Band-Aids not enough: Health care system needs a profit-ectomy

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Recently a young family celebrated the birth of their child but soon received the sad news that the baby needed heart surgery. Their concern escalated when their health insurance company refused to pay for the surgery. Why? Because the heart problem was a “pre-existing condition.” Read on.

“Tracy Pierce, 37, lived a full life. He grew up with family and faith. He went to a Catholic school, got married, had a son, and he even had the car of his dreams. It was the perfect life,” reported the Frankfort Indiana Times. But then Pierce was diagnosed with kidney cancer. For 15 months he suffered, while every treatment his doctors sought for him was denied by his insurance provider. First-Health Coventry deemed the treatments were either “not a medical necessity” or experimental. Even at the last stages of his life, he went without oral morphine for more than a week, because his insurance would not cover it.

Today the insured of America are joining the one in six Americans who are uninsured in suffering — and even dying — from substandard care. Perhaps this fact explains why the longstanding demands of health care and union activists for universal health care and a single-payer system have achieved a new level of acceptance.

A national single-payer movement is gaining momentum, fueled by the persistence of Physicians for a National Health Program. PNHP hammers away at the need for a national solution where “everyone is in and no one is out.” PNHP worked with Rep. John Conyers (D-Mich.) to craft HR 676, the National Health Insurance Act, a single-payer plan.



Single-payer defined

Single-payer describes a type of financing system for health care. One entity, a government body, would act as administrator or “payer.” This government body would collect all health care fees and pay out all health care costs. Private insurance plans would be forbidden. Premiums, co-pays and deductibles would be eliminated. Under HR 676, employers would pay a 3.3 percent payroll tax, employees less.

Healthcare-NOW! (HCN), co-chaired by leaders of the Steelworkers Union, United Methodist Church and PNHP, formed in 2003 to spearhead initiatives to build an effective national movement to support single-payer. HCN launched an Internet campaign to hold Citizen-Congressional hearings. A campaign was initiated to win resolutions of support from unions.

Ninety communities signed up to hold local hearings highlighting the problem and the solution. Sixty-five co-sponsors signed on in the House of Representatives.

Fueling this movement is the fact that a substantial majority of American people want “a government guarantee of health insurance for all Americans.” A May 2005 study by the Pew Research Center found 70 percent favored such a plan.



Rx – Take the profit out

“The last two decades have seen a corporate takeover of our health care system,” Healthcare – Now! coordinator Marilyn Clement said in a phone interview.

Our nation’s hospitals, clinics and HMOs have been turned into investor-owned companies, driven by the concerns of the market. Healing the sick is giving way to cutting jobs and reducing costs. Revenue down? Cut back on supplies and personnel. Heart surgeries proving to be lucrative? Perform more operations, whether people need them or not. These incidents are documented in countless books, articles, studies and reports.

The plight of the more than 45 million uninsured Americans is tragic. About 18,000 people die each year due to lack of insurance, but, Clement, noted the movement for single-payer also addresses the crisis of the insured as well as the uninsured. The profit system is the basis of the problem. Until profit is taken out of the system, costs will continue to skyrocket and more people will find themselves sick and broke.

Employers that up to now have provided affordable health care are forcing costs onto their employees. And even those who still have good, affordable insurance are caught up in the craziness of a system driven by market forces and privatization that shortchanges care, drives good medical personnel out and makes more and more mistakes.



Impact on unions

Contract negotiations confront the 800-pound gorilla of health care at every bargaining table. Wage increases are given up in favor of maintaining health benefits. Upwards of 70 separate union bodies, ranging from small and large locals to county labor councils and state federations, have passed resolutions in support of HR 676.

Kay Tillow, of the Nurses Professional Organization, based in Kentucky, heads this effort. She explains the avalanche of support: “People just found out how easy it was to get these passed.”



Addressing racial disparities

While this crisis affects all Americans, the sharpest edge lies in enormous disparities by race and ethnicity in access to medical care. Figures from the 1995-2004 Public Health Report in King County, Wash., for example, show that Latinos suffer the greatest rate of non-coverage at 36 percent; while a massive 22 percent of African Americans lack coverage; and 13 percent of Asian Pacific Islanders are without.

“It is the intent of this Act,” the legislation states, “to reduce disparities by race, ethnicity, income and geographic region and to provide high quality, cost-effective, culturally appropriate care to all individuals regardless of race, ethnicity, sexual orientation, or language.”



Can we afford it?

There are billions and billions of dollars in the system. Much of this is spent on administrative costs, which are estimated to take up a full third of our health care dollar. Even more is wasted on excessive corporate salaries and perks. Profits from the sales and re-sales of hospitals and clinics line the pockets of investors. For a sustainable solution to this crisis, profit must be taken out of the health care system, say health care activists.

HCN is helping to show how a single-payer program will work. Armed with the facts, advocates are rallying behind what New York Times columnist Paul Krugman argues for: “A straightforward single-payer plan” with maximum overall savings “that is easily explained.”

Proponents of HR 676 believe that the simplicity of the bill, including the straightforward approach of enacting it into law by using Medicare as the foundation, makes it an ideal tool to help people understand single-payer.



Will lesser solutions work?

Many proponents of less comprehensive solutions also support single-payer. And as they mobilize to shore up this or that government program or employer-based plan, the debate intensifies. Clement referred to the “Fair Share” campaigns which fight for state legislation to require corporations to provide health care or to pay into a state fund. Perhaps, she noted, these campaigns might drive employers to embrace single-payer. By eliminating the profit and wasteful administrative costs, these businesses would pay less for employees’ health care under single-payer.

While these activists bring more forces into the struggle and build momentum for solutions, perhaps they will consolidate their forces with single-payer activities in the near future. If in fact they do, we just may have the strength we need to finally win quality health care for every American.

Today the parents of the baby with the heart condition are scrambling to find a way to pay for the surgery. But there’s a new wind blowing and maybe soon the only pre-existing condition a newborn in America will have will be access to the best medical care our country has to offer.

Chris Lindberg (clindberg360@msn.com) is coordinator of United for National Health Care in Bellingham, Wash. She pays her own health care premium, has too many medical bills, no savings, a toothache and no dental plan.





Elements of Single-Payer as embodied in HR 676:

• Universal – All individuals residing in the U.S. would be covered. • Comprehensive – All medically necessary services are covered, including primary care, dental, vision care, mental health, prescription drugs, rehab, including substance abuse, and long-term care. • Portable – If you leave a job, end a marriage, or move, you’re still covered. • Affordable – Administration costs would be slashed under this government program. Most activists agree that a system could be implemented without spending any more money than we do now. • Publicly financed, privately delivered.



TAKEACTION

Go to www.healthcare-now.org, sign the petition, find out if a Citizen-Congressional hearing is happening near you! To read HR 676 and the official summary: http://thomas.loc.gov/ Healthcare-NOW!: www.healthcare-now.org Physicians for a National Health Program: www.pnhp.org Sample resolution or list of endorsers: contact nurseNPO@aol.com.