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Americans: In Sickness and in Health

    President Obama has announced that he is creating a $634 billion reserve fund over the next decade to provide a down payment for expanding health coverage. Just past the end of the president’s first 100 days, millions are watching to see what his plan for health care is going to do to alleviate suffering and address the disparity in our current system to provide insurance care for all.
     Unfortunately, the proponents for single-payer plans are going to the back of the bus as the for-profit stakeholders are assembling to derail any plans that offer an expanded Medicare option for younger Americans or one that offers the same plan that federal employees enjoy today.
    Meanwhile, there are excellent published articles and television productions addressing the complicated problems we face if we try to keep “fixing” the broken system we now have.
   The New Yorker recently published “Getting There from Here,” on how our current jerry-rigged health care system contains many models that reformers can on build on, including the Massachusetts plan, those of France and Britain, our health plans like Medicare and the V.A. for veterans.
    PBS’s recent Frontline: Sick Around America illustrated how
difficult it is for sick patients to purchase or even keep their
insurance when they are most vulnerable. Some Americans find that even when they are able to find health insurance, their insurance companies try to rescind their coverage, usually pointing to finding small signs that there may have been a pre-existing condition, proving that the insurance companies do not need to pay for treatments. Sick Around America showed how several patients had their insurance rescinded after they had suffered from heart attacks and diseases like lupus. Not only did their insurance fail them, they were too sick to work, and their medical costs skyrocketed as they lost their jobs. One patient who was diagnosed with lupus had her insurance rescinded and as a result, could not receive the treatment she needed. By the time the insurance company straightened out the rescission, she had died. This is the American way?
   What many Americans don’t know is that they are one health
problem away from losing everything they have—health, peace,
financial security, their careers and life as they know it, even if
they think they have insurance coverage. They face losing their
homes, life without insurance, and financial ruin. It this what we
believe in?
   Health insurers have an economic rational for rescission. They
claim that some people go in and out of their systems, thus
defrauding the insurance companies. Some insurance company
spokespersons admit that they find rescission uncomfortable and would stop rescission if every insurance company would. Yet, as Lisa Girion of the Los Angeles Times reports, bonuses have been paid to insurance company employees who are responsible for the most rescissions in a given year.
   In a 2005 paper, “MarketWatch: Illness and Injury as
Contributors to Bankruptcy,” published in Health Affairs, authors
David Himmelstein, Elizabeth Warren, Deborah Thorne and Steffie Woolhandler wrote that about half of personal bankruptcy filers cited illnesses that led to bankruptcy. They found that out-of-pocket costs averaged $11,854 since the start of illness and that 75.7 percent had insurance at the onset of illness. Medical debtors were 42 percent more likely than other debtors to experience lapses in coverage.
    The French have the best health care in the world. They also
have much longer lives. Brits offer universal health care to all
their citizens. So do all the other Western democracies in the world. And the Brits cover everyone at half the cost we pay for our system that leaves tens of millions of Americans without coverage, thus removing any safety net when hardship strikes. Our system is rated 37th in the world. This is shameful.
    However, the well-heeled proponents of our current profit-driven health care system are ready to strike down Obama’s promise to fix our broken system. According to the The New York Times, Richard L. Scott and his group, Conservatives for Patients’ Rights, have hired the PR firm, Creative Response Concepts to fight Obama. Creative Response Concepts is infamous for its work with the Swift Boat Veterans for Truth who notoriously smeared Senator John Kerry when he was running for president.
    Scott is well-known for building Columbia/HCA into the largest health care company in the world. Scott was booted out by the company’s board of directors in 1997 amid the largest health care fraud scandal in our history by overbilling state and federal programs. Columbia/HCA settled for $1.7 billion. Scott was given a severance payment of $10 million and 10 million shares of stock (then valued at $300 million, according to the Journal Record.) Now Scott goes with the same zest that he was known for at Columbia/HCA by demanding aggressive bottom-line profits, attacking an Obama health plan before it is even presented to the public. Scott’s current portfolio includes walk-in medical centers in places like Wal-Mart, which he promotes as alternatives to emergency rooms. Scott has pledged $5 million to create a media blitz to challenge the perils of “socialized medicine.” Donors have added another $15 million.
    According to the Times, Scott’s “four pillars of reform”
are choice, competition, accountability and personal responsibility.  This is simply ludicrous in the face of today’s health care options.  Millions of Americans cannot buy insurance anywhere—they are uninsurable. Forget choice. Forget competition. No insurance company wants to insure people who they think will lose them money. And let’s get real: Personal responsibility falls on its face when you think of the many people we all know who led healthy lives—they exercised, ate right, had regular check-ups, didn’t smoke—and they still become sick or died at young ages. No one sets out to get cancer. Or Parkinson’s disease. Life isn’t fair. But insurance should be affordable, and everyone should be charged the same rates—regardless of health status. Any other rate discrepancies should be viewed as discrimination.
    I know business owners who currently offer their employees
health insurance. The problem is that the costs are over $1100 per month per person. These kinds of rates are a hardship for small businesses, especially in this economic climate. If we could fix the health care problem with a single-payer plan, many experts say we could afford to cover all Americans, just like any other civilized country in the world.
    Many of us find the current system that denies health care to
over 47,000,000 and leaves another 25,000,000 underinsured morally unacceptable. If some of our representatives in Congress find universal health care to be too radical for their vested
contributors, I would suggest they willingly surrender their taxpayer-supported health care and attempt to purchase health insurance in the marketplace like the rest of us do. It would be the “free market” thing to do.—Pam Berns

Published: June 07, 2009
Issue: Summer 2009 Urban Living


I'm with you, cousin....
Well-written and incisive. What is scaring people so much that they're disrupting town meetings? I actually heard one demonstrator say "Keep government out of my Medicare!" Exactly who does he thinks runs Medicare (and efficiently, at that)? I have a French brother-in-law, and can vouch for the fact that they payless and get more when it comes to health care.
Cindy in DC, Aug-08-2009
This was a brilliant summary of what is wrong with our health care system. Thank you
Angela, Jun-07-2009