Wednesday, August 19, 2009

Health-care reform: Matters of life and death from an alternate universe


Last weekend, the healthcare controversy came to my door when friends from South Florida arrived for a visit. Years ago, they were former neighbors. We shared a backyard retention pond that had grown into a wildlife preserve. Each morning, I recall, my neighbor threw birdseed to the resident ducks and moorhens. She had a name for every critter. “My buddies,” she called them.

My former neighbors and now dear friends had an appointment at the Mayo Clinic in Jacksonville. Her cancer is treatable and manageable, but she suffers20from fatigue and takes mega doses of Percocet and morphine to relieve pain. Last week, she and her husband checked into a Marriot Inn near the clinic for days of blood tests, X-Rays, MRIs, and consultations.

Since I live within two hours of Jacksonville, I invited them to stay for a weekend. On Saturday, we treated ourselves to a boat ride, dined on fennel and endive salad, baked grouper, and homemade hazelnut cake. On Sunday, we talked, watched sailboats lumber past my balcony, watched billowy cotton ball clouds turn red against a setting sun.

On Monday morning, just before their return trip to Jacksonville for more diagnostics, the hospital called their cell phone: Their insurance carrier had not “pre-authorized” the tests.

For my friends and millions of families like them, this is our current healthcare system: Arbitrary decisions made, not by medical doctors, but by insurance carriers that force them to chose between timely treatment or bankruptcy, living or dying.

To read conservative commentary is to enter a Universe of reverse polarity where private health insurers are the angels, and the devil by default is government. You read dire predictions about “Death Panels” run by bureaucrats who will eat your baby or kill your grandmother; but you will hear nothing about the Death Panels of private insurers who would kill my friend or bankrupt her family … and pocket their insurance premiums with a crocodile smile.

One can understand misplaced outrage with some justification. All of us, liberal and conservative alike, were rightfully angry about the $700 billion bailout of Wall Street and the outrageous bonuses paid to crooks and scoundrels at taxpayer expense. Yet, our rightwing friends ignore an inconvenient truth: The same greed and corruption that almost ruined Wall Street are ruining our healthcare system. Here is a snapshot of our current situation:

In 2008, total US healthcare spending reached $2.4 trillion, representing 17% of Gross Domestic Product (GDP). By 2017, healthcare spending will climb to 20% GDP.

How does our current healthcare system compare with other countries? At 17% GDP, we spend far more than Switzerland 10.9%, Germany 10.7%, Canada 9.7%, and France 9.5%.

Since 1999, health insurance premium costs have risen 120%. In contrast, cumulative inflation rose 44%, and cumulative wage growth rose 29%. When adjusted for inflation and runaway healthcare costs, real wages have fallen.

Has the most expensive healthcare system in the world reduced infant mortality? Not according to the
2009 World Factbook, published by our own CIA. The USA ranks below 45 nations: USA 6.26, Cuba 5.82, European Union 5.72, Canada 5.04, Switzerland 4.18, Germany 3.99, and France 3.33, as examples.

Bankruptcies: In 2007, medical bills accounted for 62.1% of personal insolvencies, an increase of 50% in six years.

In short, the most expensive healthcare system in the world is not making us healthy, wealthy, or wise. To maximize earnings, private insurers ‘cherry pick’ the most profitable subscribers, reject high-risk applicants, eliminate those with “pre-existing” conditions, limit benefits, drop customers, and charge higher premiums. One inevitable consequence of a profit-driven system is a large pool of “medically uninsurable” applicants who are denied access to affordable, quality healthcare.

Another consequence are high premium costs that partition our people into ‘haves’ and ‘have nots.’ An estimated 47 million people lack healthcare coverage, and medical debts will drive a million people each year into bankruptcy. In an anti-Universe, there are those who proclaim: “The U.S. has the best damn healthcare system in the world.” The real Universe knows otherwise (

When the Bush/Cheney administration proposed a prescription drug plan for seniors, Big Pharma won concessions that barred Medicare from negotiating lower prices or importing drugs from cheaper markets. Today, seniors pay 60% more for drugs than veterans because the Veterans Administration has the right to negotiate discounts whereas Medicare does not.

Private insurers, demanding an opportunity to compete with Medicare on “a level playing field,” won $177 billion in subsidies payable over 10 years. When one pays money but gets nothing in return, the more apt term is ‘extortion.’

Shortly after the prescription drug plan became law, 15 congressional and administration officials resigned to take multi-million dollar a year jobs with the drug lobby. Thus, crony capitalism perpetuates a feeding frenzy whose purpose is to
privatize profits and socialize risks … turning subscribers and taxpayers into chum.

South of the border, Mexican drug cartels wage bloody turf wars for control over territory and profits. In an anti-Universe north of the border, healthcare cartels wage turf wars in Washington for control over profits and monopolies. In the real world, one plus one equals two. In the anti-Universe of K Street, healthcare cartels script this message: One plus one equals socialism, government-run Death Panels, euthanasia, dead babies and dead grandmothers, service rationing, even shortages of toilet paper.

How do you move the debate from the real world into the shadowy anti-Universe of astroturfing and public hysteria?

Easy! Hire a K Street public relations firm such as
Shirley & Banister Public Affairs, whose client list includes: AETNA, CIGNA, Ann Coulter, the Heritage Foundation, and the Republican National Co mmittee. Hire Jack Bonner and Associates to spread false rumors with forged letters. Hire Dick Armey, former Republican House Majority Leader, to organize protests and create the illusion of spontaneous public uprisings.

In a year of deep recession, job losses, home foreclosures, and massive bailouts at taxpayer expense, one can always capitalize on the passions of an angry citizenry fed up with chicanery and corruption … and the all-too-human tendency to seek scapegoats for ritual sacrifice. Those who disrupt town hall meetings are angry, but their anger is misplaced because little do they know that those who incite them do not have their best interests in mind.

Manipulating public opinion is easy when you are the CEO of a corporation with lots of money and lobbyists and politicians in your pocket ... and you can always find a willing mob of malcontents and misfits ready to do your bidding.

In three weeks, my friends from South Florida will return for another visit. Again, we will reminisce about the adorable critters of our fabled pond. Again, we will share a splendid meal, watch a DVD or two, or take a stroll on the beach and splash in the surf. How much time do we have left to enjoy a few precious moments?

Meanwhile the stories of my friends from South Florida and the plight of millions of people in their situation remain untold; their voices drowned beneath the chirps and scrapings of late summer cicadas. Real people in the real world have no lobbyist, no advocate to argue their case, influence the debate, or quell the angry mobs … and that is how America’s healthcare cartels win every time.

(Cross-posted at
The Swash Zone.)

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