HEALTH CARE/Joan Retsinas

Cure for Our Ailing Health Care System

At last a cure for the ailing healthcare system is on the horizon. The FDA just approved sale of the first self-contained artificial heart (made by Abiomed). Cardiac surgeons, as well as failing patients, have been waiting for these devices. Medicines and surgery can do only so much; some hearts are beyond repair.

These artificial hearts may also save the healthcare system.

Our system is a marvel of design, but the designers -- our leaders -- have defective hearts. The diagnosis is obvious: no empathy. Their hearts spew forth love (erotic, paternal, maternal, fraternal), patriotism, courage, friendship. But not empathy. Something is amiss.

Artificial hearts should do the trick, especially if programmers have programmed the gizmos with empathic responses to suffering -- one of the hallmarks of "heart."

So hurry up with the transplants -- the healthcare system is moribund. Without some empathy on the part of our leaders, the system may die.

The powers-that-be have invested lots of brainpower in our health system. Analytic tomes (mostly analyzing costs) line the shelves of think-tanks. The government healthcare programs are startlingly complex. Look at the Medicare Part D rules; talk to an enrollee lost in the intricacies of choosing a plan. Look at states' Medicaid regulations; a slew of bureaucrats decipher those rules. The people behind Healthcare USA are more than thoughtful -- they are often brilliant.

Money isn't the problem either. The United States has invested more of its GDP (almost 15%) in health than any other developed nation. The private sector honchos from managed care companies, insurance companies, pharmaceutical companies and lobbying firms have grown rich from this industry. Besides, we are a wealthy country that hasn't stinted on consumer-consumption: SUVs and high-definition televisions are standard accoutrements for suburban families. Even while we fight wars in Iraq and Afghanistan, we are cutting taxes. At taxpayer expense, our decision-makers write checks for "special interest" boondoggles. They could, if they wished, pick up the tab for national health insurance.

The problem must be a lack of empathy.

Certainly the flaws in the system are obvious. Almost 15% of the nation is uninsured. A swathe of employers don't offer health insurance. Others offer it, but exclude new, part-time, temporary and contract employees. For employers who offer insurance, premiums can be too high for low-income workers. Enrollment in state-supported Medicaid and Medicaid expansion programs would be up -- if states could afford to add more people to the rolls. Retirees have watched that their pensions, as well as their health insurance, shrink.

The underinsured have emerged as a sub-population. These people are lucky to have insurance, but their insurance doesn't cover much -- not nearly as comprehensive coverage as government employees enjoy. Or their policy has caps, effectively shutting off coverage before some treatments are complete.

Congress, the administration, Governors, state legislators -- all concede the flaws, yet don't empathize with the constituents suffering from the flaws. Our tin-men solons see these constituents all the time: the cashier at the Big Box store; the new college graduate interning in a government office; the woman who spins the clothes rack at the dry-cleaner; the National Guardsman returned home safely, to reprise his $10/hour job at another Big Box store. Few of these people have insurance. And some need medical care, medications, physicians' oversight. Some of those with insurance, moreover, have discovered that their barely affordable policies still leave them with hefty medical bills.

In this election season, candidates profess to "feel your pain." I don't think they do; their hearts don't feel anybody's pain. It's time for transplants.

Joan Retsinas is a sociologist who writes about health care in Providence, R.I. Email

From The Progressive Populist, October 15, 2006

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