Saturday, October 10, 2009

The Struggle for Health Care

Revolution in the Streets?
Or Revolution in the Mind?

Unless ordinary American working people—blue-collar, white, or green—demand adequate, accessible, and affordable health care—shouting out much more vigorously than they have so far—their views will have no impact on Congress.

That was the most distinct message delivered at the public Health Care Reform Forum at the Naro Cinema in Norfolk, VA, the evening of Oct. 7.

And, as some speaking at the forum cautioned, getting that message heard may well mean going to Washington by the hundreds of thousands, sitting down on the Capital Mall, and, if need be, getting arrested.

Whether the hundred or so people who turned out for the forum are ready for that kind of activism was not clear. Still, interest in the issue certainly seemed keen enough, given that so many turned out for an event which came together on short notice, was publicized solely on e-mail lists, and competed that night with some heavy hitters appearing at the Old Dominion University literary festival.

Clearly health-care reform is an issue which people are paying attention to. And, judging from conversations among participants both before and after the Naro event, the bills emerging from Congressional committees and moving toward consideration on the floors of House and Senate are generating a considerable level of frustration. People wonder if it will take a violent uprising to get the attention of politicians, who seem impervious to the needs, let alone the will, of the public.

Most of those in the forum audience seemed to support a single-payer, Medicare-for-All health-care system, which, as many polls show, is favored by a majority of the public, including health care professionals. But it also seemed that many who favor universal Medicare are willing to settle for a strong public option as a fall-back position because they don’t believe their preference has a chance of passing in Congress.

Without at least that minimum provision, it’s safe to say that virtually everyone in the audience felt that any health-care reform Congress passes would, at best, be meaningless.

“This is the civil rights issue of the day,” said Tim McCarthy, who organized the forum with Naro co-owner Tench Phillips. “This issue is where we find the soul of who we are.”

Emphasizing the moral aspects of health care, he said, “We are all in the same boat together. We have to embrace that. We are called to act and engage with deep compassion for one another.”

McCarthy, director of the Family Counseling Center in Virginia Beach and a member of the Virginia Interfaith Center for Public Policy, also served as moderator and lead-off speaker among four others assembled, who each made brief comments based in their own expertise.

Andrea Miller, local coordinator for Progressive Democrats of America and a member of the Virginia Coalition for Guaranteed Health Care, favors Medicare-for-All, covering “all necessary medical, dental and vision treatment from the cradle to the grave.”

Joe Cook, Hampton Roads coordinator for MoveOn.org, agrees with Miller in favoring a single-payer system but believes it’s politically dead. He hopes change will come incrementally, beginning with a public option. “If we could get a public option it would be a tremendous step forward,” he said and asked people to call Virginia Senators Warner and Webb and urge them to support it.

Theresa Stanley, South Hampton Roads coordinator for the Virginia Organizing Project, spoke passionately from her perspective as a grassroots activist working with social justice issues. “Seventy-eight percent of low-income workers have no benefits,” she said. “We can’t afford not to fix health care.” But she agreed with Cook that the public option is the only practical alternative at this time.

Nic Renz, regional Recruitment Coordinator for MoveOn.org, urged people to e-mail their Senators and Representatives. “We need at least the public option if not single-payer,” he said.

Dr. Mimi Rosenthal, a professor of Biochemistry at Eastern Virginia Medical School, called the public option “a gimmick” which “doesn’t get rid of the overhead, the competition, or anything. We want a system that actually provides care for people.” Like Andrea Miller, she supports “a real universal system” without co-pays or the need for supplemental insurance.

Focusing the evening’s discussion was the feature-length documentary film Money-Driven Medicine, a stern indictment of the American health-care system as an industry designed to enrich insurers, drug companies, and to some extent doctors and hospitals rather than to meet the health care needs of those suffering from illness.

The film is weighted toward the negative, as if the system functions so poorly it cannot deliver positive outcomes. This is probably overstated. Yet, as anyone knows who has had to navigate the system in quest for relief of a serious illness, getting well is often a hit-or-miss affair, with much waste, faulty diagnosis, and unnecessary, expensive procedures to be endured and high-end pharmaceutical drugs to be paid for along the way.

Two film clips were also shown, one decrying the much-publicized Baucus Bill, hammered out in the Senate Finance Committee chaired by Montana Democrat Max Baucus, which requires all Americans to buy health insurance from industry insurers while providing no public option. This bill is due to be voted out of committee on Oct. 13, after which its provisions will be integrated with a second bill already passed by the Senate Health, Education, Labor, and Pensions (HELP) Committee. When the integration is accomplished, a health-care bill will finally be brought to the Senate floor.

The second film clip was a brief and favorable explanation of the public option by Clinton-era economist Robert Reich, who says the plan simply creates a government entity based within the Medicare system which will provide people who have no insurance the option of buying a policy from the government at a lower premium than the for-profit companies charge.

Questions and comments from the audience closed the evening’s agenda, though lively conversations continued in the theater lobby well past the forum’s end.

Admittedly, the views of those in the Naro audience leaned toward an inclusive national health system in which health care is more of a human right than an earned privilege. At the same time the information presented in the evening’s agenda was not substantively different from what was learned at the Community Conversation on Health Care held Aug. 30 at the Norfolk Farm Market—see my article below, “Is Health Care a Civil Right?”

Clearly, even in Libertarian-leaning Hampton Roads, there is a strong contingent of intelligent people who share the view that health care, at the least, should not be left to run loose in an unregulated market place.

But in all the discussion on this issue, going back decades, we’ve hardly been talking about health care at all. We’ve been talking about money. Who’s going to pay for our care? Meanwhile, the care we’ve been getting for our money, no matter who’s paying for it, is rarely questioned. What constitutes approved treatment is narrowly defined in terms left to medical authorities and industrial lobbyists.

It seems we are terminally invested in a prohibitively expensive, hit-or-miss system of high-tech procedures, complex surgeries, and ever-new drugs with long lists of possible side effects inducing misery and occasionally death, and we rarely question if these treatments are somehow off-track.

Nor are the potential causes of illness looked at squarely. The fact that our factory foods are laced with chemicals of questionable if not dangerously toxic properties, for instance, is generally isolated from the health care debate, even when the evidence of harm is staring policy-makers in the face. There is a societal disconnect between public policy and regulation of even the most commonly known causes of medical problems—excessive salt and sweeteners in most of our foods, for example, or junk marketing aimed at a civilization of fatties glued to their television screens.

Where is the leadership on reforming the American way of life, racked by competitive stress and poisoned by relentless, shameless appeals to sensory indulgence? The crisis in health care is only a symptom of that deeper crisis of a population in which the tools of effective self-diagnosis have been deactivated. Rather than encouraging us to regard our health, even when ill, as an expression of self, who our first task in life is to get to know and understand, we are indoctrinated to run to a doctor for a prescription to “knock it out” at the first sign of a physical aberration.

Fundamentally, Americans are bogged down in a negative medical philosophy. We don’t regard illness as a potential learning experience, expressing, for instance, the body’s simple need to take a break. We certainly don’t see it as part of a deeper healing process preparing us for an enriched future. Instead, illness for us is a condition to be fought off. And that reflects an image of Nature as a stalker, seeking to maim and eventually kill us when our guard is down. This defensive stance against Nature guides the medical philosophy incorporated into all these health-care plans, from single-payer to the current laissez-faire network of corrupt corporations.

Critics of those opposed to all reform plans, on the table or off, are fond of ridiculing their do-nothing opponents. Derisively, they say the Republican health-care plan, for instance, is summed up in one simple injunction: Don’t Get Sick.

Actually, that’s not a bad idea. At least it unencumbers us, pointing us in a direction of health, freeing us from the burdensome spectre of ever-mounting allocations—billions upon billions to maintain the current system with its existing institutions perpetually at war against illness.

We lack a medical philosophy built around health, an approach which aims to keep us well rather than cover the cost of our expensive care when we fall ill.

Can we imagine a world without illness? Such a utopian condition isn’t likely to emerge from Congress or from politicians at town-hall meetings or from community forums and certainly not from behind closed corporate doors. But it can happen within individuals who not only take care of themselves—you know the drill: moderation in all things—but who also understand illness as part of the process of renewing health.

Health care reform has to be about something more—or other—than money. It has to be about healing—in body, of course, but also in the mind, in the psyche, in the soul. Otherwise, any plan passed into law will only exchange one set of physical hassles for another, with the potential for unintended consequences that creates as much suffering as it was meant to relieve. When it comes to health, there has to be a spiritual dimension, and that’s a technology money can’t buy.

“Don’t get sick.” Or better yet, “Stay well.” I think I’ll adopt that as an affirming mantra, not in fear of illness but in embrace of health. What is there to lose? Besides, the way things are shaping up in Washington, it’s the best reform plan that’s likely to come my way.

2 Comments:

At 6:35 AM , Anonymous Kate Loving Shenk said...

Agree with " Don't get sick," and a pure single payer system, which we are more and more likely to get in Pennsylvania, (HB 1660, SB 400).

Once the health insurance companies get wind of what we are doing, massive Civil Disobedience efforts are planned.

We are poised here in good ol' PA.

We are having a huge Single Payer Rally October 20 at the Capitol Rotunda in. Harrisburg, featuring Wendell Potter, who is expected to endorse the PA Single Payer resolution. It starts at 10 am.

Great article, D!!

I will Twitter it fir you!

 
At 8:38 AM , Anonymous Anonymous said...

1. According Reid in "The Healing of America", there are 4 systems of care in this country. The discussion at the Naro centered on private medicine involving most people, and its confusion, costs, etc.

2. Last week I learned what most people know: Paying for care is like buying a car. There is a sticker price, and there is a real price. One hospital bills $9.5 M/month and collects $2.6M/month. This is perfectly acceptable to the administrator, as he knows he can make money on what he receives.

3. The same would be true if he sent his bills to the state (or city) non-profit voluntary insurance company as well as to Medicare, Medicaid, and for-profit insurance companies (~20% profit at the moment.)

4. There is nothing to stop any city of sufficient size from setting up its own voluntary non-profit (or for-profit) medical insurance company: We don't have to wait for gridlock in Richmond (or Washington) to go away.

5. Such a company would tell citizens the costs of various hospitals in the area. Citizens would immediately compare costs and value: How clean is the ER, how soon does the nurse answer the call for help, how much does the hospital cost, etc.

6. Guidestar.org and CharityNavigator.org publish IRS Form 990: You can see where the money goes. Most hospitals take Medicare money. Medicare is going broke. Costs matter. When you push the button to call for help, who answers?

 

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