Crisis in Health Care

health beatBy The David

I have worked in health care most of my adult life. I am a Registered Nurse. My resume includes years in both acute care…. hospital, and home care. I have worked extensively with the elderly, and have some experience in the field with Public Health. What I am writing isn’t conjecture. I have seen it.

I’ve seen it, and I am angry. I am angry with those who control the purse-strings. I am angry with those who head Insurance Companies. I am angry with those State officials who make the laws that allow the insurance companies to reap what are sometimes obscene profits, often at the expense of those who cannot afford them. I am angry with the Pharmaceutical Houses that also gouge the sick and dying so that their “bottom line ” is more healthy than any of those who use their products.

Should anyone in the United States have to make the choice between feeding their families or buying the medicine? Should so many of our elderly have to make that same choice? Food or medicine. Should one starve or die by inches because the medications that have been prescribed to slow the advance of Congestive Heart Failure or some other progressive disease cannot be accessed?

Should a parent have to stand by and watch his or her child perish because there is not enough money to buy the life-saving surgery that will save the precious life that is being lost? The American Medical Association, , hospitals, medical equipment suppliers, pharmaceutical houses and insurance companies can all share in the guilt. The United States Government is certainly not exempt. Every Representative, every Senator and every President who has been lobbied and allowed their influence to be bought by the lobbyists from those groups who are opposed to the provision of Universal Health Care share in the guilt. None of them can escape the finger that history will point at them.

Those politicians, those providers and those third party payers who know the sorrow that is out there and who fight the remedy through charges that a Universal Health Care System is the first step to Socialism, and that government bargaining with drug manufacturers is un-American and damaging to our way of life are guilty of lying to their constituency and maintaining a grid-locked situation that is quite literally causing unnecessary suffering and death. They are all guilty, these men and women who are responsible for the laws that should work toward the benefit of all of us.

It is incumbent that these people in positions of power vote a system into being. Their constant maligning of the systems provided in the UK, Canada, Sweden, France, Germany and in many other countries is no better than calumny. Most of these countries, and with good reason, consider their health care program the jewel of their citizens rights. We would do well to emulate these countries and end some of the suffering and death caused by the profiteering in our own health system. (Actually health system in the United States is an oxymoron…. there is no system.)

We live in the richest Nation in the world…. maybe the richest Nation in the history of the world, it is “God’s Country” to many. Yet there are, within our borders, children who are never seen by a physician and are burdened with the swollen bellies of malnutrition, pregnant women who cannot afford an obstetrician, so-called street people who have fallen through the cracks, elderly people who are mired in poverty and who cannot afford medical care or the medications that might be prescribed. These people all exist, and if we do not see them it is because we just don’t look.

The richest Nation in the World and we are guilty of neglecting so many of our citizens and withholding what should be one of the basic birthrights accruing to citizens of this country: adequate health care.

If we could have the health care plan enjoyed by the members of that exclusive club called the U.S. Senate, then we would never have to be concerned about how we will provide care to ourselves and our families. But we cannot. Medicare is limited to acute illness for those who are over 65 and those who are disabled. Chronic illness is not covered and prescriptions can only be covered if the beneficiary is able to purchase a supplement to the basic Medicare. Many cannot. Prevention is not covered.

For the Working man or woman who loses employment, Cobra may be utilized. This allows the purchase of health insurance through the company he is leaving, for the same rate the company enjoys. For a man with a family, this may be as much as $1500.00 a month. A person obtaining $350.00 in unemployment compensation is asked to pay out $1500.00 for health insurance.

Pharmaceutical houses make much of the fact that a person can contact them if they cannot afford a drug that has been provided. The number of persons who can access this assistance is few, and the path toward access is narrow.

If we need more proof that health care in the U.S. is broken and needs to be fixed, access the statistics from the World Health Organization (WHO) that tell us that the United States is first in health care expenditure. We are also first in Obesity. We are 47th in life expectancy, We are 35th in mortality of children under 5, we are 37th in over-all health care. We rank behind most of Europe, Canada and many third world nations. We should hang our heads!

It is time to insist that the cost of health care be reduced, and to insist further that a system be developed that will allow all people in the United States to have access to the benefits of adequate health care. The alternative may be to reinstitute a practice used by Alaskan natives many years ago. Members of the tribe who became old and infirm were placed on an ice flow, given water and a fish or two, and were floated out to sea. If things do not change, is this an option. my god people, THINK.

About karlsie

Some great perversity of nature decided to give me a tune completely out of keeping with the general symphony; possibly from the moment of conception. I learned to read and speak almost simultaneously. The blurred and muffled world I heard through my first five years of random nerve loss deafness suddenly came alive with the clarity of how those words sounded on paper. I had been liberated for communications. I decided there was nothing more wonderful than writing. It was easier to write than carefully modulate my speech for correct pronunciation, and it was easier to read than patiently follow the movements of people’s lips to learn what they were saying. It was during that dawning time period, while I slowly made the connection that there weren’t that many other people who heard the way I did, halfway between sound and music, half in deafness, that I began to understand that the tune I was following wasn’t quite the same as that of my classmates. I was just a little different. General education taught me not only was I just a little isolated from my classmates, my home was just a little isolated from the outside world. I was born in Alaska, making me part of one of the smallest, quietest minorities on earth. I decided I could live with this. What I couldn’t live with was discovering a few years later, in the opening up of the pipeline, which coincided with my first year of junior college, that there were entire communities of people; more than I could possibly imagine; living impossibly one on top of another in vast cities. It wasn’t even the magnitude of this vision that inspired me so much as the visitors who came from these populous regions and seemed to possess a knowledge so great and secretive I could never learn it in any book. I became at once, very conscious of how rural I was and how little I knew beyond the scope of my environment. I decided it was time to travel. The rest is history; or at least, the content of my stories. I traveled... often to college campuses, dropping in and out of school until one fine day by chance I’d fashioned a bachelor of arts degree in psychology. I’ve worked a couple of newspapers, had a few poems and stories tossed around in various small presses, never receiving a great deal of money, which I’m assured is the norm for a writer. I spent ten years in Mexico, watching the peso crash. There is some obscure reason why I did this, tightening up my belt and facing hunger, but I believe at the time I said it was for love. Here I am, back home, in my beloved Alaska. I’ve learned somewhat of a worldly viewpoint; at least I like to flatter myself that way. I’ve also learned my rural roots aren’t so bad after all. I work in a small, country store. Every day I greet the same group of local customers, but make no mistake. My store isn’t a scene out of Andy Griffith. The people who enter the establishment, which also includes showers, laundry and movie rentals, are miners, oil workers, truck drivers, construction engineers, dog sled racers and carpenters. Sometimes, on the liquor side, the conversations became adult only in vocabulary. It’s a good thing, on the opposite side of the store is a candy aisle filled with the most astonishing collection, it will keep a kid occupied with just wishing for hours. If you tell your kids they can have just one, you have an instant baby sitter; better than television; as they agonize over their choice while you catch up on the gossip with your neighbor. We also receive a lot of tourists, a lot of foreign visitors. They are usually amazed at this first sign of Alaskan rural life style beyond the insulating hub of the Anchorage bowl. Many of them like to hang around and chat. They gawk at our thieves wanted posters. They laugh at our jokes and camaraderie with our customers. I’ve learned another lesson while working there. You don’t have to go out and find the world. If you wait long enough, it comes to you.

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4 Comments on “Crisis in Health Care”

  1. Editor’s Note. A.B Thomas made this comment:

    Here in Canada we do have a health care system that is universally applied with basic premium (except for Alberta where all health fees have been waived because of extra oil revenue – those bastard oil companies and their royalty payments) that ensures that all Canadians have acesss to the basic health care concerns. This has not ensured all will get what they need as there is now a large glut in the health system because of overusage – a Canadian gets a sniffle, a cut on their leg, or something else minor they go to the emergency room to seek treatment. There are also massive waiting lists for surgeries because of a shortage of doctors – who study and do their residency in Canada but immediately when they become ‘real’ doctors leave to the much more lucrative American market. Alot of our rural and northern hositals are in crisis because of the lack of doctors willing to work for less pay in these areas. I think for any changes to happen in both Canada and the U.S. there has to be a common sensification (yeah I just made it up, cool word though, eh?) of legislators, insurance companies, health care staff and the public. Obviously for the States the priority would be the insurance companies and legislation to make health care more accessable to those of middle and lower income. What I think should be done is to look up north to Canada before the States digs itself a hole similar to the one Canada is in regards to universality.

  2. I agree, it is past the time to do something about this. The problem has become so complex with those who would be seen as health care champions accepting contributions from the insurance and drug companies, like Herself, Hillary Rodham Clinton. What I feel it is going to take is a grass roots movement of depth and power, which is no easy feat in itself. There are also many Doctors out there outraged with the way things are working, but stuck because of liablility. People have to be convinced to stop suing their doctors in order to “get back at the system”. This will leave Doctors with more room to support thier patients without fear of losing thier livelihood. The unfortunate truth is we allow this system to happen out of fear. Fear of not having coverage, so we don’t opt out of our lame employee benifits, fear of not making a living so we press suit against someone else for reasonable risks, fear is the food we have been living on in so many areas and health care is only one of them.

  3. A. B., while reading your comment, it occurred to me a similar phenomena was evidenced here in Alaska, and probably to some extent in the Continental U.S., when a booming, oil-rich economy took place. The Social Service department had deep and very willing pockets. Welfare recipients not only received government paid food stamps and supplemental income checks, they also qualified for low-cost housing. Since there was no low-cost housing that fit federal guidelines, the State agreed to pay up to seven hundred dollars a month to subsidize low-cost rentals. The results were that rental units went up in price and the medical profession now had a free hand in charging clients as the boon of government covered welfare recipients swelled the waiting rooms. The middle class paying the brunt of the burden in taxes, were no longer able to live as well as their poorer neighbors. While welfare recipients ran to the doctors with each sniffle, the middle class was desperately trying to combat pnemonia with home remedies. A side effect of medical overuse of course, was reduced immune systems and strong medical dependencies.

    Mexico has a very interesting health system. It begins at the pharmaceutical level. Most life saving drugs, such as pennicillin, albuterol and insulin, can be acquired at the counter without a prescription. A large number of the pharmacists are qualified for administering necessary drugs that require a hypodermic needle. This administration is done at a very low cost.

    The medical structure is divided into a number of departments. There are the government sponsored free clinics. Here, interns receive their practice by administrating to the penniless population that comes to them, with a doctor in the background overseeing the process. The attendant doctor is chosen from a rotating process. All doctors who remain in public practice are required to take their turn.

    The public hospitals are government subsidized. They charge on a sliding fee scale, in accordance with income. If you are able to pay so much as the minimum fee required, you are entitled to their services which include a full staff of licensed medical doctors and nurses. Here, young doctors often begin building the requisites and reputation needed to go into private practice.

    Private practice is purely a personal choice as to the costs of treatment. If a particular doctor is in great demand, s/he might decide to charge very high prices for services rendered. Others might have built a personal clientele among the population that had once used the sliding fee scale but now felt comfortable with paying a middle class price for the freedom of choosing their favorite practicioner. Licensed practice can include house calls, practice within the home, even doctors who wander from village to village, administrating life saving care from the principles of their hearts. Since we wish to include Central America into the dynamics of a North American union of common goals, i think it would behoove us to take a look at their own solutions for delivering health care to millions of people on their own tight purse strings budget.

  4. Karla and Neonorth, a very interesting look into different systems. And Karla an excellent explaination of what happened in the “golden years” here in the states in terms of health care. I had noticed this too but you put it to better words than I could come up with. Interesting how serving the underserved ultimately drives up prices and headaches for the middle class. It is also an excellent illustration of how the middle class which is the largest voting body always gets caught out in the storm.
    I watched “Sicko” this week and while I was not surprised I was appalled at the lack of concern displayed here on our native soil. Not care in terms of availabilty per say…but human concern at people’s struggles, where in Cuba people our citizens were treated with respect and love….this great demon of a country (so we have been told) were more humanitarian. The Right would probably spin it this way “Satan always makes things look good and glamourous”. I have to say…if it walks like a duck and quacks like a duck….you know. Anyway I was also struck that Canadians wouldn’t go across the border without purchased health care they were that concerned about not being treated in the case of emergency here. No place else in the world did they seem to have that concern.
    These are good conversations and I hope we stick with them and come up with some useable ideas.

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