The Healthcare Crisis, year 46


51-year-old Donald Savastano after winning the ‘Merry Millions’ lottery in Upstate NY on January 3. He was dead of lung and brain cancer in 23 days after the Doctor he could finally afford to see looked at his symptoms (he couldn’t afford medical care as a self-employed contractor). Picture from ABC 7 Chicago (New York media didn’t pick up the story until February)

I have weird things that stick to my memory. It was 1972. I was a teenager in Indian Hills High School and my social studies teacher was talking about the latest article in the Scholastic Reader. It was kind of arcane for high school kids–health insurance, of all things. It was boring and wonky, but what it came down to was that President Nixon (pre-Watergate) was confronted with a problem that had been building for decades. The problem was that the way medical care had been paid for since the 1940’s was coming apart at the seams. The reason? The country’s biggest insurer, Blue Cross, was losing money. Nobody knew what to do. The American way of healthcare, which was private insurance and out-of-pocket, wasn’t a model for the rest of the world, so nobody knew of how to fix it. Or to be precise, nobody WANTED to fix it so that it was like everybody else’s healthcare in the industrialized world–a national system of single-payer and guaranteed coverage for all. We’d approached that with LBJ’s Medicare system, but the GOP owned the presidency and they weren’t going to build another big-government program like Medicare or Social Security. And there were enough ‘Yellow dog’ dems left that the GOP plus the southern Dems (who would eventually become the modern-day GOP) to prevent any discussion of single-payer/Medicare for All. 

What Nixon ultimately pushed was the failure known as ‘health maintenance organizations’, which had huge constraints on patient care and became the archetype of the treatment Americans DID NOT WANT. It became a joke in the Jack Nicholson/Helen Hunt movie AS GOOD AS IT GETS when her son cannot get proper treatment for his medical conditions. And (delusional as it was), Nixon also thought that making healthcare a for-profit endeavor was a solution. There are already ample reasons to hate Tricky Dick, but this one is a pretty solid one to pick on him today. Forty-six years later, we’re still haunted by this mis-direction. More on the mess of the 1973 HMO act here

And thus. After 46 years we have medical care as hostage capitalism. Nixon’s little scheme to keep small government begat a country where almost a million people a year have to file for bankruptcy, even AFTER Obama pushed through a system of mandated private insurance. During the run-up to the election, I posted about how unpopular the ACA was for many people. The sad part is that Clinton thought passing the ACA was a POSITIVE for the D ticket and didn’t address the problems in taking thousands of dollars from people to fatten up a private insurance industry. While there were some winners in the ACA, the issue is that Obama confused insurance coverage with healthcare–and the insurance companies know how to limit actual payouts through gaming of contracts and use of their ‘in-network/out of network’ scams. You’d think that someone who’d made Harvard Law Review would have been harder to snooker, but there you go. There’s a partial explanation of all this on a COMEDY show called Adam Ruins Everything, and the fact that you get this analysis on a comedy show when you can’t get it in mainstream media says everything I need to know about what’s wrong with medicine AND JOURNALISM. Obama thought that health insurance = healthcare. Silly him.

We KNOW that limiting access to medical care kills. The pre-ACA figures I saw showed that 45,000 Americans die annually from lack of access to medical care. And with the limits put on coverage through the ACA, things haven’t improved much. The story above should be exhibit A– poor Donald Savastano earned a living for his family, but wasn’t enough to cover insurance even through NY’s healthcare exchange. He thought he’d timed things correctly when he won the ‘Merry Millions’ lottery and was finally able to afford to see a doctor. But the doctors quickly explained that those odd pains he was having were from stage 4 lung and brain cancer, and he was dead 23 days after getting his picture in the paper for winning the Lottery. It took awhile for New York media to pick up his story.  And it’s hard to see how ‘Trumpcare’ could make things worse, but that’s why even hard-core libertarians wouldn’t back it. So instead, Trump and the GOP are undermining the financing of healthcare, even as House Speaker Paul Ryan talks of ‘hard choices’ about healthcare.

Which brings me to this, a bill for insulin as found on FaceBook. . If you’re diabetic, you need regular shots of insulin to keep you alive. The patent for insulin was sold for $1 back almost 100 years ago, and nobody in big pharma was gouging patients. That was then. This is what a month’s worth of insulin costs NOW.

insulin pic

Per the hapless patient who paid this, this is the bill once a month for insulin. He has insurance, but it doesn’t kick in until he meets a prescription deductible of (READY?) $7,000 annually. Lest this seem like a one-off, Truth-Out recently ran a story from the mother of Alec, a 26-year-old who succumbed because he couldn’t afford his insulin. Alec had nominal health insurance through an employer, but it didn’t cover his costs. Insulin is a 95-year-old drug whose discoverers sold their patents for $1 each, but its price has increased over 1,000 percent since the late 1990s. A vial of the same insulin that was once sold for around $25 can now cost patients like Alec nearly $300, and many people need multiple vials per month to survive… For Alec, this meant that his insulin and supplies cost almost $1,300 a month. He and I together researched for months in advance about his health insurance options. They weren’t good. The best plan we found would cost him $450 a month for the premium with a whopping $7,600 deductible… my son Alec was found dead, alone in his Minneapolis apartment.   

And how did the new Trump-backed Republican tax bill help? You can no longer deduct medical expenses on your taxes. Remember, high earners frequently get their healthcare as part of their pay, even though the benefit isn’t treated as pay or taxed as such. Senator Ted Cruz’ wife, a Director for Goldman Sachs, has a gold-plated healthcare plan that would be worth a minimum of $20,000. She’s getting a tax break far larger than anyone in the middle class. 

I could go on. 

I wanted to leave you with one last image. This is a demonstration that took place in London last weekend. The Tories are trying to privatize healthcare under the NHS and the people of the UK are pushing back. 

Image result for british protest nhs images

protest to save NHS in London. 

The protesters were several hundred thousand in London and other cities according to media outlets. Why don’t Americans protest when we get screwed on our healthcare? 

Because we’ve been screwed for 46 years and we’re used to it?





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