It’s Time to Deliver

Yesterday there was a gathering at the Federal Building, downtown Providence at Kennedy Plaza. Again, I was struck by how many busy professional people were able to make the time to be there. I counted two doctors, two nurses, a social worker, a retired rescue captain– all there to petition our representatives in Congress to give us real health care reform.

One nurse who spoke gave me permission to post her testimony, so here are the words of Kelly Shinners, RN…

I’m here to talk about the crisis of care that exists today in the area of mental health treatment–specifically the treatment of drug and alcohol addiction.

Day after day I see patients discharged too soon, often without access to medications essential to the prevention of relapse. I hear people tell me that yes, they will relapse if they are discharged before they are ready. Too often these people are back a week later, with all their previous treatment wiped away. All too often I hear nothing more about a person like this until I read his or her obituary in the paper.

This kind of situation does not happen because a doctor or caregiver has failed to do his or her job. It doesn’t happen because a social worker is ignorant or unaware of appropriate aftercare programs. And this is not because the patient doesn’t want to get well. The reason patients are going out the door–early and unequipped–is because they are being pushed out by insurance companies which set limits on patient care which cripple and undermine the efforts of the healthcare professionals to provide patients with appropriate care. By denying claims for these patients, insurance companies are taking the decision out of the hands of the caregivers, an act that is dangerous and sometimes even deadly for the patient.

For someone dealing with the disease of addiction, proper treatment is a matter of life and death, because the next drink may lead to organ failure or a fatal accident, the next drug to an overdose. To Big Insurance, these individual are nothing more than numbers on a list; they might tell you that everyone is getting adequate treatment but every day I see a different story playing out, over and over.

I wish I could say that what the insurance companies are telling us is true– that patients who are denied treatment or who slip through the cracks are few and far between, that everything’s just fine the way it is. Unfortunately, this is not the case, and I know because I see it every day in my work. In actuality, the denial of care is the norm rather than the exception, because that’s how the Insurance game works–PROVIDING HEALTH CARE IS CONSIDERED A LOSS TO THEM!

It’s obvious to everyone, no matter their political slant, that there is a crisis in healthcare today. Healthcare professionals and workers have been more than reasonable in giving insurance companies a chance to participate in healthcare reform, but this is not enough for them.

Rather than work for their money under a ‘Medicare for All’ system, or prove that they can deliver the same care for less money as they claim by competing with the ‘Public Option’ as the ‘Private Option’, insurance companies are spending millions of your premium dollars to insure that nothing changes.

They cover the young and healthy (as long as there are no preexisting conditions, of course) and leave the elderly and the sick and the desperately needy to rely on charity, and on the government-supported healthcare already in place: Medicare and Medicaide.

If Big Insurance doesn’t want to operate in honest competition, in the spirit of legitimate concern for others–if they continue to treat the addicts, the mentally ill, and others as abstract numbers on a page–then my suggestion is that they be cut out of the equation entirely. We institute a single-payer system, one that’s been proven to work over and over, in country after country around the world.

It isn’t just a slogan. We need real healthcare reform, and we need it now.

Vehicle of the Soul

Some years ago I did a few days of meditation at the Zen Center in Cumberland, (a scary town full of trees and deer ticks), and they had a kind of in-joke. When the monks and nuns got sick they would call it ‘car trouble’.

Around that time I studied martial arts with a young and athletic doctor. She said that when she had to visit a mechanic she felt empathy for what her patients went through when they were not firing on all their cylinders. It’s tough to have to trust your wheels to a disdainful guy who may not like your kind. (You girls know what I’m talking about).

Well, we’ve progressed. Bob at D’Ambra’s Service Station on Hope St. has taken very good care of my cars. Having spent more time searching for an honest mechanic than true love I have a high respect for mechanic’s skills. After all, you have to trust them to keep your car prepped for the high speed lane.

As for that other vehicle–

Andrew Sullivan
makes a good comparison when talking about the free market approach to health insurance, explaining why health insurance is different from car insurance…

To continue with the car insurance analogy, pretend that everyone has one car that cannot be sold. Some people have lemon cars whose brakes fail every week, or have continuous oil leaks, etc. In other words, the insurance company knows that it will have to pay out on the people with lemon cars, not just occasionally, but continuously. There’s absolutely no incentive to insure these people at all. We could, as a society, say well, that’s tough. Only, eventually, we all end up with lemon cars – we’re all going to die one day, and the large majority of us will be sick for some time before that.

This is a brilliant insight. Your soul has one vehicle in this world. Is your value as a human being defined by your ability to go from zero to sixty in under 10 minutes? Can your worth to society be measured in your yearly income?

Sullivan touches on the question of what we are. A society that cares for its own, or one that holds profit as the supreme value. Right now Steven Hawking is sick. His contribution would have been lost to us if we discarded all our citizens who need care to get by.

Children, Disabled, and Elderly to Lose Health Insurance

It’s good to know in our difficult financial times, the right people are being asked to make up the difference. This article from the Associated Press has more details:

SACRAMENTO, Calif.—Financially strapped states are looking to take away government health insurance and benefits from millions of Americans already struggling with a souring economy.

An Associated Press review of the budgets in all 50 states reveals coverage would be eliminated for hundreds of thousands of poor children, disabled and the elderly. More than 10 million people would lose dental care, access to specialists, name-brand prescription drugs or other benefits. About 20 million could see their care jeopardized by further cuts to doctors’ reimbursements.

Health care is a choice target as governors and legislators confront the worst deficits they’ve faced in a decade or more, but that’s not their only target: They’re also considering cuts in aid to schools and universities, shrinking state workforces and even releasing prisoners before their sentences are completed.

Safety-net programs for the elderly, disabled and out-of-work also could be cut, even as the demand for those services is on the rise.

Despite the dire conditions, only a handful of states are seriously considering general tax increases or even modest hikes on the wealthy to close the gaps. Lawmakers say they fear such actions would only further stress the economy.

Instead, states are looking to increase lottery ticket sales, promote Indian gambling or further raise taxes on cigarettes and alcohol. Those taxes disproportionately hit the pocketbooks of the same poor and working-class that would be hurt by the spending cuts, studies show. [full text]