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Health Care Is a Human Right

By: healthcareforall Monday May 26, 2014 10:43 pm

Health care is a human right. No one should have to suffer or die because they can’t afford to pay for a drug that can make them well. No one should have to walk around sick or watch a child die because there isn’t money to pay a doctor. No working-class person should lose the savings from a lifetime of labor because he or she falls ill. Talk about immoral!

A woman in a lab coat with a stethoscope draped around her neck

Health care is a human right.

This principle came home to me recently through the technological magic of social media, which enabled me to reconnect with an old friend with whom I had not spoken in nearly 25 years. We’re both from a Southern state one associates with images of Jim Crow segregation and bigoted stereotypes demonizing the poor and less fortunate. I moved from there to the West coast, and my friend (whom I’ll call Maggie) remained in the South.

I was delighted to find Maggie again. We began a conversation on-line, catching up on all that happened in our lives since that long-ago evening when we parted. Then one day I shared an article with Maggie, a piece that addressed homelessness and the difficulties faced by people who find themselves out of work with no resources. I thought it would be meaningful to her because I knew that there had been a period in the ‘90s when she found herself in that situation.

To my amazement and dismay, Maggie responded with a stream of vitriol worthy of a Tea Party apparatchik, all about parasitic welfare queens too lazy to work, milking the system by continually popping out babies and getting rich on the taxpayers’ dime. She said things like, “I know them. They think they’re entitled. I see them when they line up in WalMart with their brats, buying groceries with my tax money.” This was the sort of wearisome nonsense I used to hear as a child, sitting around the dinner table with my white, racist Republican family.

Maggie isn’t white, which makes her attitude that much more disturbing. Even more troubling is the fact that she is a professional woman, Christian, and educated in one of our nation’s finest universities. Sadly, the incident changed my feelings toward my friend. After this exchange, I found myself backing off, we communicated less and less, and now it’s as though we had never found each other again after all those years.

The Maggie story points to an attitude in American society that stands in the way of our recognizing health care as a fundamental human right. It’s that viewpoint that the poor are poor because they’re lazy, that their poverty is the result of flawed character or moral failing, instead of the consequence of being born in the wrong place or with the wrong skin color, or of a family that doesn’t have the social or political connections necessary for their children to attend a decent school. The attitude: because people are less fortunate they are somehow leeches milking the rest of us “hard-working Americans” dry.

These accusations even get leveled at the working poor, some of whom work more than one substandard job and still haven’t sufficient means to provide for themselves and their families. The attitude is also related to the pernicious Horatio Alger myth–the “pull yourself up by your own bootstraps” rags-to-riches bit: the poor are poor and deserve their fate because they lack the moral compass to subscribe to the ‘profound truth’ of a 19th century writer of juvenile fiction.

Then there are the right-wing governors and legislators in the states that have refused to expand Medicaid under the Affordable Care Act, who pride themselves on failing to make that program available to low-income people. Sick people, who would get better with access to affordable health care, are dying as a direct result of these legislators’ refusal to allow them access to a public benefit that is already the law of the land. Why is this happening? The attitude: those people don’t deserve to have health care because they’re too lazy to work and pay for it.

With a prevailing attitude like this, is it a surprise that we don’t have single-payer or (God defend apple pie, grandma and the American way!) socialized health care in this country?

Americans talk a lot about rights, but we don’t do much about them. What good are freedom of speech, association, religion, etc. if you’re unable to afford food for your table, a decent place to live, or medical care for a sick child? It’s great that our Constitution enshrines those rights, but as Americans we need to stop ignoring other fundamental human rights, such as the right to health care, the right to food, to clothing, to a safe home, and to meaningful work. Yes, these are rights, and we need to stop acting like they are not.

 

It’s not profit that is destroying our health; it’s the private insurance business model.

By: healthcareforall Monday December 3, 2012 11:53 pm

By Samuel Metz, MD

Many Europeans use private health insurance companies, a few of them for-profit. These Europeans enjoy better care for more people at lower cost than we do. But the European business model differs radically from that in the US. In fact, American insurance companies find the European model not only alien, but intolerable. Imagine American insurance companies playing by these European rules:

  • You can set any price on your policy, but you must sell it at the same price to everyone, regardless of health.
  • You must sell a policy to anyone who applies, no exceptions.
  • No policy can be cancelled for any reason, not even failure to pay (the government will step in). Patients, however, can change companies without notice.
  • Every policy must cover all treatable diseases. No matter what policy they purchase, patients will never risk destitution (or death) if they suffer a treatable condition.
  • Your company must pay every claim from every licensed provider within 30 days. You can protest the payment, but only after you pay the bill.
  • Every provider receives the same payment for the same service, regardless of patient or their insurance.
  • Your records are an open book. Every dollar (or Euro) that passes through your hands is open to the public. There are no proprietary secrets.
  • If you still manage to cherry pick healthier patients, the government will impose a premium to subsidize other companies with sicker patients.

With this model, European companies compete with lower prices, extra benefits, and better customer service. Isn’t that a refreshing change?

The American business model has no such rules. How do American insurance companies compete?

  • They avoid sick patients. Highly paid underwriters detect potentially expensive patients before policies are offered. And the best way to avoid sick patients is with high policy prices.
  • They slash benefits. Reduced benefits both discourage sick patients from buying a policy and reduce provider payments if they do.
  • They pass costs to patients with increased deductibles and co-pays. Healthy patients (the ones companies want to keep) won’t notice because they don’t need health care. At least until they get sick.
  • They delay or deny provider payments. If the payment process is frustrating enough, many providers simply give up trying to collect. That’s money they keep.

Profit? No difference. To succeed, both for-profit and not-for-profit companies follow the same rules. If not, your company is toast.

It is not profits but the business model that places the financial interests of our health insurance industry in opposition to the medical interests of its clients. Neither removing profits, nor enhancing competition, nor deregulation will increase health care quality or make health care more accessible.

Our American insurance business model is the source, not the solution, of our health care problems. We must run – not walk – away from letting private insurance companies determine our health care.

 

Samuel Metz is a Portland anesthesiologist active in health care reform. He is also a member of two organizations advocating publicly funded universal health care: Mad As Hell Doctors and Physicians for a National Health Plan. He is the local chapter representative of Health Care for All Oregon, an umbrella organization of over 50 groups working for better health care in Oregon.

Photo by Mattes under Creative Commons license.