"The reason our health system is so crazy is we treat healthcare as a commodity. That really doesn't work. Most countries see it as part of their job to take care of their people," Meizhu Lui, executive director of United for a Fair Economy, quoted by the InterPress Services, April 10, 2006
My wife's Ob-Gyn recently raised her fees from about $225 a visit to more than $300. And she doesn't take insurance.
The news was tough to take, of course, another in a long line of increasing expenses that seem to impinge upon the freedom of choice we Americans supposedly enjoy.
Yes, we could change doctors, find an Ob-Gyn who is in our plan or one who might charge less, but my wife likes her doctor, feels comfortable and confident in her abilities, so changing doctors seems foolish.
We will be reimbursed for some of our costs, but we still have to put the cash out and deal with the personal cash flow issues.
Our story is not unusual, which points out something that has been mostly absent from the health-care debate. The American health-care system is failing not only the 47 million without insurance but many of the rest of us forced to rely on employer-provided coverage. The reason is that the system is based on profit and not on care. Every decision made by employers who negotiate contracts with insurance companies, every decision made by those insurance companies about the legitimacy of medical expenses and even many of the decisions made by doctors -- including who to see and what kind of services to provide -- are made with the bottom line in mind. The idea is to minimize expenses but to maximize price, meaning that we are paying more and more for each visit to the doctor but getting less time with our doctors.
That's one of the points that Michael Moore has been making as he makes the rounds promoting his film Sicko (as of this writing, I have yet to see the film). As he told Business Week in June:
"Do you know of anyone who hasn't had a problem with the insurance company, or getting some procedure covered?" he asks. "Anyone who sees this film will understand exactly the mess we're in right now."
Moore, as Daniel Vallin writes on the Common Dreams News Center Web site (www.commondreams.org), is attacking the profit-focus of the system, which elevates the bottom line of health insurance firms, corporate hospital chains and the drug companies above consumers.
"The need, codified in law, in fact, to increase profits as much as possible for the benefit of the tiny number of shareholders of the corporations, trumps the concern for adequate health care for the policy holders," he writes. "The health insurers are institutionally bound, not to care for the sick, but to turn a profit for their shareholders, and thus many who believed their health care costs were covered find that they are cut out from the most expensive healthcare system in the world in order to cut costs for the insurance company."
And we're not talking about extreme or experimental treatments. We're talking about regular care in most cases, such as standard diagnostic testing and referrals to some specialists.
Numerous studies have backed this up, including a 2005 Harvard Medical School study of Medicare patients that found that, "on average, quality of care was lower in for-profit health plans on all four clinical measures studied."
"Modern medicine," Joanna Garritano, chairwoman of Physicians for a National Health Program and an emergency department physician at Virginia Mason Medical Center, Seattle, wrote in the Seattle Post-Intelligencer in January, "has morphed from a healing profession into a business where the primacy of profit takes precedence over greater human needs. Trusting relationships with medical professionals have taken a back seat to efficiency standards as patients are rushed through doctors' offices.
"With just enough time to peer into a few orifices and change a prescription or two, doctors race to keep up with market demands," she adds. "Market-driven medicine tears at our moral fabric as people are seen as commodities -- mere bodies to insure rather than complex individuals with diverse human needs. Sharp market strategies, though suitable when shopping for goods, will always fall short in defining the value of health, or the value of life, for that matter."
So, it's not just he 47 million Americans without health insurance who are suffering under the current dysfunctional system, though they tend to suffer more than the rest of us. It is all of us.
Syndicated columnist Marie Cocco summed it up in late June:
"We are guilty of national malpractice for allowing the profit motive to drive decisions about who gets health care, and of what sort."
Malpractice is an apt way to describe the problem -- though the only court we have in which we can petition for redress is the court of politics.
Of the presidential contenders, John Edwards and Dennis Kucinich understand this best, though both Barack Obama and Hillary Clinton are offering proposals designed to fix at least part of the problem. The GOP plans, where they exist, would do nothing.
But plans crafted in the run-up to elections often fall apart once candidates gain office as high-paid corporate lobbyists -- in this case for the health insurance and drug companies -- work to preserve the status quo (remember Harry and Louise?).
So it is up to us -- the system's abused consumers -- to create momentum for change.
Groups working for national health insurance include:
Healthcare-NOW!, 339 Lafayette St., New York, NY 10012-2725; phone (800) 453-1305; http://www.healthcare-now.org/; email, info@healthcare-now.org.
Institute for Local Self-Reliance, New Rules Project, 1313 5th St. SE, Minneapolis, MN 55414; phone (612) 379-3815; www.newrules.org/.
Physicians for a National Health Program, 29 E. Madison, Suite 602, Chicago, IL 60602; phone (312) 782-6006; http://www.pnhp.org/; email info@pnhp.org
Universal Health Care Action Network, 2800 Euclid Ave., Ste 520, Cleveland, OH 44115-2418; phone (800) 634-4442; http://www.uhcan.org/joomla/.
Hank Kalet is a poet and managing editor of the South Brunswick Post and The Cranbury Press (NJ). Email grassroots@comcast.net. See his blog, Channel Surfing, at www.kaletblog.com.
From The Progressive Populist, August 1, 2007
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