Published on Circleville Herald

The floodlight lit Cleveland Clinic at night towered over Cleveland’s dirt poor east side like an Egyptian pyramid. As a paramedic on those desperate streets I could see the plush helicopters chauffeuring the Arab oil sheiks in for their cardiac bypass grafts. Some say this is proof America has the best health care system in the world. I say it means we have the best health care system that oil money could buy. My patients that I took to the ERs at Charity, Sinai and St Luke’s didn’t get good health care. The ER was their only refuge. They lived sick and died young while the plush helicopters landed at the walled-off shining white pyramid.

American physician Dr. James Peter Warbasse understood the problem over a hundred years ago saying in 1918: “Among the wealthy there now is a surfeit of doctors; among the poor, too few… I believe that the wives of coal miners and iron workers are as worthy of the best of the best scientific attention and tenderest care in the hour in the hours of their need as are the wives of the the rich. I believe that they should have it, not as a charity or welfare enterprise, but as a matter of social justice. It is their right.”

I have been told that my intensity and passion in these columns has been disturbing to some. I do believe we have to allow facts to guide our ideology, rather than ideology blinding us to the facts. Business and markets do not work for health care. My passion, even anger, stems from being face to face and heart to heart with the intense suffering, pain, even death visited upon our good, hard-working neighbors who are abandoned by health care business and markets. They have nowhere else to go but the ER.

My professional association, the American College of Emergency Physicians (ACEP) reports that 81 percent of its’ members report seeing patients seriously harmed by lack of health insurance. I submit that the 19 percent who do not report such either work in extremely affluent areas or are so focused on pulling drowning patients out of the river, that they are too busy to look upstream to note that it is business and markets ideology that is throwing their patients in the river in first place. ACEP is actively suing Anthem for protecting its’ profits by denying payment retroactively for ER visits it deems ( deems as a “Monday morning quarterback”) to have been unnecessary, thus forcing patients to try and wait out a potential stroke, heart attack or appendicitis at home out of fear for the cost. Proud to pay my dues to ACEP!

My friend and fellow activist member of the Ohio Single Payer Action Network (join us !) Dr. Jonathan Ross is eminently quotable :

“Americans have an almost religious belief that market forces can solve any problem. Narrow physician networks (my parentheses: narrow networks is your insurer limits Docs you can see) are at the heart of the ProMedica vs. Aetna dispute. Narrow networks are supposed to create competition that will control costs and improve quality. Instead, they create out of network price gouging by providers. This is not the first bad idea promoted by the acolytes of market forces in health care. We have tried privatization of Medicare through competing Medicare Advantage plans, privatization of Medicaid by competing HMOs, privatizing facilities like nursing homes, home care, hospices and dialysis. We have tried insurance reforms such as marketplace exchanges like those of Obamacare, the federal employee health benefit system, high risk pools to reduce insurer risk, and expanding insurance markets across state lines. We have tried putting providers and patients at risk through HMOs, PPOs, ACOs, capitation, health savings accounts, high deductible health plans, bundled payments, pay for performance, narrow networks, and the Holy Grail for doctors—-malpractice reforms. All have failed to control cost, improve outcomes, or expand access.”

Dr. Ross goes on to note that Winston Churchill said that Americans can always be counted on to do the right thing, after we have tried to do everything the wrong way first. We are the only advanced nation in the world that believes that having business and profit, MBAs and pin-striped financiers at the bedside is the best for our health. Many are afraid of “government health care”, really, are you afraid of Medicare? I am afraid of Wall Street corporate health insurers and Big Pharma—I see every day the harm they wreak upon my innocent neighbors. It is time for single payer improved and expanded “Medicare for All”. We shall continue to explore on these pages both the moral underpinnings as well as the precise specifics of how “Medicare for All” is not only safe and compassionate but is cost-effective, saving you and your family large sums of real money.

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