James Clay Fuller

Things We're Not Supposed to Say

Saturday, October 21, 2006

Health 'care' in America: Outrageous failure

It is a very bad idea to become seriously ill in these Corporate States of America. It is an even worse idea to be old and ill in these Executive States of America, under this government by the rich, of the rich, for the rich in America.

We peasants, we workers and salary slaves and consumers cannot be either seriously ill or old and expect anything but misery. Illness is the major reason for bankruptcy in this country; medical costs cause more than half of all personal bankruptcies, as reported frequently, most recently on CNN Friday evening. And going bankrupt does not mean you'll get the medical help you need; it just means the money for doctors and hospitals and prescription drugs is entirely gone.

The Republican lords and Republicrat footmen have seen to it that our best choice is to die as quickly and quietly as possible. And do not bother them in the process.

Same goes for the soldiers the lords are so fond of telling us to “support,” while they force the poor bastards into a health care nightmare.

I am a touch angry. If you're not angry about what passes for a health care system in this mess of a country, you do not understand what's going on here.

What inspired today's spike in the anger level is contact with two old friends. Both of them are getting a screwing over by Medicare and the medical system that would not be allowed in any other developed country on the planet. You have to look to North Korea and Sudan to find anything worse.

Nothing comparable would happen in Canada or England or South Korea or France or Iceland or Portugal or even Morocco. Definitely wouldn't happen in Cuba.

I have for months been collecting facts, verified stories and data on what (sort of) passes for a health care system in this country. The pile is high. But what it contains is exemplified by the stories of my two friends and one other situation powerfully covered by the newsletter of Veterans for America, a national veterans' organization.

Story one: A man who has been one of my closest friends for 50 years, became a paraplegic five years ago as a result of a perhaps unavoidable slip by a surgeon. The surgeon really is not to blame; it was very high risk surgery, but necessary to save my friend's life, and he was warned of the likelihood of such an outcome.

Since that surgery, his life has been a constant struggle – not so much to adjust to his new physical limitations, which he has done with amazing courage and acceptance, but with the medical system, which eats up countless hours of his time, great quantities of his limited energy and much of his small nestegg.

He has discovered that he must fight constantly, almost daily, to get the medical care and the equipment he needs to live and to get it without becoming destitute. At times the fight is overwhelming and he sinks into deep depression.

The system is designed to impoverish him and keep him bedridden.

He's been through a great deal again lately, all of it made worse by the insane maze of regulations, forms, interviews, and errors of the system.

He was to have had surgery a couple of days ago to close a wound he got while transferring from bed to a wheelchair more than a year ago; he can't feel anything below the waist and so didn't realize he was hurting himself. The wound will not heal completely –- he's also diabetic –- and the surgery is to close it so that it will finish healing.

The surgery was postponed because a nurse failed to tell him that he had to stop taking one of his medications five days prior to the operation. Among the results of that glitch are the fact that the private room he had been promised for recovery is no longer promised. And he had to go through the entire admittance procedure again – answering questions for a half hour or more even though none of the information has changed since he went through the entire process just over a week ago. Also, of course, it means more time confined to bed.

He was in bed for a year. Because of that he required a special mattress, as ordered by his doctor. It's apparently the only thing that would prevent him from getting serious bedsores which, because of his condition, would at best be very slow to heal. Medicare paid the outrageous cost of the mattress. (All equipment for the handicapped, like prescription drugs, is outrageously priced in this country.) Now, the day after the surgery was postponed, he learned that Medicare has decided it won't pay for that mattress after all – and, oh, by the way, it wants $3,000 from him for the use of the mattress to date.

My friend has fought at least a couple dozen such battles over the past five years. He has won most of them, at considerable cost to him in time and stress, but wonders what happens to people who have his kind of physical problems but not his education and professionally-learned ability to fight for his rights.

Story two: The other friend is going through something akin to my own experience of four to five years ago. Her father, in his 90s, has a chronic kidney problem and has been hospitalized recently. He sensibly has decided against dialysis, recognizing that he is too old and frail to tolerate that only to prolong his life a short time.

With his family's approval, the hospital transferred the old man to its hospice, a rational and humane decision.

However, Medicare won't pay for hospice care, or so his family has been informed. That appears to leave them with the choice of impoverishing his elderly wife by paying for the very expensive care out of pocket or sending him home, to be cared for by that same increasingly frail wife and his two daughters, one of whom lives 1,000 miles from here. None of the three women has any medical training.

As with my male friend, the women are educated, highly intelligent and the daughters have the guts and the smarts to fight. They may find the way to unlock Medicare's purse so that their father can die in dignity and as much comfort as is physically possible for him. But maybe they won't find a way to make that happen.

Conservatives and rightwing sociopaths masquerading as conservatives are likely to say that the problem is the bureaucracy –- lazy, stupid and inept bureaucrats making life difficult for honest citizens.

That's not the problem, people. The many government bureaucrats I know work hard and try their best to help the people they serve.

The system was designed by members of Congress and high-level political appointees to be what it is. Their goal, which they have reached, was to keep costs of social services, including basic medical care, to a minimum in order to keep corporate profits high and taxes on the rich low. The system has been worked over and reworked again at the behest of the same corporate toadies who designed the new Medicare prescription drug plan. That plan, as every sentient adult knows, was deliberately designed to be a giant cash cow for the pharmaceutical companies that are so generous with campaign contributions and other bribes.

Regulations are terribly convoluted, and even where care is covered, the roadblocks are so numerous and so high that – as intended – many people who lack the intellect and/or the arcane knowledge required to fight give up before they get through the process. They become convinced that the service they require is not available to them. Again, that is exactly what the legislators and high-level appointees intended would happen.

A system so complex was not designed by accident, though that's what a lot of the phony pols would have you believe.

The bureaucrats didn't design the system, and most of them don't like it. But they are required by law to follow the Byzantine rules.

Third story: The veterans the Republicans and Bush lovers claim to be supporting are taking a beating on health care, and the Bush administration and the Pentagon damned well know it and approve of it.

Veterans for America and a very few newspapers here and there have been reporting steadily of late on the brutal treatment the military and the health care system are visiting upon recent war veterans suffering from emotional and mental disorders.

What most of the corporate news outlets have refused to tell the public is that at least 10,000 American veterans of Iraq and Afghanistan fighting have sought help for post-traumatic stress disorder, and the number is growing at a shocking rate. It climbed from 4,500 to 9,000 from October 2005 to June 2006, and the growth rate is at least as great now.

And those are only the ones who have so far recognized their need for help. Further, a report issued Oct. 19 by the House Veterans Affairs Committee's Democratic staff (the Republicans choose not to participate in such studies) says the number of veterans with other types of mental health and readjustment problems also has doubled and, in some cases, tripled.

Veterans Affairs officials also have reported that mental and emotional problems are surfacing lately among Vietnam-era and Desert Storm veterans at an alarming rate. And, they say, there is much more to come because many of the people who remain on active duty or in active reserve outfits won't yet admit that they have problems because of peer pressure in such situations. They call it the “not me syndrome.”

Here are some of the results –- some of the known results thus far --of that great addition to the list of emotionally and mentally disturbed veterans, according to the Democratic Congressional report:

Half of Veterans Affairs medical centers admit that expanding caseloads have affected their ability to treat clients. The Bush administration's failure to increase staffing and other resources for vet centers “has put their capacity to meet the needs of veterans and their families at risk” the report says.

Forty percent of the VA medical centers say they have assigned veterans who need individual therapy to group therapy. Thirty percent say they badly need more staff now. A quarter of the centers have cut services in the face of the growing need and have put many veterans on waiting lists for therapy.

Twenty percent of the centers said they have little or no capability to provide counseling or therapy for families dealing with veterans suffering from post traumatic stress disorder (PTSD) or other mental problems.

Paul Sullivan, director of programs for Veterans for America, said the report didn't surprise his organization.

“We've been saying that VA is in crisis,” he said. “It shows that VA does not have a plan.”

The VA “vastly” underestimated the number of PTSD cases it would see this year, Sullivan said. It predicted 2,900 cases, but by June of this year, its staff already had encountered 34,000 cases of PTSD among Iraq and Afghanistan veterans.

There is money in the VA budget for more treatment. It wasn't allocated because of the absurdly low estimates of the number of cases that would surface this year. But it remains to be seen whether the VA itself, and Congress and the administration, will allocate enough to treat seriously troubled veterans promptly and adequate -- and in the years ahead. Thus far they've been dragging their feet on providing adequate care for physical injuries, let alone mental and emotional problems.

In some cases, several sources have reported, veterans of the Bush wars are waiting two years and more to get any kind of treatment at all for their war-derived emotional and mental disorders.

A couple of other little facts: More than 46 million Americans have no regular access to health care, and the number is rising rapidly. The New York Times reported recently that 7.9 million children in this country lack health insurance, and that number, too, is increasing very quickly. It rose about by about 365,000 last year.

Handicapped people are rapidly losing services and access to necessary equipment; the Associated Press reported within the past week that many medical suppliers, probably more than half of them across the country, have determined that they no longer will provide power wheelchairs and some other mobility equipment to Medicare recipients because Medicare has reduced payments for the equipment to a level that results in losses for the suppliers (not necessarily for the manufacturers).

It is possible to do a list of more than 100 points of equally appalling weight to demonstrate the level of failure of health care in the United States. I can do it out of that pile on the floor.

The only possible way to adequately “support our troops” and to overhaul our miserable failure of a health care system is to throw out the incumbents – Republican and Republicrats -- and keep them out.

But we also need to avoid replacing them with other pols who are enamored of uncontrolled capitalism and big-money donors. They will offer only small-increment “improvements” wrapped in more rules, regulations and roadblocks. A Hillary Clinton won't do enough good to be worth a stroll to the polls.

Democrats have been promising recently that if they gain control of Congress they will initiate major health care reforms such as requiring the government to negotiate with drug manufacturers to lower prices on medications provided under the new Medicare drug plan. (Republican leadership expressly forbid such negotiations.) That would be a baby step toward correcting the egregious failures of our health care system, but it would be a start.

We must sit on, yell at, bombard with letters, everyone elected to state or national office unless and until they do something real about our health care disaster. If they won't do something, then they must be pushed out of office. No second terms for people who fail to act strongly.

It matters greatly, and it matters now. Americans are suffering and dying needlessly.