Wednesday, July 22, 2009

The Self-Hating City On The Hill

This week I have been reading the news with a dreadful feeling that health care reform, long overdue, is going to fail. Again. The death of health reform will be a bipartisan accomplishment, another tragic consequence of our inane two-party system.

The minority party wants the majority party to fail, and has been working hard to derail any action at all. A prominent conservative columnist advised his party that this is the week to "go for the kill." What an apt phrase.

We have some excellent hospitals and highly-trained doctors in the United States, but a great number of Americans cannot access them. This is unjust. The Senate Republican leader, Mitch McConnell, maintains that emergency rooms are a sufficient safety net for the poor. That is the minority party's view of justice, and also the view of some conservative Democrats; and their hatred of the poor blinds them to the fact that this the most expensive and inefficient safety net, setting aside abstract concerns like justice or dignity.

The President, who once claimed to be an advocate of single-payer universal health care, crafted a compromise that would maintain private insurance, but ask the for-profit health providers to compete with a public plan. An interesting idea, daring the profiteers to compete with a plan that is funded by and accountable to the public.

This is not to say that private insurance providers are evil. I don't regard any business corporation as evil. Corporations are, however, legally required to secure profits for their shareholders. They are not accountable to the people as a whole, but to their shareholders. The notion that a social conscience obligates a corporation to do the right thing, even if it costs money, is a fantasy. A private business is obligated to make money for its shareholders, that's it.

Reform will be shot down for the sake of political sport, in hopes of bagging Obama and winning seats in 2010, and to preserve the status quo, which works well enough for those who can buy power.

Moreover, the death of health reform will not arouse public outrage because, as a people, we buy into certain myths. We are eager to believe the myth that poverty is a moral disorder, that every poor person is likely getting what they deserve. We are also eager to believe the free-market religion, the benevolent "invisible hand" that will solve all social problems cheaply and fairly.

So health reform will die, and in the second year of my contract with the Deming Public Schools I am paying more for health insurance that provides less coverage for my own family.

On this issue, the United States as a nation is unjust. We cling to deluded ideas that allow the greedy to prevail over the lives and dignity of the poor. More people are willing to show up and take over town hall meetings to exercise lunatic conspiracy theories about the President, than to protest a health care system that kills Americans.

What a sick, deluded, self-hating country. What is the matter with us?


Pam said...

I heard somewhere that as far back as Roosevelt ( one or both) a healthcare reform has been on the agenda somewhere.

As always, the devil is in the details and the HUGE hill to climb called consensus.

I don't have the answer, but, since I've been on Medicare I've seen what happens when the government runs a HUGE, inefficient system. It's enough to just make a person want to lie down and just die rather than have to jump through hoops of the left hand not knowing what the right hand is doing.

Private insurance companies are equally as frustrating and grossly selective and expensive.

Medicare providers, hospitals and doctors say getting reimbursment from the govt. is a nightmare

Insurance companies have people who just look for loopholes to prevent paying claims. (if it sounds like I've had experience, I HAVE!).

So, I don't have a clue as to the way to go about this. I assume there must be one. Quite frankly I shudder at the idea of single payer via the govt. Like I said, I'm dealing with Medicare now.

There does have to to a better way. I just don't know what it is.

My guess is that the people with the power don't either.

Nathan said...

Well, my previous comment vanished into thin air! Anyway, I've been uninsured for over 7 years now, put zero faith in the current health care bill, even if it's passed. Sadly, other than eliminating the pre-existing condition clauses that allow insurers to inflate prices, the current bill does little to upset the balance of the system as it is. It's probably going to take a further collapse to change the health care system, and in the meantime, millions more suffer.

Pam said...

I agree with you, Nathan. My daughter was laid off several months ago (retail management) and hasn't found a new job yet.

She had to go to Cobra to get the kids covered. They are 9 and 11 and have serious psychiatric disorders that require quite a bit of medication and, as of next week, Day Treatment for the 9 year old.

Once the Cobra option vanishes and until she finds a new job, who the hell is going to insure her boys?? Their pre-existing conditions will make that virtually impossible!

Because they live with me they have a roof over their heads but the boys don't qualify for Medicaid.

There are just so many loopholes that need to be fixed, closed or revamped.

Nathan said...

I'd take a government run system, flaws and all, over the mess we have now. I know relatives that have had similar experiences with Medicare, so I'm aware it's not some perfect solution.

But the for-profit system is just that - for profits! United Health Group, just to give one example, cleared over $800 million in profits in just the last quarter year. And they claim to be a non-profit. It's all over the top when it comes to for-profit health care - and at our expense.

When you have a cookie cutter system like we do, both ends of it clash and neither ends up being all that effective. I'd bet some of the problems with Medicare are linked to conflicts with hospitals and clinics run by for-profit companies. We've never had a national system, so we really don't know if it would better or not. But I have a hard time believing that we will ever approach full coverage - all citizens covered - under a for-profit system. It's to their benefit to keep things expensive, which leaves those of us with low incomes, or without jobs, out.

I've spent a lot of time reflecting on this issue, as it personally impacts me, and has for a long time.

A few other ideas I have are the following: as long as insurance of whatever kind is linked to employment, we're screwed. Not only does it create unnecessary fears about job loss - which happens sometimes regardless of how well you perform - but it also makes it a much less fluid employment landscape. People stay somewhere because of benefits only, and often to the detriment of their health and well being. Stupid situation if you ask me. Two, if we don't transform our attitudes towards death, we'll continue to have extraordinary expenses at the end of life. We spend more money on the last 10 days of life than the rest of our lives in total. Almost all of this money goes to extraordinary measures to keep someone alive who would have died in any other generation. And then we say we can't afford to cover all Americans. Not intelligent if you ask me. And finally, if we continue to run hospitals, clinics, and other medical establishments like businesses, we're screwed. No matter what system is put in place, if profits are placed before people, then nothing will really have changed. It's more than just a turn of phrase; it's an entire shift in approach. The majority of hospitals and clinics, beginning in 1960's, were taken over by MBAs. Doctors and medical administrators either were thrown out of leadership, or went to school again and were brainwashed into thinking we should run medicine in the same way we run Wal-Mart.

So, there's a bit to chew on. I don't have all the answers either, but I definitely have some opinions :)

Pam said...

One of my brothers is a retired physician. He's often told me that the HUGE medical expenses are at the beginning and end of life.

People can be bankrupt for life by the time they bring a really tiny premie home from the hospital. Same goes for end of life care.

My daughter is a single mother (the ex is a loser drug addict who has never and will never provide support for his boys. He can't even be bothered to call unless he wants money from my daughter. He hasn't seen or talked to his children for years). She and the boys live with me as she has always worked, primarily, to provide the horrifically expensive care our boys need.

Even WITH insurance the boys will be paying for the over and above expenses already incurred.

As I said my daughter is in retail management and excellent at what she does. She lost her job due to the economy. Whatever job she is hoping to find must have benefits that will enable the boys to have the care they require. They are young - 9 and 11. These kids can't go without care and medicine.

The youngest has to go into Day Treatment next week. $700 a pop per day. Children's Hospital, the only good option for us since our child psychiatrist, a man we trust implicitly, and who has been our physician from the beginning, is head of the program, is out of network on her Cobra. Also, it seems the deductible for this program is $9000. She has had to beg and borrow $3500 just to get him in the door next week.

This is just wrong. But, at the moment there is no other option due to the fact they live under my roof and aren't out on the street. If they were, she might be in luck and be able to get some kind of Medicaid.

We fall through the cracks.

And we aren't alone. That's true of many Americans.

AT the very least we should be able ( we as in Americans ) to provide the care our children need. These boys were probably damaged before birth genetically by the irresponsible lifestye of a father, who, it seems, has been self-medicating on drugs and alcohol since he was a preteen.

These boys did nothing to contribute to the illnesses they suffer from. As a parent and grandparent we will not allow them to go untreated,where, if LUCKY, they only end up on the street and self-medicating on drugs and alcohol. At worst dead or incarcerated.

That shouldn't be the only option for ANY child in America.

So, yes, I want something more for my kids and my grandkids. There has to be a better way than what we have now.

quid said...

This fight is not over yet. I remain optimistic that we can get something somewhat sane passed, and modified over the next 7 years, as we need to.

I don't understand why everything in government is in one big "package deal" that is so big and so complex, we can't help but make bad decisions.

Corporate projects have an overall mission, and are usually organized in phases. As Phase I is getting finished, Phase II is organizing and ramping up, etc.


I wish I had all the answers. But, I am still cautiously optimistic that change will come.

It has to.