Health Care Debate Makes Me Sick

Marion County does have a free health care clinic; it's from 1pm to 4pm on the first and third Saturday of each month at Walker Middle School in Salem. To actually be seen, it helps to get to the clinic and get in line by 7am. Chances are you will be seen if there by 7am, that is provided the doctors who have volunteered to staff the clinic actually do show.

This free clinic is where I need to be going to get my prescriptions filled; it's my only option.

There's a story behind this.

I've been without health insurance, minimally employed and couch/room surfing since October 2008. In these circumstances the most basic tasks of daily life become a chore. This kind of emotional and mental wear and tear can really take a toll. It certainly has in my case. By late autumn of 2008 I was fighting an internal battle with a juicy depression; a battle that continues to be fought out each day.

I went looking for mental health help last autumn; specifically anti-depressant and counseling help. Marion County's psychiatric programming offered nothing. The message was loud and clear; as long as I wasn't actively trying to kill myself or someone else there were no services to offer. I called a bunch of medical clinics too. I'd pay cash for the appointment I told these clinics. Alas, no health insurance meant no appointment, cash or no cash.

So, for six months, I sucked it up. I used every trick I knew, meditation, daily and hourly self evaluation, constant sorting and re-sorting of my depressive thinking tendencies, making sure I didn't isolate myself... The whole gamut.

All the same, the psychological stress dam burst in March. I spent 10 days in an acute psych ward with a major depression. Only after this hospitalization were anti-depressants prescribed. To keep this prescription going from month to month my only option is the Marion County free clinic... 1pm to 4pm every first and third Saturday of the month.

Health Care Reform:

The uninsured health care count in the USA is somewhere in the area of 60 million people. A fix of the health care system was a major plank in the Democratic campaign of autumn 2008. Will such reform happen? Don't hold your breathe...

Right now, batting around the White House and Congress are three sorts of loose ideas on fixing health care. The most progressive plan, and this is in a relative sense because it really isn't very progressive, is Obama's idea of a government operated health insurance plan; a sort of super-medicare. A major downside of Obama's plan is that roughly 30 million people would remain uninsured.

Second, we have government run clearing houses which would funnel the uninsured into market driven private health insurance plans. I feel too cynical to comment on this scheme.

Third, we have "health care cooperatives". I suspect nobody in Congress or outside knows what these "cooperatives" would really be, but it is a catchy title; "cooperative" is such a nice and benign word! In reality, I suspect these "health care cooperatives" would be nothing more then establishing regional/community based health insurance groups where the operation of these regional groups would be contracted out to private market driven health insurance companies. This is just my guess however.

All three of the above schemes would require a mandatory purchase of health insurance coverage by all individuals. Only in America! In the context of the worst economic depression since 1929 all three schemes operate on the principle of loading additional costs onto millions of people who now have nothing. Those who can't pay will be subsidized we are told. Here I will stay clear of what means tested eligibility for subsidies would mean in an American context; the subject is too depressing.

A Fourth Option:

Also batting around Congress we have HR 676, the Single Payer option. Single Payer of course involves a government run single health insurance plan covering all citizens. As such, Single Payer involves universal health care coverage and government monitored and controlled health care costs through centralized negotiation of costs with all health care providers.

The downside is this however. Nobody in Congress, the White House, none of the health care pundits are willing to take Single Payer seriously. It's "socialistic", "un-American", and therefore "undesirable" these politicians and pundits tell us.

The Irony of the Whole Thing:

Polling data and just plain listening seems to suggest that people in the USA deeply want significant health care reform. People are dying (can't pass the pun up) under the weight of constantly rising and exorbitant deductibles, loss of health care through unemployment (often when you need it the most with serious life threatening illness), decreased coverages and legalistic denials of claims. In a nutshell, lots of people are at the breaking point with health insurance.

The reality is that the only option which would address the peoples' health care needs is Single Payer, ala' HR 676. Yet, this is the option that is constantly and intentionally ignored and ridiculed by the health care industry, Congressional and Presidential "powers that be".

Drawing Conclusions:

The current conversation in the health care industry and Washington D.C. isn't about about providing universal and quality health care to the population. Instead, the conversation is about saving the capitalist health care system including the private insurance corporations, hospital chains, lucrative speciality medicine, the clout of the AMA (American Medical Association), and the centrality of the profit system within the health care system. Nothing else can explain the ludicrous pronouncements and the quality of the dialogue that's been bandied about over the last month or two.

Left to their own devices, Washington D.C. and the health care industry will pass a public relations joke version of health care reform. Whatever comes out of the process will be neither universal or affordable. Real health care objectives will be buried under the weight of market tweaking and a zillion qualifying and contradictory details. Real reform will instead be replaced by the facade of reform.

Something Positive? Something Positive? Something Positive?

Real progress on health care will only happen when and if enough people stand up and say, "Enough!" Some of this is happening, although not enough to change the outcome; yet!

Some of these positive signs are recent public disruptions and confrontations of Congressional health care hearings by Single Payer activists. Other positive signs are a growing list of primarily branch and local labor unions who have passed resolutions calling for the passage of the HR 676 Single Payer option (Unfortunately, I am not aware of any national/international union which has yet weighed in on behalf of Single Payer). A third positive sign is a growing perception by many that the health care reform plans currently on the table are a screw job.

My two cents, for what it's worth, is this:

Nothing of value with health care (and a myriad of other issues) will happen unless a movement of people become politically active around what is needed. Only such a movement has the power to offset the concentrated and entrenched power of the capitalist health care industry and their bought and paid for political hacks. Grim as it sounds, I can see no other options.