Still waiting for health care

My late son, Michael, with his niece, Meghan.

Today marks 13 years since my son called me to say he was feeling better because the doctor found and drained a couple quarts of fluid from his abdomen.

We didn’t know why the fluid was there, but in the back of my head was the fact that fluid like that is a symptom of end-stage cancer.

A week later, we found out that was the cause, that the cancer was back and nothing could be done to cure it. He had, at most, a year to live. He would die just six weeks after getting the news.

This year is the 13th time I have relived this seven weeks, and I still have to lament that we are no better off than we were in 2008, when I promised my son I would work for access to health care for every human being.

In fact, things have gotten even worse. Where some 45,000 people were dying every year from lack of access to care in 2008, that number has been revised upward to 68,000 now — and that estimate is from before the pandemic began.

We had 35 million people with no insurance. We still have that many, plus another 45 million or more who can’t gain access to care because of sky-high deductibles. In a time when nearly half of Americans say they can’t pay a $400 surprise bill without borrowing money, 70 percent of employer-sponsored policies have deductibles over $1,500, and the average deductible on a health insurance policy is over $3,000.

That is not access to care.

Today, I live in one of 12 states that have so far refused to expand Medicaid to cover everyone living in poverty. I have tried calling, writing, visiting and pleading with the Republicans in charge to accept the billions of dollars in federal money to cover people whose incomes can’t cover insurance. These are people making minimum wage. Many of them already have chronic conditions that they can’t manage without care, and that will kill them prematurely.

In North Carolina, three of them will die today.

Three more will die tomorrow, and the next day, and the next, just the way my precious son did 13 years ago on April 1.

I have been arrested three times in Raleigh, trying to talk to legislative leaders about access to health care. I was not violent or even threatening. I asked to speak to leaders and was told they weren’t there, even while I could see them sitting there. I offered to wait because what I had to say was so urgent. Instead, I was arrested and hauled off in zip-tie cuffs.

I am forced to relive these last days of his life year after year after year with no end in sight to the carnage caused by our broken system.

I had hoped to see some improvement by now, but the Affordable Care Act has been so sabotaged by insurance companies and other monied interests that we’re actually seeing more people die from lack of access to care than we did 13 years ago, and we have more people who don’t have access to care.

I promised my son I would work for access to care for everyone as long as I have breath in my body. I have kept my promise. But I really hoped we’d have seen some progress by now. Instead, we’ve been skipping happily backwards, giving insurance companies, Big Pharma and the rest of the crooks everything they want, while keeping us fooled that we’re doing better because pre-existing conditions have to be covered and young people can stay on their parents’ plans — as long as their parents can afford to have insurance plans.

I’m exhausted. I’m stressed. I’m grieving. I’m frustrated. I have all but lost hope that we can get anything done.

But I will not stop.

Everyone deserves care.

You can help in this fight. Every one of you can call legislators at the state and national level and let them know you need to see improvements if they want to keep their jobs. Demand that every candidate tell you how they plan to improve health care access.

Then, you need to vote as though health care matters to you, because health care needs to matter to you.

You need to care that people are dying every day from curable and/or preventable causes.

My son would be a lawyer now if he had survived our broken system. He would also be a proud jackass, a master of inappropriate humor and practical jokes, a dedicated volunteer helping people get and stay sober, a man with a brilliant mind and a kind heart.

Those of us who loved him still grieve every day over this hole in our hearts that won’t ever heal.

This has to stop. We have to demand better, and we need to demand it now.

It’s my vote, not yours

We can’t afford to do this anymore. It’s time for Medicare for all.

I’ve taken a lot of criticism lately for saying I won’t vote for anyone who doesn’t support a single-payer health care system.

Here’s the thing: You don’t get to decide who gets my vote, not in the primary and not in the general election.

I have good reason for my position. I call it the Dead Kid Card (only because that’s what my son called it before he died from lack of access to health care). I suffered a loss most parents only have nightmares about. I sat beside my precious child as he breathed his last, and his cause of death was neglect for profit.

My son should not have died, nor should any of the half million people who have been murdered by our profit-driven “system” since his heart stopped beating.

Universal access to care was proposed by Theodore Roosevelt more than a century ago, and we’re still waiting. The rest of the world has found ways to do it, but we still prostrate ourselves before the altar of profit. We spend twice as much per person as any other system in any advanced nation, and our outcomes are always the worst among the industrialized nations. Hell, Cuba has better outcomes than we do, and that’s because everyone has access to the care they need.

I’m not willing to wait any longer. I believe enough people have died, and it’s time to stop the unnecessary deaths so some insurance executive can take home another few million dollars and stash it in an overseas tax-sheltered account.

Health insurance companies are parasites. They add nothing of value to our system, but they suck billions of dollars out of our economy, and they deny lifesaving care that causes the deaths of tens of thousands of people every year.

OK, so now you’ll argue that some people love their plans. Well, I have a couple of problems with that. First of all, Medicare for all will get care to everyone, not just the few well-to-do people who have their access to care but don’t even think about people who have little or no access. That’s called selfishness, or greed. Remember, Jesus never said, “I got mine, get your own.”

Secondly, we know that 70 percent of employer-sponsored plans are high-deductible — meaning you have to spend $1,000 or more before you see a penny in coverage — The average deductible is $3,000. This is in a society where nearly half of the people say they can’t pay a surprise bill of $400 without borrowing money.

No one can make me believe that most Americans love their health insurance in light of those statistics.

And it’s getting worse.

According to a study by The Commonwealth Fund, (https://www.commonwealthfund.org/ ), median household income in the United States between 2008 and 2018 grew 1.9% per year on average, rising from $53,000 to $64,202. But health care costs rose 6 percent per year in the same time, and the Affordable Care Act has been in effect for about half of that time.

“The most cost-burdened families live in southern states,” said Sara Collins, lead author of the report and vice president for health care coverage, access and tracking at The Commonwealth Fund.

In general, those states tend to have lower median incomes, so even if the sticker price for premiums and deductibles is lower than in higher-income regions, health insurance costs take up a greater share of Southerners’ income.

The next argument I get is that people who work for insurance companies need their jobs. Well, jobs administering Medicare will be plentiful. Even managers will be needed, although the CEOs who have been skimming billions in our national treasure can go and live on their blood money because they won’t be stealing any more from us.

The longer we wait to do this, the worse things are getting, as for-profit companies take over health care systems, especially in rural areas.

Rural hospitals are cutting services or closing altogether, especially in states that refuse to take the federal Medicaid expansion money that their citizens are already paying for. Here in Western North Carolina, women in labor have to travel up to two hours to get to a labor and delivery facility. Ambulance rides can cost up to a whopping $40,000. People are dying because they have to call an Uber because they can’t pay for an ambulance.

Under the current administration, the Affordable Care Act’s protections have been weakened. Premiums and deductibles have skyrocketed. Since the mandate that everyone buy insurance has been lifted, people of moderate means have dropped their coverage so they can afford to pay for food and shelter.

Meanwhile, plans have become more and more restrictive, putting drugs and care on tiers so that if a doctor comes to see you while you’re in the hospital and they are not on Tier 1 in your plan, you could be faced with thousands of dollars in uncovered care. That lifesaving antibiotic could wind up costing you $300 per pill.

So, when I hear a candidate say we can wait for Medicare for all, my response is, “Nope.”

Our corporate overlords may not care if you die from lack of access to care, but I do.

I will not vote for someone who thinks people can wait for health care, and you have no right to tell me I have to. People are dying NOW, and we have to fix this NOW. I really don’t care if the rich don’t like it. They’re not the ones I’m worried about.

My vote will ONLY go to someone who’s ready to fix this.

One day

 

Me and Mike on his wedding day.

Today was Monday in 2008, Mike’s last full day with us.

The house was empty except for Rob, Mike and me, and he seemed to appreciate the quiet. He was allowed to smoke in the house because as much as I hate tobacco, I was not about to deprive him of it.

Somebody, I don’t recall who it was, had suggested in these final two weeks that he should quit smoking — conquer that final addiction — before he died. His response was to smile and light a cigarette. He didn’t want to die totally virtuous, after all.

There wasn’t much left he could eat, and none of it was particularly good for him. He could still drink coffee with almond milk. He also could take a few bites of Frosted Flakes doused in chocolate almond milk. And he could nibble on good chocolate. He had given up Cadbury Creme Eggs because everyone knew they were his favorite candy and we were inundated with them. For years, he had bought all he could in the weeks before Easter, claiming he would make them last until the next spring. But they were usually gone within a month of Easter. During these final few weeks of his life, it seemed no one crossed the doorway to his room without an offering of a half dozen or more.

Finally, a few days before he died, he told me he couldn’t eat another one.

“I’m Cadbury Creme Egged out,” he said as he gazed at the one in his hand. “I think I’ll have to wait until next … ” he paused and looked up at me. “I think I’ll have to let other people have them. I keep forgetting I won’t be here next year.”

It was said matter-of-factly, as though he had forgotten his raincoat on a drizzly day. But it slapped me in the face and forced me back into the moment. I had to live in the moment because I had so little time left to do that with him.

Rob went to work that evening and Mike and I watched Star Trek and nibbled on good dark chocolate. We watched an episode from the original series and then the episode of Deep Space Nine where the Klingon character, Worf, joins the crew.

“You know, I’m having a good time here,” he told me as Worf stepped onto the space station on the television.

Here he was, confined to a hospital bed in a small bedroom. His life had been reduced to a tiny room with a bed, a dresser, a single chair and a TV, and he managed to find joy.

“I have everything I need here,” he said. “I have my TV, my Playstation, Boo Bankie, Idiot Bear and you, my personal valet.”

Boo Bankie was the tangled remnants of the blanket I had crocheted him when he was a kid. As it had unraveled, he had tied the ends together until it resembled a blue football-shaped mass with bits of red in it. I still have it under my pillow.

“I’m not sure I’ll ever be able to complain about anything again,” I told him.

“Oh, I have faith you’ll find a way,” he said, smiling.

If only we’d been able to get him the screening tests he needed. If only he’d been able to get health insurance. If only even one doctor in Savannah had given a rat’s ass about his precious life. If only we hadn’t lived in the most ignorant and immoral nation on Earth when it comes to health care.

Here we are, the richest nation ever to exist and we can’t even offer the basic level of health care to our people that every developed nation — and even some developing nations — offers its people. Our health care outcomes are the worst among the developed nations, and worse than many developing nations, even though we spend about double per capita what other nations spend. How can people not understand that?

People still tell me we can’t afford it because they believe the lies put out there by Big insurance and Big Pharma. We could have saved my son’s life for a fraction of the cost of allowing him to die. We could save tens of thousands of lives every year, one precious soul at a time, instead of killing them with criminal neglect.

Mike was developing a pressure sore on his elbow. He didn’t want me to bother wrapping it in soft cloth, but I insisted. Lifting his arm was like picking up a broomstick. He had no muscle left.

When I finished wrapping the sore, he sighed.

“You were right,” he said. “This does feel better. Thanks.”

He closed his eyes and drifted off to sleep. I sat and watched him for a little while, just trying to be present in the moment. I knew we had few moments left.

On this day, in this moment, I had just 18 hours left with him.

 

 

 

One final belly laugh

Mike being Mike. His main mission in life was to amuse himself and others. He was a proud jackass and I still believe he chose to leave us on April Fool’s Day.

 

It was Sunday on this date 11 years ago. The crew from Savannah spent the morning and early afternoon with us, and when Mike was tired and needed a nap, they headed back south.

I took the opportunity to soak in the hot tub for a bit with two friends who were helping Mike plan his memorial service. He didn’t want to leave anything to chance. That service would reflect his desires for a funeral he’d be sorry to miss.

As we came back into the house, there was an insistent knock on the door, as though someone wanted to deliver an urgent message. When I opened the door, there was a woman I’d seen drive by a couple times, but I didn’t know her. She was tastefully dressed, a little overweight, had an unnatural shade of blonde hair and way too much makeup.

“What the hell are you doing parking all these cars on my street!” she demanded. “People have to drive here, you know. You don’t own the street and I’m getting tired of dodging all these party cars! I don’t know how long you’ve lived here, but you should know we don’t put up with that in this neighborhood …”

She ranted on for a minute or two and when she finally stopped to take a breath, I spoke.

“First of all, this is not your street. My taxes pay for as much of it as yours do,” I said.

She opened her mouth to speak again, her face still angry. I held up my hand.
“Nope,” I said, “I’m not done. These cars belong to friends of my son. They’ve come to say goodbye. He’ll be dead in a few days and then you can have your road back.”

I started to close the door and she put up her hand to stop me.

“Wait! Oh my god! Is there anything I can do?”

“Yes,” I said sweetly, “you can drive carefully so none of these people has to the add the burden of car repairs to that of the grief of losing a friend.”

And I closed the door.

Even 11 years ago, some people were mean-spirited by nature and not afraid to show everyone they encountered that they wanted people to do everything their way.

Later another neighbor would see me outside and ask, “I saw a lot of cars over the last week or so. I know it’s not always a good thing, so I just said a quick prayer that everything’s OK.”

Now, that’s the way to ask why there are so many cars parked on the street.

The nasty neighbor has never spoken to me again.

Mike woke up a little while after the angry neighbor left, and I told him what had happened. He had a good laugh over that.

“Oh, I wish I could have seen her face,” he said. “I’ll bet she was horrified. Good for you, Mom. Good play.”

It would be our final Cancer Card moment, his final belly laugh.

In 48 hours, he would be gone and I would never hear that laugh again.

When people tell me we should fix health care gradually so businesses and the economy don’t get hurt, I ask why they want to put the welfare of corrupt insurance companies and Big Pharma over that of the 35 million Americans who still don’t have access to health care, plus another 12 million or so whose insurance has such high co-pays and deductibles that they can’t afford to use it. That, after all, is the very basis of fascism — money over people, the good of corporations above the welfare of human beings.

Some 30,000-plus people are dying every year the same way my son did. and we have done almost nothing.

Yes, insurance companies can’t deny people with pre-existing conditions insurance anymore. In states where Medicaid has been expanded, poor people finally have real access to care.

But Big Insurance and Big Pharma don’t want these changes to stand and they’re paying out huge amounts of money to walk back what little ground we have gained.

Every day we don’t fix this, people die unnecessarily. Every damn day, more family members and friends go through the hell my family and I have gone through. In fact, about three times every hour, another American dies of lack of access to care, just they way my precious son did.

As I count down these days again every year, I spend a good part of my time in tears.

Why can’t we see that people shouldn’t be dying like this when it would actually be cheaper to take care of them — both economically and morally? I tried to explain this to someone yesterday who just said, “I don’t believe you. We can’t afford it,” and turned her back, completely unwilling to listen to anything not sanctioned by the liars at Fox News. I wanted to scream, to call her a fucking fascist, but I walked away instead.

On this beautiful spring day 11 years ago, I so desperately wanted to hold onto him. I still wish I could go back and get him. I think I’d want to take him along on the coming cross-country road trip with my pregnant granddaughter. I can’t even imagine what an adventure that would have been.

I tried to soak up all I could of him during these final days.

On this Sunday 11 years ago, everybody cleared out. James, Mike’s closest friend, and Janet, who still loved Mike and who was still adored by him, went back to pick up mail and check in with their bosses. Janet’s boss would fire her for not coming in on Monday; James’s boss told him to take whatever time he needed. They were both planning on returning Wednesday. Mike would not be here to greet them.

On this beautiful Sunday 11 years ago, we would have just two days left with Mike.

 

They’re not done trying to steal our health care

Do you really think this man and his partners in crime are going to give up and stop trying to take away our access to health care?

 

Everyone seems in a celebratory mood this morning.

Stop it.

Stop it now.

Mitch McConnell announced the latest version of Trumpcare is dead, and that saves Medicaid — for now.

But he also announced he will try a “clean repeal,” meaning the ACA would go away in two years. It would leave up to 33 million people without insurance. Thirty-three million. That’s how many people have gained insurance under the Affordable Care Act.

When my son died on April 1, 2008, I started fighting for reform. In 2009, I left my job as a newspaper reporter — I volunteered to be laid off — so I could devote all my time to the effort.

I wasn’t thrilled with the Affordable Care Act, but it was a step in the right direction. It would have forced insurance companies to cover my son and he likely would still be alive — that is, if it had passed in 2005 instead of 2010.

As it is, my friend, Kelly, who worked with me in the fight to pass the ACA, will die if this is repealed. Kelly has lived with cancer for years, and if the ACA goes away, she will lose her insurance and her access to the care she needs. She will die.

Middle-aged people with diabetes, asthma, high blood pressure, high cholesterol, depression and any number of other illnesses, will be left to die. Cancers that are treatable when diagnosed early will be diagnosed too late to save people’s lives — exactly what happened to my son.

Think about it: if you make $35,000 a year and you have a policy with a $10,000 deductible and high co-pays, you won’t be able to afford care unless you sell your house — if you own a house and can sell it in time to save your life. That’s what the Senate version of “replace” had in it, a two-tiered insurance system that would give people with a lot of money good insurance while the rest of us would be able to get only junk plans.

Before the ACA, some 45,000 Americans died every year from lack of access to care. That’s one every 12 minutes.

Under the ACA, an estimated 33 million more Americans are covered than were before. Most of the 12 to 15 million without coverage now are low-income people in states that have so far refused to expand Medicaid. That’s also where most of the approximately 20,000 who die every year from lack of coverage live.

So, we’re saving 25,000 lives every year with the ACA, but the powers in Washington want it repealed because — well, why?

The ACA is not failing. Insurance companies are not going broke. In fact, a federal court has found that United Health Care was not losing the money it claimed it was losing when it pulled out of the ACA marketplaces.

What’s happening is that a group of ultra-wealthy, ultra-conservative thugs want more money. They want more tax breaks for the rich. They want less regulation. And they don’t give a damn about you and me. They don’t care about the opioid addiction epidemic — in fact, they deliberately caused it to make money.

If you don’t remember, Purdue Pharmaceuticals began marketing synthetic opiates in about 1996. They told doctors and others that this new synthetic wasn’t addictive, although they knew damn well it is. Before long, doctors were prescribing it for things as simple as a tooth extraction — things where an over-the-counter painkiller would do.

They now ship enough painkillers into West Virginia alone to kill everyone in the state.

And you think these murderers are going to give up now because they can’t get a “replacement” through for the ACA?

Think again.

Their disdain for us runs so deep that they won’t give up. Tax cuts are far more important to them than our lives. They want that money.

They’re talking about passing a repeal that would take effect in two years — after the next election so we we can be distracted easily, since we’ll still have our insurance at election time. They can keep promising a replacement that they have no intention of passing.

Please remember that they’ve had seven years to come up with a replacement and they showed us already that they have nothing.

If they genuinely cared a whit for us, they would have had some idea how to do this. But the ACA was a conservative idea, generated by a conservative think tank (The Heritage Foundation) and implemented by a conservative governor (Mitt Romney) in a single state. The Democrats pushed it because they thought conservatives might be willing to go with their own idea.

They weren’t.

Obama offered a huge olive branch with the ACA, and he put icing on the cake by taking single-payer off the table at the outset. Had we started discussions there, we might have been able to get a public option and give insurance companies some competition.

But we started negotiations in the center and landed right of center, and they still want to get rid of it.

That alone should tell you that they will stop at nothing to take away our health care. If it is at all possible, they will do it. And they won’t stop trying.

Don’t let up now. Don’t stop calling, writing, e-mailing, faxing … Our lives depend on it.

 

 

 

Murder. That’s what ‘repeal and replace’ really is.

“You die and you die and you die …”

The House will vote today on whether to murder tens of thousands of innocent Americans.

While you might not think the repeal of the Affordable Care Act and a replacement that takes health insurance away from some 24 million Americans is murder, but it is the premeditated removal of access to health care.

In my book, that’s murder, just as the death of my son was.

My son didn’t have to die. He shouldn’t have died. But he was denied insurance because a birth defect was a pre-existing condition. Because he didn’t have insurance and he didn’t have thousands of dollars in cash, he was denied care.

Think about this for a second.

My son was denied care when he got sick.

He was turned away, even though he was in pain and obviously sick because he didn’t have insurance.

Michael, age 3, playing with his food.

He committed no crime, but he was handed the death penalty for being born with a birth defect.

Yes, he went to the emergency room. But the emergency room only has to stabilize you, so my son was given pain pills and a laxative when the problem was a malignant tumor blocking his colon.

He went to the emergency room three times and got no help.

He was denied a colonoscopy for three years running — even though he’d already had pre-cancerous polyps removed by the time he was 25.

Yes, Republicans, he was working when he got sick, but he got too sick to work — try reporting for a shift waiting tables when you have stage 3 cancer.

And if you think you’re safe because you have employer insurance, this new law allows states to remove the protections of mandated coverage from your plan as well.

That’s right, you could lose maternity coverage, addiction treatment, mental health coverage. And while you may not want maternity coverage because you’re a man, your wife or daughter could lose a child because of lack of access to maternity care. In fact, you could lose your wife or daughter.

But go ahead, laugh and say, “like I need maternity coverage, chortle, chortle.” Maybe it’ll be a little less funny when your wife or daughter dies from lack of access to care.

And if you think they don;t know what they’re doing, consider this: They kept all the protections of the Affordable Care Act for themselves in this bill. We can die, but they won’t because they wrote the law to protect themselves and their families.

These murdering thugs belong in  jail, not in Congress.

But because they’ve been able to convince enough Americans to vote against their own interests, because they’ve been able to gerrymander their districts to prevent a Democratic majority, they get to murder tens of thousands of Americans.

If the ACA goes, I lose coverage because I have asthma.

If the ACA goes, 22 million Americans are in the same situation I am.

Are you one of them?

I have tried to appeal to my congressman, Mark Meadows — a man who claims to be “pro-life” and “Christian.” He is neither. I have called, written, e-mailed and faxed appeals to him, trying to appeal to his better nature.

As it turns out, Mark Meadows has no better nature. Nor do Robert Pittinger, Patrick McHenry or Paul Ryan. These are not reasonable people. These are criminals who belong behind bars for their part in this heinous crime.

You can say I’m a little over the top with all of this, but if you lose a loved one to this mess, you’ll understand.

If you don’t have health insurance, you are not a criminal, as much as those in power would paint you as such. Why else would their first question on hearing my son’s story be, “Was he working?”

Perhaps they should have to watch their children die. Perhaps that’s the only thing that will work to change their minds.

I really do hope there is a Judgment Day. I want to be there when they’re condemned. I want to see it happen.

 

 

Waiting and hoping for a miracle

Kelly and me in the Green Room of the Ed Shultz Show on MSNBC.

I have hoped for miracles before. Sometimes I’ve been disappointed, like when I could do nothing for my son as I watched him get sicker and sicker.

Then there’s my friend, Kelly Cuvar, who has had a rare form of cancer for 13 years. Pretty much everything about her is a miracle. Knowing her has made me believe miracles are possible.

Kelly has never been in remission. She is from Ohio (from John Boehner’s district, of all places), but she lives in New York, where she is able to get care for her disease.

But, she says, worrying about health care has caused her more angst than her cancer. What if she loses Medicaid? What if she had to find care on her own for some reason? What if the Supreme Court overturns the Affordable Care Act and Paul Ryan gets his way on Medicaid and Medicare?

Kelly and I don’t talk as often as I would like — we tend to keep up on Facebook and via e-mails these days. She’s pretty upbeat most days. Often, she’s downright irreverent. She has a right to be.

Kelly has said time and again that dealing with our broken health care system is more difficult than dealing with cancer. In most other countries, she wouldn’t have to worry about whether she would be thrown to the curb. In most other countries, she would get care. Period, end of discussion.

In the US, however, she never knows whether the doctor she’s seeing will stop accepting Medicaid, forcing her to find another doctor who will. Her well-being depends on which way the political, and lately, judicial, winds will blow.

Every decision she makes about her life revolves around her health care. It determines whether she’ll marry (she can’t now), where she’ll live, whether she can work (she can’t) … Just about every decision most of us make without thinking, Kelly has to make with an eye to whether it will affect her health care. Worrying about her care causes her more distress than her illness, Kelly says.

Kelly and I were fellow travelers along the road to getting the Affordable Care Act passed. We met in Washington, DC, when we both went there for rallies and lobbying. I carried my picture of Mike; Kelly carried her cane. We realized very quickly that we share a similar twisted sense of humor and the guts to speak truth to power.

When the ACA passed, Kelly and I were on the phone to each other, laughing and crying.

Sure, the law didn’t give us everything we wanted, but it was a start and we vowed to continue working to improve the system. We had won a battle, but there would be more and we knew it then. We would work for a public option, for the ability to buy into Medicare. Someday, insurance companies will have competition and people will be able to gain access to the care they need.

We didn’t believe we might have to start from scratch, though, and if the Supreme Court overturns the law, we’re back to Square One.

Kelly has cancer and I’ll turn 60 later this year. Neither of us has unlimited time. But neither of us is willing to give up, either.

No matter what the Supreme Court decides, Kelly and I will keep advocating for access to quality care for all Americans. Getting sick shouldn’t mean having to choose between bankruptcy and death.

If the ACA is upheld, Kelly will be able to buy insurance in 2014, as will others who have had cancer, diabetes, high blood pressure, depression, acne … all the things the free market has used to deny insurance coverage to people. We will be able to go to the doctor with the assurance that our needs will be met.

Some 20 million people will remain uninsured, however, and Kelly and I will continue to fight for improvements to the system. We may get tired because she’s sick and I’m old, but we won’t quit. I assure you, we’re in this for the whole race.

It may take a miracle, but Kelly and I have seen miracles; we believe in them.

 

 

The myth of government dysfunction

By my friend and former colleague Matt Davies.

As a Supreme Court announcement on the Affordable Care Act nears, the volume on the rhetoric is rising almost to the pitch it was before President Obama signed the bill into law. House Speaker John Boehner is promising to eviscerate the law if it is upheld so that President Obama won’t be able to boast about success during the coming election season. GOP nominee Mitt Romney is denying he had anything to do with the Massachusetts plan on which the federal law is based. He now says he would work to repeal the ACA.

So, what about the good of the American people? Is our current “system” really worth defending? Are we really OK with more than 45,000 unnecessary deaths a year and hundreds of thousands of bankruptcies because of massive medical bills?

Big Insurance is fighting anything that will pinch its profits, and the GOP spin machine is talking about how the ACA will remove all control of their health care from people, and how the system will drown in an avalanche of paperwork.

But over here on the left with the ghost of Ted Kennedy, we’re talking about how to expand coverage, possibly to single-payer.

Here’s a little truth for you: Medicare spends 97 percent of its funds on direct services; health insurance companies are whining about having to spend 80 percent of the money they take in from customers on care. Why? Because of executive pay and bonuses, lobbying, advertising, marketing.

Here’s another uncomfortable fact for the right: Since 1970, the number of physicians has less than doubled, while administrators’ jobs have grown by about 3,200 percent, according to figures from the U.S. Bureau of Labor statistics. Those administrators work for insurance companies and for doctors’ offices, mainly because doctors need so much help coping with the different forms, codes and requirements of each insurance company. In the US, we spend more than $700 per person on health care administration than they do in Canada, which has a national system.

About 31 percent of everything we spend on health care goes to this administrative mess, and the worst of it comes from the private sector. Under an improved Medicaid-for-all system, bills would go to one place; forms and codes would be universal instead of having a different set for each of dozens of companies.

If everyone has the same coverage, there will be no tricks to deny people coverage, such as denying a claim for a colonoscopy because it was done in a doctor’s office instead of a free-standing clinic.

Doctors and patients can make decisions based on the needs of the patient, not on what the insurance company will or will not pay for. The bureaucrats who interfere with doctor-patient decisions work for the insurance companies, not the people.

A nurse complained to me a couple years ago that she was on the telephone with a Medicare representative for almost two hours as they tried to come up with a code that would pay for what the patient needed.

I told her a private insurance company would have denied the care and hung up, and she agreed that likely would have been the case. The bureaucrats in the government might be somewhat burned out, but they aren’t eligible for a bonus just for denying you care.

We could save somewhere between 45,000 and 101,000 lives every year because we all would have access to appropriate health care, not to mention the money saved by managing chronic illnesses so they don’t become crisis care.

Insurance companies are spending billions to avoid letting everyone have access to care because there’s no money in it for them.

We are the only one of the so-called wealthy nations that does not see health care as a basic human right.

No matter what the Supreme Court decides in June, we all need to demand a better solution — one that puts people before corporate profits.

 

Numbers don’t lie

One of the things Republicans like to say when they argue that we can’t afford health care for everyone is, “Numbers don’t lie.”

Well, here’s a number for you: Official estimates by the US Census Bureau say that 49.9 million Americans now are uninsured, an incerase of about a million people from a year ago.

Statistics say that translates to about 5,000 more premature deaths every year, bringing the likely total to about 50,000 Americans.

“That’s one plane crash every day,” says Dr. Margaret Flowers of Physicians for a National Health Plan. “It’s the equivelent of another 9/11 every month.”

Most people are unaware of these numbers because they rely on the corporate media for information, Flowers says, and I agree with her. Instead of getting the truth, we get distractions and misrepresentations leading most Americans to believe we can’t afford health care for everyone.

For example, in Monday’s debate, Wolf Blitzer’s “hypothetical” man chose not to pay $200 a month for insurance. I don’t know anyone whose insurance costs are that low unless they have huge deductibles — $10,000 and more — and co-pays. Almost two-thirds of Americans don’t even have $1,000 to lay out for an emergency at any given time, so I don’t imagine our “hypothetical” man is being cavalier in making his decision.

“The number of young people who can afford insurance and choose not to get it is very, very small,” Flowers said. “If you have these huge deductibles and co-pays, you’re going to go bankrupt if you get sick. So of you’re going to go bankrupt anyway, why shell out hundreds of dollars every month to a big corporation?”

So, Wolf Blitzer’s example is misleading to begin with, although you won’t get that information on CNN.

The money we’re spending on wars and the money we’re not taking in from the wealthiest Americans and corporations would more than pay for Medicare for every American. Instead, we tell people we can’t afford it and 50,000 people die every year — one every 11 minutes.

“It seems to me that’s morally reprehensible,” Flowers said.

So, here are a few of the true numbers you probably don’t know:

  • TheCensus Bureau says 55.3 percent of Americans were covered by employment-based plans in 2010, down from 56.1 percent in 2009. It was the eleventh consecutive year of decline, from 64.2 percent in 2000.
  • In Massachusetts, whose 2006 health reform is supposed to be the model for the Affordable Care Act, 370,000 people were uninsured in 2010, representing 5.6 percent of the population, a jump from 4.3 percent who were uninsured in 2009.
  • Some states saw more than a 3-percentage-point to 5-percentage-point increase in their uninsured rate (Idaho, Louisiana, Mississippi, Montana and South Carolina). In terms of absolute numbers, Louisiana had the largest increase in the number of uninsured, 240,700, followed by New York (177,700) and South Carolina (173,300).
  • Among various population groups, the greatest loss of coverage was among working-age adults ages 35 to 64, people with incomes below $49,999, and people with disabilities.
  • Latinos continue to  face uninsurance disproportionately (30.7 percent), compared with blacks (20.8 percent), Asians (18.1 percent) and non-Latino whites (11.7 percent).
  • About 7.3 million children remain uninsured. Young people ages 19 to 25 had a drop of 1.6 percentage points in their uninsurance rate, a figure likely linked to the federal health law’s provision that allows dependent children to be covered under a parent’s health plan up to age 26.

I suggest you print this out and show it around. It’s what corporate America doesn’t want people to know.

The ‘hypothetical’ young man

My very un-hypothetical son, Mike, who died because he didn't have insurance.

I didn’t watch the GOP debate, but before I went to bed Monday night, I checked the headlines.

There it was: video of people cheering, “Yeah!” at the prospect of letting a “hypothetical” young man die rather than care for him. No one, not the candidates, not the moderator, not anyone in the audience reprimands them.

There is nothing hypothetical about it. About 45,000 people die every year — one every 12 minutes — because they don’t have insurance. The vast majority of them do not CHOOSE to be uninsured; they either can’t afford the premiums, or like my son, the insurance companies won’t sell to them.

My son had a birth defect, which is a pre-existing condition. It left him vulnerable to cancer, so he needed colonoscopies every year. He couldn’t get them, though, because he didn’t have insurance and he didn’t have the money to pay cash-up-front for them.

So, here is how it went for my not-hypothetical 30-year-old son:

First, he gets stomach pains. Eventually, they get bad enough so he decides to go into debt to see a doctor, who informs him he can’t have the medical tests he needs because he’s uninsured and he can’t pay the full cost, in cash, up front. The doctor writes in his medical record, “Patient needs a colonoscopy but can’t afford it,” and bills the patient for the appointment.

A week or so later, the patient goes to the Emergency Room, where he’s told it’s persistent gastroenteritis. Still no colonoscopy. The patient is unable to move his bowels and wonders why it would be diagnosed as gastroenteritis. He is billed for the ER visit.

A little more time goes by and the patient is still suffering, so he goes back to the ER.  This time the doctor says he has an ulcer and gives him an antibiotic. He is billed for the ER visit and the medicine.

Still a few more days and by now the patient has lost 30 pounds and is still in pain, still unable to move his bowels. His family is frantic with worry, but no one has enough money to pay cash up front for the colonoscopy. He goes back to the ER and is told he probably has diverticulitis. He is given a strong laxitive and sent home. He is billed for the ER visit and the medication.

The next week, the original doctor agrees to do a colonoscopy and bill the patient, who will be allowed to pay over several months. The patient is sent home without hearing any results. What he doesn’t know is that the doctor didn’t even finish the procedure because the colon was completely blocked. He never told the patient.

Three weeks later, the patient is down to 112 pounds. He is 6 feet tall. He is vomiting fecal matter and his kidneys are shut down. He is hours from death. The doctor realizes he probably could get in trouble for neglecting the patient so badly, so the patient is admitted to the hospital, where it takes five days to stabilize him.

By now, the patient’s cancer is Stage 3. It has spread. A charity pays the hospital, the doctors and the pharmaceutical company for chemo and radiation, so he at least gets treatment.

But six months later, the patient again is in pain and vomits up everything he eats.

This time, the doctors take a wait-and-see attitude, even though they know the radiation has caused another blockage. The patient drops to 104 pounds and family members threaten to take the story to the media as his doctors refuse to feed him intreavenously. They finally agree to feed him and a few days later, he is wheeled into surgery again.

The pathology lab finds “a few viable cells,” and the patient is told he will die. The doctors don’t bother to come talk to him about further treatment, even though he is on the oncology floor for another week. They don’t bother to treat a life-threatening infection in his incision.

The family searches and finds a doctor who will consult with the patient for about $400; as soon as he sees the patient, he knows he has to adopt him to give him any possibility of even short-term survival.

There’s more chemo — the patient has to leave his wife so the giant pharmaceuticals will get paid for his meds through Medicaid. The patient has no income because he has yet to be approved for disability, as though someone with his medical records might be scamming the system.

His family and friends gather round to support him, both financially and emotionally, but he was neglected too long, and he dies on April 1, 2009. His first disability check comes nine days later.

The doctors got paid by the charity; the pharmaceutical companies made hundreds of thousands of dollars from his chemotherapy. But the patient spent three years in horrible pain and in abject poverty. He was treated as though he wasn’t worth saving until he was adopted by a doctor with a heart, although by then it was too late.

His family still grieves, and always will. His friends still tell stories about his amazing courage, his gigantic heart and his decidedly off-kilter sense of humor.

He was not a bum; he was never lazy.

He was my son, and he didn’t deserve to be left to die.

For those whe cheer the thought of his death, I just want you to know I would never wish the same thing on you or anyone you love.