End Waste, Inequality



During his town hall meeting in Eureka, Congressman Mike Thompson repeated (and repeated) what seems to be the Obama mantra for the health care debate: "If you like the health care program that you now have, you will be able to keep it."

There appears to be a minority out there who like paying up to three times as much for medications as the rest of the world, who are content to see their co-pays increase about 10 percent a year, who like donating 30 percent of their medical expenses to industry shareholders and insurance executives, who actually enjoy spending days on the phone trying to reach the low level employees who are paid to deny them coverage. Since masochism isn't unconstitutional, under the presently proposed reform bills, they'll be able to continue the practice.

But what if, like pretty much everyone I know, we don't like our present health care situation? Why is a very vocal minority so adamant in preventing us from trying something new? (Well, not "new" -- just trying something that has been working quite well in almost every "developed" nation for the past half-century.)

My wife has full medical coverage through her employer. In a period of several years, she gave birth to our two sons and then went through a fairly rigorous treatment for melanoma. After each of the births, she spent a good part of the month of maternal leave on the telephone with insurance company representatives -- holding them to the terms of her insurance policy. We were repeatedly billed for procedures supposedly covered by insurance. The same thing happened during the toughest part of her melanoma treatment. She probably wasted a full month and a half of her life on the telephone because of that cancer -- while she was feeling downright sick.

Lisa is a health care worker and a meticulous keeper of records. She only received the coverage she was entitled to all along because she was tireless, and because she knew what she was dealing with. It's lucky that she truly loves her work, though, because she now has a very unwelcome "pre-existing condition," and her insurance will most likely not follow her to any next job.

Most of my relatives live in New Brunswick, Canada -- perhaps the poorest province. Many of them are older, none of them are wealthy. My 80-year-old aunt suffered a major heart attack a few years ago. It was so bad that she was moved to palliative care. She received such good care there -- for a whole month -- that she decided to stay alive. She is still with us -- slowed down considerably, but as sharp and cantankerous as ever.

When my aunt came home from the hospital, she didn't need to bother with phone calls to the insurance company. She doesn't need to shop around on the Internet, or go without dinner, to figure how to pay for her ongoing medication.

My aunt's health care isn't free. She pays somewhere around $2,000 a year in taxes. For that, she gets better care than I could hope for if I paid $12,000 a year. It works because everyone is in the pool, with a progressive tax rate. Since everyone is in the pool, the Canadian government has incredible bargaining power with doctors, hospitals and drug companies. There is almost no bureaucratic waste -- and no profit motive involved.

None of my Canadian relatives have to worry about being dropped by their insurers, nor wonder if they will be covered by a new employer. None of my relatives would even think about trading what they have for our health care system.

Yes, sometimes they have to wait (although not for emergency services). But they don't have to fight with insurance representatives while they wait. But anyone who thinks there are no waiting lines for health care in the U.S. obviously hasn't tried to get authorization for an MRI or CAT scan lately -- or perhaps they haven't tried to find an available general practitioner in this county, or spent a couple months in pain while they shuffled through several SSI case workers in hope of a hernia operation.

Congressman Thompson assured the town hall crowd that we are not going to get a Canadian-style health care system. I'm not assured. Why wouldn't we want to trade something that's wasteful, intentionally convoluted and unworkable for something based on the real needs of people?

I've heard the argument that it's not fair to ask those who are paying their own way to have to subsidize others. While some might consider that an "American" sentiment, it is surely not a very Christian one.

The truth is, though, if you have private health insurance now, you are already subsidizing the rest of us far beyond what a public option would ask of you. Sixty percent of insured Americans are already on a public plan -- state workers, county workers, federal workers, the armed forces, veterans, Medicare and Medicaid recipients. Your taxes are subsidizing all that. An increasing number of uninsured ER visits are being covered by inflating your health insurance payments. The rest of the world is benefiting from your overly generous contributions to pharmaceutical giants. Legions of lawyers involved in the malpractice practice are padding their wallets with your largesse. And I'm sure those chosen few who sit at the top of many health care, health insurance and drug companies appreciate your multi-million-dollar subsidies to their bank accounts every year.

(If one needs to complain about taxes, why look at the six percent of the federal budget going to health and human services? We could easily pay for all our health care needs if we looked closely at the 57 percent that goes, one way or other, to the military.)

Beyond all that, American style health insurance isn't necessarily insurance at all. Two-thirds of all bankruptcies in this country are due to illness or disease -- and almost 80 percent of those have health insurance.

The present system is meant to be cumbersome, arcane and top heavy. It is designed to appear too complex for "the average Joe" to deal with. By this time, though, the average Joe knows what the real health care problem is. The average Joe knows that the average congressman is pretty much bought and sold with corporate money. The system is designed so that a privileged few can leverage our misery for their own private gain.

I don't have any problem with people making obscene profits from iPods or cable TV, but some things should be placed outside the schemes of the marketplace. I would put our health in that category.

Pure and simple, the purpose of most private health insurance companies is not to provide the best health care possible. Their primary concern is their corporate concern -- providing the highest returns possible to their shareholders. The sicker we are, the fatter health care corporations become. Our collective welfare, our fear, our misery, has become merely a game on which financial giants place well-calculated bets.

I think we would all agree that health care workers should be well compensated. It is difficult, personal, often stressful work. We demand that they are extremely well educated and updated on the latest innovations. Most of us probably feel the same way about medical researchers. Paying them, in a nutshell, is paying for health care. Everything else -- the insurance industry, the CEO salaries, the shareholders, the advertising, the lobbyists, the competing health care bureaucracies, the armies of phone representatives and form filers -- has nothing to do with our health (other than what they add to our stress levels).

Basically, instead of just paying for health care, we are paying for health care and four or five other whole industries at the same time. Therein lies the real cost of the system we are presently stuck with.

Nothing involving millions of people is clean and easy. Cutting the waste from health care would admittedly mean the loss of thousands of jobs. We would be better served, though, if those workers were involved in the hands-on aspects of health care -- or family planning, or renewable energy, or land restoration, or teaching, or family farming, or ... anything that actually benefits us.

We're not the only health care system in crisis. Global depression, aging populations and unsustainable population growth are overburdening every nation. But couldn't we face those looming problems more effectively if we had an efficient system to begin with -- a system with people's needs at its core?

As an advocate of single-payer health care, I know I'm about to be disappointed. However, the words "single payer" were almost unknown and definitely unspoken in Bill Clinton's push for reform. Now those of us supporting it are perhaps the largest single cohesive segment of the debate. I can only hope that we see a "robust" public option in the Senate's bill. Anything short of that means merely that we will be revisiting the same issue in a few years with a lot of new faces in Congress.

Alan Sanborn is a writer and painter living in Arcata.

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