Note: The video from Wednesday's briefing on the Massachusetts healthcare system, which Donna Smith discusses here, is available online from Healthcare-Now.
by Donna Smith. Published on Friday, February 27 at CommonDreams.org
I am haunted again. Two stories told in very different venues and for very different reasons are nagging at my conscience. And I ponder the President's budget points designed to begin some down payment on healthcare reform. All I know for certain is that the two stories and the human suffering associated with them do not add up with Obama's confident campaign assertion of healthcare as a human right or the 10-year plan he'll now support as he charges Congress to work on larger reform issues.
We need honesty going forward. We need full disclosure of our options. We need courage and clarity. And we cannot have that if this President and this Congress participate is a pre-choreographed dance to reward the big health industry interests at the expense of the rest of us. Simply asking for-profit insurance giants to bid on Medicare Advantage business that is robbing many seniors and disabled folks of access to care they were promised under traditional Medicare is simply a poor attempt at gilding the lily - it is not reform.
During a briefing held in DC on Wednesday, Dr. David Himmelstein of Harvard Medical School (we still think those credentials adequate, do we not?) recounted the shortcomings of the Massachusetts model for health reform. Plan after state plan has cost more than anticipated, covered fewer than the promised universal claims and left states like Massachusetts and those that came before them in the same mess now faced throughout the land with soaring costs, inadequate delivery of what is sold as the financial protection called "health insurance," and with health systems begging for more cash.
Yet it was Dr. Himmelstein's final points that left me shaken. He said he has just treated yet another cancer patient who has decided to decline chemotherapy because he or she cannot afford the co-pays associated with the treatment. Dr. Himmelstein will have no choice but to honor the patient's declination of treatment for what they both know is a curable cancer. My heart breaks just thinking about it. Getting a cancer diagnosis stinks. I know. My cancer ripped open my life. I had to fight like Obama's mother to make sure I kept my job and got care - even though I had insurance. And knowing another cancer patient is deciding to die due to a lack of cash in the state some want us all to model is barbaric. And I didn't fight for this hope for change to remain in a barbaric state of healthcare delivery and financing.
I do not think for one minute that my new President has truly internalized this struggle - nor that of his own mother - as this Massachusetts cancer patient decides to die rather than bankrupt his or her family. Some kill themselves more abruptly. Others live longer but often fight with insurance companies as Obama's mother did. But this person in Massachusetts is hurting - this American citizen is dying a preventable death. And I am at a loss about how President Obama would explain his down payment on reform to this patient or the patient's kids or spouse... especially when it could be fixed.
Then I listened to ABC News tell the story about a McDonalds employee in Arkansas who came to the defense of a female customer being attacked in the restaurant by another man. The abuser shot the McDonalds employee in the chest. And now the McDonalds workers comp insurance company has decided that the employee's medical bills of more than $300,000 should not be covered because the employee was not acting during the normal scope of employment. Huh? Apparently, McDonalds thinks employees who see crimes being committed should first remember that flipping burgers and salting fries are their duties, not defending customers. Again, how very barbaric. But no sign of our President on this one either, no siree.
But, he tells us, he gets it. Really? Either I need to take President Obama at his word that he gets the immediate suffering of the American people and is willing to allow insurance companies to dictate life and death - quite literally - for years longer and become even more powerful dictators of the value of American life or he is just flat lying and he doesn't get it at all. I don't really like either of those possibilities.
If either of these patients - one with cancer in Massachusetts or the other trying to recover from a gunshot wound to the chest in Arkansas - lived in any one of the other industrialized nations on earth, they'd be treated with dignity and get the care they need without going broke. Maybe hero pilot Sully can fly them to another nation that respects human life enough to help? Somehow I think that would be fitting. Sick Americans need a hero long about now - a 10-year plan or a lousy expansion of the defective product known as private health insurance won't cut it.
Making the insurance industry bigger and more powerful through expansions of "coverage" to the millions of uninsured is not the only answer. It isn't even the best answer. And the severity of the crisis demands intellectual and policy design honesty from the get-go. If the American people get three years down the road and have another and deeper mess in healthcare robbing them of health and financial security brought to them by this President and this Congress, it won't matter much who inherited what - especially if this part of the process was tainted by dishonesty and special interest powers.
Lofty rhetoric cannot hide a basic dishonesty of discourse and this President knows it. Doing what's right requires us to fully explore every option available. "Ye Shall Know the Truth and the Truth Shall Set You Free," seems maybe a verse we may want to explore. And this President is not allowing that -- yet. He is tightly controlling who offers opinion and testimony, and only those already friendly to his pre-selected agenda are welcomed.
Let's open next week's summit to all plans and ideas - all we have to fear is - well, we know the finish to that line. If we see all reform ideas explained, studied for their costs (and scored by the Congressional Budget Office), their benefits and evidence of their viability, and we hear testimony from clinical RNs and practicing doctors invited and prized in the same way as the opinions from corporate docs and industry vetted officials and industry friendly voices, then we'll know that our President is serious about honest reform.
So far, many who advocate for the publicly financed, privately delivered option for health reform have been purposely and carefully screened out. That's dishonest and shows a lack of confidence that if all the facts were known clearly by the American people that they would choose the currently preferred political strategy -- to keep the defective product of for-profit health insurance and expand it and truss it up with massive amounts of taxpayer money and package it as healthcare reform. If that is the outcome that has already been promised to the health insurance industry that so heavily invests in this President and his friends, then tell us that up front, skip the expense of the forums and the summits and the exercises in self-congratulatory polls and just tell the patients in Massachusetts and Arkansas that you don't give a damn - you have friends to whom you are beholden above and beyond the citizens of this nation.
On the other hand, if Dr. Himmelstein's cancer patient in Massachusetts deserves at least some of the care afforded another prominent Massachusetts cancer patient - Senator Ted Kennedy - then let's open up the process, be as honest as we can and get to it. Because if we let another 10 years go by, more than a million Americans will die preventable deaths with the life and death decisions administered by those who don't care about any one of us anywhere near as deeply as they care about profits.
Mr. President, fully vet and fully disclose every available option for healthcare reform. Invite all voices into the summit - even a patient or two. To do otherwise would dishonor your mother's struggle and the two patients haunting my thoughts. And as the mother of three sons, I hope I can trust that even political ambition cannot trump a son's love for the woman who gave him life and fought for his welfare even as she fought her own cancer.
Donna Smith is a community organizer for the California Nurses Association and National Co-Chair for the Progressive Democrats of America Healthcare Not Warfare campaign.
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