Health Care for “We”

by Brad Cotton

 (published 6 April 2012, Circleville Herald)


“ We pride ourselves on getting anything the patient wants… if they have a craving for lobster tails and we don’t have them on the menu, we’ll go out and get them” notes the Director of Hospitality at New York’s Mt. Sinai Medical Center’s  Eleven West, one of many exclusive pricey “Concierge Care” units catering to the ultra-rich. From New York to Los Angeles, many large hospitals that are taxpayer subsidized have opened such “gated community” units featuring butlers, marble baths, imported sheets at price tags over $2400 daily. Downstairs, sicker and poorer uninsured patients are treated in overwhelmed emergency departments or on gurneys in the hallway for days waiting for a bed, with proven worse outcomes. This is what the market does for health care. ( “Chef’s, Butlers, Marble Baths: Hospitals vie for the Affluent” NY Times 22 Jan. 2012)


100 years ago the Titanic sank. Rich folks got on the lifeboats, everyone else was locked below decks and drowned. 50 million of our neighbors have no access to health insurance. Nearly 50,000  of those die yearly as a direct result. (American Journal of Public Health, September 17, 2009)  This was a very conservative study—the true number is likely much, much higher. 60% of all bankruptcies in the U.S. are caused by medical expenses. 1 in 5 Americans has trouble paying their medical bills, for poorer folks that is 1 out of 3, according to the Center for Disease Control and Prevention. Many more Americans are just not getting care, can’t see their Doc, can’t fill their prescriptions. ( “ 1 in 5 U.S. Families say they struggle to pay medical bills: half say they can’t pay a cent” Associated Press 6 March 2012)


Health care reform is not a question of constitutional law, soon to be decided by a Republican-activist Supreme Court. Access to health care rather is a moral concern, a reflection of the presence or absence of a genuine Christian character for our nation. When health care is a marketable possession, a privilege granted only to those lucky enough, or ruthless enough, to claw their way over the bodies of their neighbors to the top of an economic-Darwinist Ayn Rand heap there is no community. No “we”, all “me”. Author Wendell Berry succinctly observes: “Rats and roaches live by competition under the laws of supply and demand; it is the privilege of human beings to live under the laws of justice and mercy.” Martin Luther King, shot and killed supporting striking municipal sanitation workers, noted “Of all the forms of inequality, injustice in health care is the most shocking and inhumane.” American author John Steinbeck in his 1939 classic “Grapes of Wrath” warns : “If you who own the things people must have could understand this, you might preserve yourself. If you could separate causes from results, if you could know that Paine, Marx, Jefferson, Lenin were results, not causes, you might survive. But that you cannot know. For the quality of owning freezes you forever into ‘I’, and cuts you off forever from the ‘we’.” The health insurance industry is not into “we”, it is “me” in the most immoral way possible. Profits over lives.


The Patient Protection and Affordable Care Act is deeply flawed, chiefly as it is a Republican plan to prop up insurance companies originally proposed by the ultra-conservative Heritage Foundation in 1989. By reining some of the worst abuses of us by the health insurers it is better than the status quo. Barely. In 1993  Republicans twice introduced bills featuring an insurance mandate: the “Consumer Choice Health Security Act” and the “Health Equity and Access Reform  Today Act”. The mandate to buy insurance was praised by Newt Gingrich in a 2007 column: “In order to make coverage more accessible, Congress must do more  … and require anyone who earns more than $50,000 a year to purchase insurance or post a bond.” Mitt Romney, flip-flopper in chief, urged President Obama and Congress to follow his Massachusetts example on insurance mandates in an op-ed published July 2009 in “USA Today” : “There’s a better way… the lessons we learned in Massachusetts could help Washington find it…. First we established incentives for those who were uninsured to buy insurance. Using tax penalties, as we did, or tax credits, as others have proposed, encourages ‘free-riders’ to take responsibility for themselves rather than cost their medical costs on to others.”


Perhaps this is why Obama pushed for the mandate, thinking for sure Republicans would back a Republican plan. Regardless of what happens to the PPACA, single payer, aka “Medicare for All” is the most compassionate , cost-effective and Christian means to care for us all. Steinbeck, King, Berry all agree: essential human needs must not be entrusted to corporate boardrooms.