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​Health care: Privilege of class or right of citizenship?

by Ed Raymond | .(JavaScript must be enabled to view this email address) | Gadfly | January 17th, 2018

Corky had a knee replaced in late December and she has been diligently doing the physical therapy connected with the rehab. Although the operation was done in Fargo, I imagine the procedure would have cost about the same if it had been done in Minnesota.

I haven’t asked, but I do wonder if it cost Medicare and our supplementary insurance $6,200 or $47,000. If we use free market principles at the grocery store, do we pay as little as 88 cents or as much as $7.04 for a head of lettuce?

According to a new Minnesota study based on insurance payments for knee replacements, Minnesota insurers paid as little as $6,200 or as much as $47,000 for the procedure. That’s an 8-fold price difference.

In today’s political climate does a consumer of medicine dare ask the question “why?” Well, I’m asking. Are we as nuts as our current president? We should all know by now that Americans pay 18% of our gross national product for health care and still have 28 million without health insurance -- while the rest of the developed nations pay between 8 and 12% of GNP and cover everybody. This is truly nuts.

Other parts of the study are as fascinating. The prices on hip replacements (I had one about eight years ago) ranged from $6,700 to $44,000. Why? Vaginal deliveries ranged from $2,900 to $12,300. Why? C-section deliveries ranged from $4,700 to $22,800. Why?

Back in the 1950’s we had our first three children at a naval hospital at Camp Lejeune, North Carolina. Cecilee and Cathy cost us $1.25 each and Mark $1.15. Honest. I guess boys were cheaper by a dime for some government reason.

The Minnesota study did not include any costly high-risk cases that occur, and included 1.1 million health care claims covering more than 4.3 million Minnesotans. State law forbids (of course!) revealing hospital or doctor names used in the data. The study will reveal heart and back surgery price ranges in the spring. I can’t wait.

A Privilege Of Class Or A Right Of Citizenship?
True conservatives long ago determined that all citizens need to be under a government health plan to ensure that their society develops “for the common good.”

Chancellor Otto Von Bismarck of Germany made that decision on universal health care in 1883. He added accident insurance in 1884. Is insurance so difficult for “conservatives” to understand?

Democratic Representative Alan Grayson described the health care plan of the GOPPPPP (Grand Old Party of Prevaricators, Pedophiles, and Parsimonious Pricks) this way: "Don’t get sick, and if you do, die quickly.”

Prime Minister Winston Churchill of England made the same decision as Bismarck before the end of World War II because the war had raised havoc with the Brits. He was responsible for the formation of the National Health Service which serves all of the British people.

Is water a luxury or a necessity? Should governments play a role in providing it and ensuring its safety? Sewage treatment and picking up garbage and other wastes: luxury or necessity?

What are the government’s highest purposes and priorities? Certainly physical security, water, shelter, and health care are near the top. Food security is also important to maintain the general health of society.

We may have first-rate physicians and health facilities but overall we have third-rate or banana-country care for many of our citizens, because 28 million have no insurance.

In 2009, a Harvard University study indicated we had 45,000 unnecessary deaths because of lack of sufficient health care.

More than 50% of the personal bankruptcies in the U.S. prior to Obamacare were caused by excessive health care costs even if the filers had health insurance.

In 2010 before Obamacare we had 48.6 million without insurance, but the Medicaid expansion program covered 20 million—even if 18 Republican-dominated states rejected that Medicaid provision.

The recent tax cut vote eliminated the Obamacare individual mandate requiring everyone to buy insurance or pay a penalty. This act will remove an estimated 13 million more people from health insurance rolls.

Why do we have 13 million veterans who do not receive care from Veterans Administration facilities? I spent seven years on reserve and active duty in the Marine Corps and have never entered a vets facility at this point in my life.

The standard health care in the developed world is universal care
The World Health Organization has rated health care systems in the developed world for many years. We usually rank from 33rd to 36th in overall quality, somewhere around or between Cuba and Slovakia.

My French brothers and sisters usually rank first or second for having the finest health care system in the world—while spending about 9% of GNP compared to our expenditure of 18%. Even in Latin American countries universal health care is the law of the land--even in countries with great income inequality.

West Virginia has the same infant mortality rate as Rwanda, and many poor men in the American South have the same life expectancy rate as the men of Botswana, at 65.7 years. In Marin County, California, men live to 81.4 years. How many men would like to live 16 more years?

Women in Marin County live 22 more years than the women in Tunica County, Mississippi. Why do people in developed countries such as Japan, Switzerland, Australia, Spain, Italy, Iceland, Israel, Sweden, France, South Korea, Canada, the Netherlands, New Zealand -- and shall I go on to dozens more -- live about four years longer than U.S. citizens? Even Brazilians in the favelas, or slums, of Rio de Janeiro, São Paulo, and other cities, are covered by Brazil’s universal health care program.

A government single-payer program is now the only answer to our problem
Currently, hundreds of U.S. insurance companies are spending $500 billion of our health care money each year to keep the insured from collecting what they are due from their insurance—or to keep them from getting on the insurance rolls at all.

The bizarre, incomprehensible, and Rube Goldbergish paperwork is astounding because of hundreds of wasteful and complicated insurance plans. And the call centers in India and Bangladesh don’t help much. I’m sure many of you have examined those “THIS IS NOT A BILL” letters from your insurance company and asked yourself: “What the hell does that mean?”

I was on or led salary and fringe benefit teams from both sides of the table for 28 years, including health insurance policies. But I’m not a genius like our president, so I have difficulty even reading a “THIS IS NOT A BILL”

There are 11 columns to describe what happened to your last medical visit. That’s only the beginning. Two more pages are added if you wish to challenge the bill.

Corky’s radiologist charged us $39 but the allowed Medicare amount ended up being $9.34. Then $29.66 was placed under “Provider Responsibility.” No wonder insurance companies spend $500 billion trying to duck costs.

In France’s universal care system, if you are a visitor to France and need medical attention, a “providing” system takes care of your problem and sends a bill to the government to cover your service. The clinic or hospital providing the service is usually paid within three days. As a visitor you don’t even get a bill. That’s how a smart (or even genius) system works.

Do you hear the screams about socialized medicine in the background?
We always hear the screams of “SOCIALIZED MEDICINE” from the GOP every time Congress starts talking about healthcare.

We consider education for all a fundamental right. By law we must provide an adequate education for all, including the mentally and physically handicapped. Poor six-year olds and rich six-year olds must be provided a basic education. We constantly argue about what those basic fundamentals are.

Some students have rich parents who provide permanent full-time tutors through K-12 and Harvard University. A few poor students can end up at Harvard when they are recognized as being far to the right on the Bell Curve.

We generally provide a base level of schooling for everyone. Why is basic education a right while basic health care is a privilege of wealth?

Let’s look at other functions in a society where certain services are necessary for the common good. We have SOCIALIZED roads and bridges. We have SOCIALIZED sewage, water, and sanitation services. We even have SOCIALIZED airports and electrical power. We already have SOCIALIZED Medicare, Medicaid, and VA hospitals for health care. We have SOCIALIZED our fire departments and police forces because everyone deserves protection. We decided long ago that national defense should be SOCIALIZED.

Please send me names and addresses of sixty-year-olds who have never spent a dime on healthcare
Let’s think about this scenario for a minute. A U.S. millennial without health insurance has a catastrophic accident in his insured car and is taken to the for-profit hospital in an ambulance on taxpayer-paid roads and bridges, where she is cared for utilizing taxpayer-paid sewer, water, and sanitation services. Because of her injuries she lies in a coma for weeks and then requires extensive rehabilitation. Who pays for his care?

Meanwhile, in France’s SOCIALIZED system, a citizen can visit and use any health facility in the country. A provider is “never out of network” as in the U.S. A citizen cannot be turned down, he can’t have his insurance terminated, and almost never is denied a claim. The French don’t know what “deductible” means. There are no co-pays.

While we spend up to $500 billion on administration, paperwork, and denying claims, the French pay almost nothing on administration. There are no shareholders to collect dividends and to vote “NO.” Prices for all types of treatment are set by the government. French citizens do not have to change insurance companies when they change jobs. The French have never heard of “pre-existing conditions.” French doctors still make house calls. French universal care costs a little over 9% of GNP.

When are we going to control our drug manufacturing crazies like the greed-ridden Sackler family, owner of Purdue Pharmaceuticals? They have $14 billion from making and pushing Oxycontin and other opiates on doctors and patients, creating millions of addicts while killing thousands. They are mainly responsible for the overdose death of 200,000 Americans in the last decade and killing 63,600 more from drug overdoses in just 2016.

When are we going to get rid of $10,000 pills and $300,000 drug regimens? Why should a cancer drug that cost $50 per pill for decades suddenly cost $768 per pill in 2018? Ever heard of ransom or death??

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