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!”
Last year’s three-ring Congressional shutdown circus — for many little more than a desperate rearguard action by an isolated rightwing fringe to undo the fait accompli of Barack Obama’s health care reform — reinforced with each passing day the gaudy dysfunction of the American political system. But we miss something crucial if we construe the perseverance of Barack Obama’s 2010 Affordable Care Act (ACA) as nothing more than the overdue victory of commonsense health care reform over an irrelevant and intransigent right, or, even more, as the glorious culmination of a progressive dream for American universal health care long deferred. For many commentators, though, this is precisely what the ACA represents. With the law’s passage in March 2010 and its survival in the face of a constitutional review by the Supreme Court, they have concluded that the battle “over universal health coverage,” as one writer for the Washington Post put it, “is basically over.” Unfortunately, the evidence does not permit such a sanguine conclusion.
The Affordable Care Act, which goes fully into effect next year, could mean that patients with cancer, multiple sclerosis, rheumatoid arthritis and other conditions will pay more toward the cost of their expensive medications. In California, for instance, patients could end up paying as much as 30% of the cost for some pricey drugs, according to The Associated Press. Other states have said they will set flat co-pays, even for high-priced “specialty drugs.” In case you have been lucky enough not to encounter these drugs, we’re not talking about a $3 bottles of aspirin. Many of these designer drugs can hit six figures for a single course of treatment. Here are 10 of the priciest drugs currently on the market:
To the surprise of many people, and to the great consternation of Republicans, the Affordable Care Act (ACA, or the dreaded “Obamacare”) failed to fail. Last week, to much fanfare, the Obama Administration announced that the ACA’s enrollment target had been met, which means that the health care law will not collapse from lack of adequate participation. This was surprising, of course, because of the early software problems that emboldened the ACA’s opponents, and which raised the possibility that technical problems would doom the new law before it could even get started. Now, however, we know that we will proceed to the next stages of our national experiment with a broad expansion of profit-oriented, subsidized health care. Despite this success, we must now plan to get rid of the ACA, and replace it with something much better.
From CreativeResistance.org: Mercy Killers is a remarkable one hour, one man play written and performed by Michael Milligan. It’s about a libertarian car mechanic whose wife gets sick and things quickly go downhill. Mercy Killers takes place in the interrogation room of a police station. Milligan is taking Mercy Killers to community theaters and even smaller community spaces around the country. The audiences are brought to tears. At the end of the play, Milligan engages with the audience and then passes the hat. He averages a couple of hundred dollars — enough to get him to the next town. But Mercy Killers is being kept out of mainstream theater spaces — mostly because of corporate influence. Mercy Killers shows a regular guy driven to the edge by the current medical insurance industrial complex. But the unspoken message of the play is — we need to get rid of private for profit health insurance. Thus the built in conflict with the big theater spaces.
When activists from UNITEHERE—the union of hospitality industry workers—were recently lobbying in Washington DC in an effort to get relief from some of the provisions of the Affordable Care Act (ACA) that are undermining the hard won healthcare coverage of the union’s mostly low-wage membership, they were told by an aide to New Jersey Senator Menendez that, “Labor needs to regress to the mean.” Of course, under the laws of mathematics, if you only reduce those factors that exceed a mean, the mean itself constantly adjusts downward. In that context, another term for “regress to the mean” is “race to the bottom”. For many workers, the ACA is having that exact effect. UNITEHERE’s recently released report Making Inequality Worse documents how Obamacare, supported by many unions as a means of leveling the playing field between union and non-union workers, is having the perverse and opposite effect of increasing inequality.
The names of the big health insurance companies are familiar – Blue Cross, Aetna, United Healthcare. But what about CoOportunity Health, or Health Republic Insurance of New York? These are among 23 new health insurance companies that started under the Affordable Care Act. They’re all nonprofit, member-owned cooperatives, and the aim is to create more competition and drive prices down. Karl Sutton is part of a food cooperative in Montana where he grows spinach. He understands the co-op model and thinks it can work for his health insurance company. Funded almost entirely by federal government loans this year, initial enrollment numbers look pretty good for a lot of co-ops, but that’s not necessarily enough to make them successful.
I have been an outspoken advocate for a Medicare for all health system. During the health reform process, I did all that I could to push for single payer, including being arrested three times for civil disobedience. I was one of fifty doctors who filed a brief in the Supreme Court which expressed opposition to forcing people to buy private health insurance, a defective product. It pains me to see that the Affordable Care Act (ACA) siphons billions of public dollars to create more bureaucracy and transfers hundreds of billions of public dollars directly to the private insurance industry when I know that those dollars should be paying for the health care that so many in our country desperately need. I am currently uninsured, so I have to make a choice. I don’t qualify for Medicaid and I’m too young for Medicare. By law, I am required to buy private insurance or pay a penalty. But I find myself in the position of not being able to do either.
It may sound like I am a bit homesick but this is not true. In fact, I am concerned that the new medical home has all the defects of the old home: balkanization of information, over-reliance on technology, medicalization, disrupted care, waste, inefficiency, values that favor the privileged, the rigid hierarchies that keep people from working well together, inattention to the needs of patients — except now it’s all electric. It’s like giving steroids to someone on acne. The problems just get uglier. There was a time when family medicine saw itself as a counter-culture in medicine with a mission to incorporate a different set of values. Our job should be to improve the wellbeing and health of our patients and their communities, not the bottom line of the corporations who thrive off our labor.
For our events, we make sure childcare is available, as well as designated people and safe spaces for anyone who freaks out. We begin with a “good faith agreement” to acknowledge that we may not be on the same political page but to think about the structural implications of what we’re saying (i.e. “is this sexist/white supremacist/queerphobic?”), and, when someone does make a mistake, address it immediately and respond respectfully. Because talking about psychological and emotional issues can be intensely affecting for most people, we also always ask that if there is a disagreement, that the response begin with a clarifying question to encourage conversation instead of argument and to ensure that miscommunication is not part of the conflict.