This is the first time I realized I had a real battle on my hands — not only to fight to save my own life but also the lives of tens of millions of other Americans who are experiencing the same injustice. We have been made to feel so desperate for health care in this country, because of the actions of Big Insurance, or “the Health Insurance Industry,” in collusion with the U.S. government. I mean, we have literally had to watch our children die, when methods and doctors were standing by that could have saved their lives, all because an insurance company decided that it did not want to take the financial loss to pay for our health care. Because that is what our health care needs are to Big Insurance — a loss to their bottom line, to their profits. And Obamacare puts this industry, by law, between us and our doctors.
When you go through the military’s Survival, Evasion, Resistance and Escape (SERE) School there are a number of things that are literally beaten into you. You are hit in the face and slammed against walls. Rifle butts and barrels strike you in the head. You are placed in small wooden boxes and deprived of food and sleep, and some of you are water-boarded (yes, it is torture). But the most important and beneficial aspects of the training are the psychological pressures and forces you are subjected to. You are taught what you should expect and what it is you should do to mentally survive captivity as a prisoner of war. You learn through practice to depend on your fellow prisoners and, most importantly, to hold fast in your faith and the knowledge your country will never forget you and the United States will always come for you.
Since the publication of my report, Sticker Shock, in 2010 on non-profit hospital accounting detailing the abusive accounting mechanisms in place (read: policies) which reward a select few at the top with outrageous salaries, bonuses, first-class travel, golf club memberships, housing allowances, personal loans, chauffer-driven limousines, tax indemnifications, specially funded split-dollar life insurance policies, and deferred compensation packages in the millions at the expense of pursuing the poor, un, and under-insured to the point of inflicting stress, bankruptcy, wage garnishment, further illness, and death for payment of hospital bills puffed up by as much as 1,500%, things have gotten much worse for people needing medical care. The breaking point for me was the story of Wesley Warren, Jr., a 45 year old man from Las Vegas with a 132 pound scrotum (roughly the size of 8 bowling balls). Here was a guy, who for four years dressed his engorged ball in an upside down zip-up hoodie because it couldn’t fit into his pants and carted this enormous appendage around in a wheelbarrow just to go to the store for milk and coffee.
We have heard the promises as the Affordable Care Act (ACA) was being sold to the public, including — you can keep your doctor and insurance if you like it. We now know those promises to be mostly false as the ACA enters its fifth year of implementation. Under the guise of “competition” and “efficiency,” the ACA has unleashed a new round of disruption throughout the health care system. We are seeing further fragmentation of care, with less continuity of care with patients’ physicians. The physician-patient relationship itself is at risk in a “system” increasingly headed for strangers taking care of strangers. More than one-half of U.S. physicians are no longer self-employed and now work for organizations, mostly growing hospital systems but also some insurers that are moving into the delivery side of health care. Two examples illustrate the new landscape: • Several hundred patients at the University of Pittsburgh Medical Center (UPMC) recently received certified letters informing them that they could no longer see their physicians. The reason: their insurance, Community Blue, sold by Highmark, is now both a rival hospital system and an insurer. Patients were cut off from their UPMC physicians even in the middle of cancer therapy. (1)
It has been nine days since I updated my numbers of health care dead and broke. Who noticed? Well, I am sure the dead and the broke did. The profit-first, greedy health care system in the U.S. continues its march toward ever increasing profits for those who are already wealthy. Disclaimer: I am not against being wealthy, making money or enjoying whatever the finer things in life are to each person. I rather like money and having enough of it not to worry about paying the bills. I do object to profiting off the suffering of others or as a friend of mine used to describe it, “bartering human life for money.” And our health care system has become so dysfunctional that most of us just accept that we must wade through the mess in order to receive the care needed. For the past several years, I have fought to change this system to an improved and expanded Medicare for all for life system. Fighting this fight has been enlightening in that even within the social justice movements their is a sort of hierarchy of power, wealth and leadership, and sometimes those powers and leaders are distracted.
The Obama administration has quietly adjusted key provisions of its signature healthcare law to potentially make billions of additional taxpayer dollars available to the insurance industry if companies providing coverage through the Affordable Care Act lose money. The move was buried in hundreds of pages of new regulations issued late last week. It comes as part of an intensive administration effort to hold down premium increases for next year, a top priority for the White House as the rates will be announced ahead of this fall’s congressional elections. Administration officials for months have denied charges by opponents that they plan a “bailout” for insurance companies providing coverage under the healthcare law. They continue to argue that most insurers shouldn’t need to substantially increase premiums because safeguards in the healthcare law will protect them over the next several years. But the change in regulations essentially provides insurers with another backup: If they keep rate increases modest over the next couple of years but lose money, the administration will tap federal funds as needed to cover shortfalls.
In a modern democracy, it seems to me that it’s a responsibility of the government to guarantee all necessary care to everyone in the democracy, and also to protect the privacy of the decision making between the patient and his or her caregiver. And if you think about that a little bit further, what would it mean if we had national health insurance? What would it mean if we had access to all necessary care? – we didn’t have to worry when our mother needed to make a transition to a nursing home.; we didn’t have to worry when our child got leukemia; we didn’t have to worry… like all of my patients – every patient I have in the hospital is worried about the money problems that are going to follow their illness. And it is an absolute national disgrace – Yes, we can indict that, but let’s think about that the other way. What kind of freedom would we have if we could travel anywhere we wanted and know that there would be an adequate health care infrastructure?
The biggest secret of politics in the United States is that a majority of the population is to the left of both major parties. This can be amply demonstrated by comparing public opinion on a host of issues to the policies pushed by corporate and political elites. Whether it’s US aggression overseas, raising taxes on corporations and the super-rich, expanding social services or any number of other issues, there is a vast disconnect between the people and those who purport to represent them. This perhaps more than anything explains the widespread lack of public interest in voting. Rather than a result of apathy or ignorance, as many elite pundits arrogantly assert, public withdrawal from the electoral process is actually an informed choice. Since the policies of both major parties are generally in opposition to the will of the public, people often rightly view voting as a lose-lose proposition. As a result, voter turn-out in the United States is significantly lower than anywhere else in the industrialized world, plus millions who do vote – perhaps even a majority – do so with little enthusiasm. On no issue is the disconnect between elites and the public more striking than health care. For decades, public opinion has favored a single payer system such as exists in every other industrialized country. Simultaneously, corporate elites and their representatives in the two major parties have been waging an unrelenting war on the people’s right to comprehensive health care.
It feels truly Orwellian that progressives are applauding the forced purchase of private health insurance — one of the most hated industries in the United States — while the right is opposing a model that originated from their political leaders. The Affordable Care Act (ACA) is a step farther on the path to total privatization of our health care system, not towards the health care system that most Americans support: single payer Medicare for all. In the months leading up to the March 31 deadline to obtain health insurance, ACA supporters united around their mission to enroll people. Volunteers knocked on doors and tabled in their communities. Celebrities and athletes tweeted and labor unions ran robocalls. The media buzzed with speculation about whether the ACA would succeed or fail. March 31 felt like election night. And after it was over, ACA supporters clapped each other on the back and celebrated. Obamacare survived. But now that the law is implemented and the dust is settling, it’s time to question what this actually means for health care and what we should do now.
The accident happened in an instant. One second, traffic was moving steadily. The next, metal debris was flying past Cliff Faraci’s windshield as cars skidded across Loop 101 near Scottsdale Road. Faraci jammed on his brakes. In front of him, a battered red car was stopped sideways and steaming. Inside, a teenage girl, covered in blood, slumped in the driver’s seat. Faraci ran to the car and tried to help her out. The driver and passenger doors were jammed. He talked to the girl, told her everything was going to be OK. “I noticed smoke coming from under the hood,” Faraci said, describing the March 2013 accident as if it were still unfolding in front of him, the way it will play out inside his head for the rest of his life. “I reached in through the driver’s window to turn off the ignition … but I could not reach it … I reached further into the car with both arms and upper body. … I was halfway through the driver’s window.” The engine ignited. Faraci, standing in a puddle of gasoline, was enveloped by searing heat and yellow flames. He jerked away, trying to stop the burning. The ruptured gas tank exploded and Faraci watched the girl inside the car die.
As a CPA who, for the last decade, has prepared pro bono tax returns for citizens at the Jersey Shore, I’ve seen a lot of suffering: homelessness, unemployment, chronic illnesses, bankruptcies, suffocating student loan debt, unconscionable medical bills, and the scars of incarceration. Many taxpayers are overwhelmed and depressed, resulting from job losses through economic downsizing and privatizing schemes. They wonder how they’re going to get through the week. Living paycheck to paycheck, their struggles are life-altering, causing anxiety, relocations, and uncertainty. They’re constantly beaten down by public officials who sell them out at every turn. It is a downward spiral from which many never recover. Through my research on abuse at nonprofit hospitals who aggressively pursue the poor, un and under-insured for hospital bills (puffed up by as much as 1,000 percent) while doling out million dollar compensation packages
The trolls have been out blasting BuzzFlash at Truthout for calling the fossil fuel industry “eco-terrorists” for careening the earth into a human-made death spiral, but it’s true. Those who can’t smell the carbon dioxide ravaging the earth for hedonistic profit – enabled by federal and many state and local governments – will find out that just because you can’t smell global warming does not mean that it is not brewing a cauldron of devastation just over the horizon. Since 9/11 few Americans have been killed by terrorists, but we have built a multi-billion dollar “anti-terrorist” intelligence, military, surveillance and incarceration state to deal with a threat that pales in comparison to global warming. Toss in the lurking big bang of devastation to life on earth – the grand finale of global warming – and the 1% are living the last days of Pompeii in at least five different ways that are killing many of the rest of us.
Walid Gellad, MD, MPH is both assistant professor of medicine and assistant professor of health policy at the University of Pittsburgh and a physician in the US Department of Veterans Affairs (VA) Pittsburgh Healthcare System. He is coauthor of a recent research letter in the Journal of the American Medical Association (JAMA) [Academic Medical Center Leadership on Pharmaceutical Company Boards of Directors, also by Timothy Anderson, MD, Chester Good, MD, MPH and Shravan Dave, BS] that reveals almost all US large drug companies and 40 percent of all drug companies studied have leaders in academic medical centers on their boards. These drug company board members include deans, chief executive officers, department chairs, trustees at academic medical centers, school of pharmacy officials and university presidents.
Chanting, “This system – let’s stop it! Our health is not for profit!” and “What do we want? Single payer! When do we want it? Now!” a two-block-long river of medical and other health professional students – most in white lab coats – marched down Chicago’s crowded Michigan Avenue and rallied outside the gleaming skyscraper known as Blue Cross Blue Shield Tower last Saturday. “We will no longer tolerate private insurance companies putting their bottom line above the health of our patients!” declared James Besante, a third-year student at the University of New Mexico School of Medicine, in front of the BCBS offices. “No more!” The crowd roared back, “Patients, not profits!”