you have signed the payment plan knowing that it would render your family homeless and deeply in debt for the foreseeable future? That if you lost the gamble and died, you would die knowing that your wife and children would be destitute and without even a place to live?

While the family was considering their awful healthcare “choice”, the hospital sent a social worker with some counsel and some brochures. They were gently and courteously informed by the nice administrative employee about the hospice care program that was available to them.

At this point in the narration that I was hearing amid the milling crowd at the County Fair, the wife (who had said little to this point) could see that I hadn’t yet quite gotten it. Though she didn’t “make a scene”, there was no mistaking her deep anger, when she told me, with her husband and daughter listening, she had thrown the social worker out of their home. “You have no business talking about hospice care to us”, she told the social worker. “Hospice care is for when there is no hope for further medical treatment. Hospice care is not an ‘option’ instead of the health care he needs.”

I was stunned. I had studied and written about the health care crisis in America for years, but that was the moment when I learned that hospice care is being offered and provided in the United States, not always because it is medically indicated, but because it is financially indicated. In other words, if you and/or your insurance company can’t or won’t pay for the life-saving health care you need, you are shown the door or offered end-of-life care, instead. And subsequent conversations with experienced medical professionals have confirmed that is not uncommon.

That was not a decision by a mythical government death panel. That was a decision by a very real corporate death panel. And those corporate death panels make those decisions routinely, every day in America. Five Americans die every hour, day and night, day after day, because of those decisions by those corporate death panels, simply because we do not have comprehensive health care guaranteed for all, which would cost us less, per capita, (with no co-pays and no deductibles) than the current for-corporate-profit healthcare system we currently have. Got it? We are all paying more for this, right now, than it would cost to strengthen and extend Medicare for everyone, for life.

My friend Skip was in a similar fix that this working family had been, though in his case, hospice care was not prematurely offered. Skip just had the misfortune of the corporate gatekeepers opening the healthcare door to him too late.

These are among the countless examples of the complete nonsense embodied in the appallingly ignorant or crass suggestion that anyone can get health care by just going to the emergency room. The primary thing an emergency room is expected to do is make a preliminary assessment, and stabilize your vital signs, if possible. (Now, that responsibility is neither simple nor trivial, but it also does not include an awful lot of necessary medical care.) The for-profit hospital doesn’t have to admit you or keep you, and the ER doesn’t set your broken bones or treat your cancer, diabetes, or other affliction, or provide good primary or specialized care . And even if you don’t think you know anyone who has suffered or even died from this denial of needed health care for financial reasons, or has suffered medically induced destitution and bankruptcy, it happens every day, every hour, in America.

You have undoubtedly heard the analysis of health care reform which maintains that there are two very different reasons that people support health care reform. Allegedly, one, is that people altruistically would like everyone to have health care (this is often expressed in extremely compromised form as “everyone should be able to access affordable health insurance”). Two, is that people would selfishly, for practical reasons, like to control health care costs (this is often expressed as “everyone wants their health insurance to cost less”). This two-edged analysis is intentionally misleading, narrow, and short-sighted. It falsely implies that resolving the health car crisis places personal interest in opposition to social justice. It falsely implies that people who do not have health insurance have entirely different needs and interests than people who currently have health insurance. It sets up a false opposing tension between the goal of everyone getting the health care they need, against the goal of reducing and controlling health care costs.

Despite the constantly repeated lies, the truth is that it costs less to provide everyone the comprehensive health care they need, than it costs to ration health care to people on the basis of what the administrators figure each individual deserves. The way that our health care is administered in the United States has virtually every family playing Russian roulette with its members’ health, its financial security and solvency, and our longevity, with the ground rules set by the increasingly greedy, powerful, and arrogant sickness business corporations. The only difference between you and me in this game of Russian roulette is the number of chambers that each of us has loaded at any moment in our lives. If you have health insurance and employment today, you may not have it tomorrow. If you have health insurance when you need it, your mother, your child, your cousin, your friend may not. If you, or others, have health insurance, you won’t know what it doesn’t cover till you need it. The insurance you, or any member of your family has now may change with little or no warning in the future, without regard to what you want or need. Mandating private, for-profit health insurance for everyone does not solve these problems. It merely increases insurance corporation profits. The provision of comprehensive health care for everyone is the solution to the U.S. health care crisis.

I have tried to illuminate the health care crisis, and to clearly define the solution to that crisis, in a series of essays and leaflets over the last seven years. If you have not followed those articles, or you do not yet comprehend why strengthening Medicare, eliminating the co-pays and deductibles, and expanding Medicare to cover everyone in America, for life, is actually less costly per capita, provides superior health care outcomes for us, eliminates personal bankruptcies due to sickness and injury, and improves the economic competitiveness of businesses that are willing to employ American workers (compared to the current administration of health care by for-profit insurance corporations) please read some of those articles, and familiarize yourself with at least some of the valuable references provided in most of them.

The most despicable, ominous thing that has happened with regards to the current health care reform effort in Congress has been that the evidence and the simple proposal for Enhanced Medicare for All has not even been allowed a public hearing or a vote in the Congress this year. You may disagree with me that strengthened Medicare for all is the best solution to the health care crisis, but virtually everyone with any knowledge of the issue, and of the principles of representative democracy, can agree that it should certainly have been publicly discussed and given full and open hearings by our legislative representatives. The reason that it didn’t is simply that corporations control our U.S. government.
If you agree with me, contact your U.S. Senators and Representative, by personal visit, by phone, and/or by the internet, and urge them to sponsor, support, and vote for Enhanced Medicare for All, HR 676. Don’t wait, do it now. But the most important thing for us to do is to organize and inform every other American, one by one, about this health care crisis, and about how the corporations are exploiting us, how our government is serving the corporations, not the people, and about the simple, best solution which will be best for all the people when we finally end the for-profit insurance corporations’ control and exploitation of the health care we all need.





  1. This is a sad testimonial to American healthcare.

    Now Joe Lieberman opposes even allowing people to opt into the Medicare system at cost. He says that will harm the deficit. How? Doesn’t “at cost” translate to “budget neutral?” Or am I missing the fact that our politicians have been paid off to ensure that NOTHING sensible happens at any cost?

    Comment by MoneyedPoliticians — December 15, 2009 @ 7:27 pm | Reply

  2. Excellent analysis. After a long career of seeing this “for profit” health care rationing, it is amazing to see so many ordinary citizens falling for the corporate advertising/propaganda blitz and essentially “standing up” for even more corporate profits against the best interests of family and friends. Thanks for your voice.

    Comment by Glenn W, M.D. — December 17, 2009 @ 10:18 am | Reply

  3. Obama gave the whole store away. The guy is either stupid or he’s been bought; and I don’t think he’s stupid. He and the Congressional Democrats have managed either by folly or bribery to screw up any chance of our getting genuine reform (or any kind of CHANGE I can believe in).

    The sooner we start putting our energies into organizing an alternative to the two major parties, the sooner we’ll see significant changes in how government–or those who own and operate it–can work in the public interest. Except for a relative handful of genuine progressives, Congressmembers (of BOTH parties) don’t dare ruffle the feathers of their corporate masters/contributors. These are very sad days for the Res Publica.

    Comment by J.Hill — December 17, 2009 @ 5:43 pm | Reply

    • I know Obama is not stupid. And there is at least a third possible explanation for how he has acted, besides the other one you postulated. After all, the reason there is an important national discussion of the health care crisis by Congress for the first time in generations is at least partly because candidate Obama quite compellingly brought up the subject – and convincingly won the election, and because Democrats (not Republicans, who you didn’t even have a word of criticism for, Mr. Hill) were finally the majority in both houses of Congress. And President Obama did not, by any means, drop the subject after he was elected. Nor did the President take a different position than he did as a candidate. The last time (and maybe the only time) there was any significant reform of the health care system in the United States was when Lyndon Johnson was President, and Democrats controlled both houses of Congress. (Lyndon Johnson was the Texan who got the critically important Civil Rights Act and the Voting Rights Act passed into law, which finally, after a century of blatant, wholesale violation, put some enforcement teeth in the 13th, 14th, and 15th Amendments.) Medicare (as all American families know, love, and so need and depend on it today) became law when Lyndon Johnson was President. But at that time in history, the U.S. Senate was not nearly as dysfunctional and anti-democratic, as it is now, and both houses of Congress were not nearly as completely controlled by powerful corporate interests, and disdainful of what the people need, as they are now, and the Supreme Court was more concerned with defending everyday people’s rights and our future environment, than with consolidating and defending corporate power and aristocratic privilege as it has been in recent decades.

      Politics, even in a monarchy or a fascist state, and certainly in a representative democracy, is always the art of the possible. And the President of the United States is inevitably engaged deeply in that art. President Obama shows that he is a brilliant leader, of surpassing intellect, and possessing a very wide spectrum of abilities. I don’t really know what I would do if I were faced with the responsibilities, the limitations, the abounding pitfalls, the priorities, of being the President of the United States. But I seriously doubt that I would do as well (much less any better) than Barack Obama. I think we in America are indeed fortunate, at this desperate, dangerous time, and in the actual, perplexing, corrupted circumstances of the political system we currently have, that Barack Obama happens to be our President. Is it not at least unrealistic to expect (or even hope) that an uncompromising ideological revolutionary would ever become President of a powerful nation with a demonstrably corrupted political system, by a regular general election, and then proceed to methodically, calmly, and successfully, single-handedly upset every applecart in sight? In a democracy, it is up to the people to make change happen. If it is a sham democracy we have, it is up to the people to make it real.

      My focus is not on blaming the President for things not happening the way I think they should happen, or second guessing his long range strategy and goals. My focus is on understanding and explaining the issues (in this case, the health care crisis) so we are dealing with truth and reality, not lies, propaganda, false assumptions, or misleading distractions. I think all of us in the grassroots should do that. And we should work to ensure that our friends, neighbors, family, and co-workers also are dealing with the truth of the issues, and organize to make our government be one that is of, by, and for the people, and the future. That is the only way we can stem the contrary currents and make headway. Working together – Gung ho, America.

      Comment by clydewinter — December 17, 2009 @ 6:58 pm | Reply

  4. […] who has undertaken a careful, deep study of the problem. If you happened to pass by my very recent article in tribute to the victims of the health care crisis without reading it, please take a minute and read it now. It hasn’t been printed in any mass […]

    Pingback by Two Doc’s Heartfelt Words from Long Experience about the Growing Health Care Crisis « hearts and minds — February 24, 2010 @ 7:41 pm | Reply

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