While Arizona Senator John McCain was having his brain cancer surgery I was starting chemo treatment for an incurable blood cancer. Both he and I are about the same age and “success” means we might have a few more years to go…if we’re lucky.
The Mayo Clinic estimates the costs of McCain’s surgery at about $111,000, triple the amount of my total annual retirement income. Fortunately, between Medicare and good union-negotiated health insurance I will not have to sell our Picture Rocks double-wide home to get through this. Neither will the senator, but for different reasons.
Federal legislators and their staff and families get 75% paid by Medicare, legislators get free outpatient care at military bases, and there another half-dozen federal funding sources that bring out-of-pocket cost to close to zero. They get “government handouts” while we get “free enterprise.”
I don’t begrudge the senator his healthcare. But We, the People he works for, deserve the same. So what’s wrong with Medicare for all at an affordable price?
ILLNESS FOR PROFIT
The United States may be the only advanced economy that still treats human illness as a profit-making opportunity. Most of the modern world believes health care is a basic right, not an opportunity for greed and profiteering. The New Deal tried to include health care with Social Security, but the for-profit medical industry shot it down. Truman tried again with the same result. In the 1960s the battleground shifted from universal health care to universal health insurance, what some called “the Great Leap Sideways.” That shift was supposed to reflect our assumed preference for private industry over government-run programs. For those left out, it didn’t make much difference.
Obamacare tried to close that gap while leaving pretty much everything else in place, with subsidies for some and penalties for those who chose not to enroll. The carrot and the stick. One of many problems, however, was that, in his effort to blunt expected opposition, President Obama let Big Pharma and the medical industry pretty much write the complex legislation and there were few cost controls. The huge difference in prices for the same drugs if purchased in Canada is a measure of Big Pharma’s greed, and Obamacare did little to dial that back.
Now Senator Bernie Sanders has resurrected the fight to expand Medicare to everyone. The failure of Republican “repeal and replace” efforts left a vacuum that left-leaning legislators hope to fill. The pending Cassidy-Graham last-ditch GOP effort seems more a “repeal and punish,” rather than replace. That no hearings are being held means votes will be cast in ignorance. Unofficial estimates are that the states will lose billions of federal Medicaid dollars and the numbers of uninsured will rise.
The pros and cons, the promises and problems of a big shift in our health care funding and delivery are being debated with loaded buzz words designed to mould our opinions without much regard to the facts. And because I, like most of us, am not an economist, I am not going to presume to tell you “the truth.” There will be many points-of-view and they will all try to put their spin on their POV to get the most support with the least amount of work. That’s politics in America these days.
ABUSE FOR PROFIT
Not being a health care “expert,” and not trusting those “experts” too often bought and paid for by the special interests who want to continue raking in their high profits, I can only share my own experience. I’ve been covered by Medicare as my primary insurance for nearly 15 years and, as far as I’m concerned, it works just fine. The only real problems I’ve observed are abuses by health care providers seeking to increase profits.
A person close to me who had a heart attack last year, for instance, saw that Medicare was billed – along with everything else – for an expensive brain scan that never happened. Banner-UMC was questioned about it and said they’d look into it. No word a year later.
In an earlier incident, I went to our neighborhood clinic for my annual flu shot and was surprised to see an additional billing of over $100 for a doctor’s visit. Never saw any doctor, and why would I for a flu shot? After months of back and forth, a clinic spokesperson acknowledged that this was a way the clinic operated to maximize revenue. Wow! I reported it to Medicare but they never responded. “Medicare for All” has to address these issues along with the others.
BEGIN THE DIALOGUE
What really needs to happen is a sea change in the way we do politics. There are problems with any new program, and one of this magnitude needs as much input from consumers – us – as possible. Slick slogans pro or con don’t solve problems. Spin doctors don’t answer very real questions on either side of the debate. Perhaps Senators Sanders and McCain should launch a road show that is heavy on facts, that answers very real questions. The only way to counter the expensive propaganda barrage that the “unhealth industry” is unleashing is by convincing millions of real people – you and me – that there is a better way and that it can be done without filing for bankruptcy.
My own experience shows me there is a better way, not problem-free, but better by a lot. I lived in California nearly 40 years and had health coverage through my union’s negotiated contracts. We had an annual choice between an insured plan or Kaiser Permanente. Kaiser had an extensive network of facilities that we had to use, like the insurance companies’ “preferred providers,” but the one time they could not provide what I needed they paid for Stanford Medical Center to do it, and it was successful.
While we were encouraged to select a primary care physician, we were limited to Kaiser doctors. But when we went into the ER or Drop-In, sort of like Urgent Care, we saw whoever was available – just like with any insured plan. Both my kids were born at Kaiser, Kaiser saw my father through the eighth heart attack that killed him, Kaiser eventually found the acoustic neuroma that was making me deaf, they pulled me through a killer pneumonia. Sometimes there were long waits to see a doc, but there was always health care available. My co-pay, as I recall, was $1. No deductible.
There were some institutional criticisms of Kaiser as they grew, but I do not remember the details. I do recall that doctors sometimes got short if the patient took more than the prescribed time to tell their stories. In medicine, as elsewhere, time is money. Like most of the health care industry, Kaiser tended to rely on Big Pharma for direction, and the drug companies routinely put their own Bottom Line ahead of public health.
My spouse worked in free clinics set up in the 1960s to assist California farm workers. Maybe the government could end the war in Afghanistan and use that money to buy up a bunch of the mini-clinics that have sprouted up in drug stores and supermarkets, partnering with local providers to minimize government bureaucracy and expand access to health care. Training programs will be needed to fill the many new jobs that will be created.
We may have an opportunity to do better than what we’re now doing. Let’s not squander it with name-calling and nitpicking and knee-jerk party lines. Let’s talk to each other and make ourselves heard. Let’s ask the hard questions and insist on answers that make sense.
ABOUT COMMENTS FROM THE CHEMO COUCH: I am nearing 80 years of age and am taking chemo for multiple myeloma, an aggressive and incurable blood cancer that attaches itself to my ribs and spine and sucks the calcium out so that a sneeze breaks two ribs. That keeps me close to home. After several months of treatment it is still not clear whether the chemo is slowing the cancer down, but it all leaves me with little energy and a lot of time to think. And I think a lot, and because I’m a writer I want to put what I think into words for others to read. Give them something to think about too, about local and national politics, about nature, community, history, and maybe even about facing the end of my time on this earth. I am grateful to John and Lori Hunnicutt and the Arizona Daily Independent for carrying my opinionated stories, and hope these columns will get readers thinking. I am a trained researcher and do diligent research to present facts and avoid name-calling. Hopefully we will all learn something we didn’t know and will talk to each other about it. Right or Left, we have more in common than we are often willing to admit, and dialogue is, perhaps, the only thing that can save democracy in America.
— AVL