Thursday, August 10, 2017

For-Profit Health Care As The Engine Of Poverty In The USA

Birthing simulator in use at a U.S. Air Force hospital. What's wrong with this picture?

It's been a couple of years since I wrote the satirical novella Your Health Is Important To Us, and I've been thinking on the need to add a new chapter.

I wanted to express how for-profit health "care" has been the engine of poverty for my generation and those that followed.

Mine was the last cohort who could cling to middle class comfort by means of jobs that buffered the effects of exploitative health insurance. Many of us have lost or are losing our grip, and many younger than us never had any health care or full benefits employment to hold onto.

That sense was what I was trying to express in my novella, which owes much to the tragicomedy of life under Zionism, The Secret Life of Saeed the pessoptimist by Emile Habiby. And to Voltaire's Candide, which inspired Habiby. And to The Good Soldier Schweik by Jaroslav Haลกek, about a little man ground down by inexorable historical and cultural forces. Today's little man would be, I feel certain, a woman. Thus I created the anti-heroine Candida Albicans Smedley.

An actual heroine of the health care battles is Dr. Margaret Flowers. She has been on the front lines of the fight for universal health care in the richest nation on the planet, and I've blogged about her efforts to lead us in this direction a few times before.

Dr. Flowers was arrested in the Senate protesting the absence of voices for single payer in the hearings that led to the Affordable [sic] Care Act aka Obamacare. (Full disclosure: Subsequently, Dr. Flowers and I and my husband were arrested at the Obama White House protesting the ongoing slaughter of innocents in Iraq.) She has skin in the game of bringing health care to the masses, retiring from her career as a pediatrician to pursue social justice.

I usually keep up with Flowers' work by reading Popular Resistance, the website she helped found before "resistance" was a word co-opted by the Democratic Party branch of corporate government.

You know, the branch that brought us the insurance company giveaway called the Affordable Care Act.

This morning I read her critique of half measures like the ACA in her article for Counterpunch, "Improved Medicare For All Is The Answer." It shouldn't take someone with a medical degree to figure out what's wrong with the ACA, or to conclude that abolishing it without a replacement would be even more cruel and impoverishing to millions. Some of Dr. Flowers' clear thinking:

Most people who purchase health insurance have no idea which plan is best for them because nobody can anticipate what their healthcare needs will be in the future. A study of the Massachusetts health exchange plans done by the Center for American Progress showed that some plans were best for patients with cancer and other plans were best for people with heart disease or diabetes, but that isn’t something that can be advertised up front. Even if it were, people can’t predict if they will be diagnosed with cancer, heart disease or diabetes in the future. HR 676: The Expanded and Improved Medicare for All Act solves this problem by creating a single public plan designed to cover whatever our healthcare needs will be.
Dr. Flowers doesn't need me to explain that the goal of HR 676, i.e. covering "whatever our healthcare needs will be" is not the goal of federal health care policy.

That goal is the same whether we're talking about health policy, foreign policy or evironmental policy: protect profits for the corporations that put politicians in office.

Because of the exorbinant costs of health procedures and pharmaceutical drugs, health care is an important driver of growing poverty and wealth inequality. It's a racist issue because it falls most heavily on people of color whose health outcomes and longevity are worse than the white majority. It's a class issue because, as depicted in Your Health Is Important To Us, health care is a constant drag on the economically depressed. 

A normal health crisis such as an automobile accident, a heart attack, cancer or, increasingly often, opioid addiction, can easily cause bankruptcy and the loss of one's home. And if you die early from lack of health care? "Americans are dying younger, saving corporations billions."

Be scared, be very scared, says our corporate government. Time and tide wait for no woman -- mostly everyone needs some form of health care in the end.

Medically induced poverty will be the great equalizer of the 21st century USA, sparing only the very, very wealthy. Unless there's a revolution soon, and Dr. Flowers' ideas prevail. Here's a final quote from her article:

I refer to a saying used by my now-deceased mentor Dr. Quentin Young: “You can’t cross an abyss in two jumps.” The only way we can get to a universal single payer healthcare system in the United States is by creating a universal single payer healthcare system in the United States. Anything less than that will fail because it will not achieve the savings on administration and prices needed to cover everyone and it will not compete with the powerful private insurance industry.

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