When I walked into the exam room, a thin, pale, middle-aged man was sitting patiently in a chair waiting for me. “Mr. Richards” (not his real name) politely explained that he needed medicine for his heart and gave me a list of the medications he was supposed to be taking. I asked about his living situation, and he told me he had been living in shelters for the past two years.
As he responded to my questions, I learned this man was an engineer who had been employed by a prominent technology firm. When he had developed diabetes in his late 30s he quickly developed severe complications, including damage to his vision, and later heart trouble. He could no longer perform his work duties and lost his job; he lost his health insurance along with it. He became depressed and withdrawn, and eventually his wife left him. His health care bills bankrupted him. He lost his home. He had applied for disability benefits but had been turned down.
As this man's story unfolded, I felt my stomach clench with anxiety for what would happen to him, and unfortunately I had very little to offer. As a physician who has worked all my adult life caring for low-income and uninsured patients, I have so often been in a position to apply a Band-Aid—in this case, arranging for him to receive a month's worth of his medicine free of charge—but not a solution to the huge problems that face my patients on a daily basis. In order to get in to see a health care provider at my clinic, he had stood in line for over an hour in the heat on two successive days, waiting to find out if we would have an available appointment. Tonight he would walk a long distance alone on the street, vulnerable because of his poor eyesight, and would sleep on a cot in a shelter.
I was struck all over again by the cruelty of a so-called health care “system” that offers health insurance only to those who are employed. For this man, illness had caused the loss of his health insurance, and now lack of health insurance and adequate medical care was allowing his disease to progress unchecked. It was undoubtedly shortening his life span and was creating a situation in which we as taxpayers will all pay the enormous costs of providing care for him as he becomes so severely disabled that he requires hospitalization, heart surgery and perhaps dialysis. Yet we as a nation have not been willing to pay the upfront costs that could help this man and so many others to get the care that could help prevent or slow disease complications and extend functional years of life.
Who are we as a people? How have we allowed it to become the norm that our citizens go hungry, sleep on the street and do not have access to basic medical care? Nations vastly poorer than ours make the choice to treat health care as a human right and provide health care for all citizens. Yet we each know deep down that a sudden twist of fate could land us in a devastating situation like my patient Mr. Richards. The Reverend Martin Luther King Jr. once said, "Of all forms of inequality, injustice in health care is the most shocking and inhumane." Paradoxically, in our country, health insurance seems largely to be reserved for the healthy.
We have come to a historic moment, when we finally have a president who is willing to put all of his weight behind passing comprehensive health care reform. The outcome is not guaranteed; most worrisome is the backlash against the option of a public health care plan. The so-called “public option” would help to loosen the stranglehold that the private insurance industry has on our health care system. It would offer meaningful competition to for-profit insurers, would help to reduce costs for medical care and would provide comprehensive insurance similar to Medicare. Our president and our country need us each to speak out and let our congressional representatives know that comprehensive health care reform with a public health insurance option is essential. Let them know that this is not just what we want, it is what we demand.
Miriam Komaromy, MD Director, UNM Project ECHO Addiction Treatment Program Former Medical Director, Albuquerque Health Care for the Homeless
A Universal Right
It is imperative that this country has universal health care for all. It is not a privilege but a universal right! It is the press' responsibility to stand up for the rights of the people and resist corporate influence. Anything else is a failure on your part. Stop irresponsible and slanderous reporting and help the people get what they deserve! Fear mongering only helps the health industry continue its criminal ways.
Count Me In
I would like to be counted as one who supports efforts to change health care in the USA. It is undoubtedly a disaster playing out before our eyes, and I believe in the "practical and moral honesty" of the citizens and representatives in government to strive for a successful solution.
Health Care, New York to New Mexico
As a New Mexican for the past six years and a sufferer of a chronic debilitating disease for the past 12 years, I have gotten to see firsthand how health care is doled out both here and in New York, my home state.
While I have better insurance than most due to my wife's job, we have seen a steady increase in the co-pay, deductible and price of medication, while watching a number of doctors cutting their hours or leaving the profession altogether due to insurance squabbles. Some 15 years ago I was in the insurance field, and I can attest to how these companies do not have anyone's continued good health in mind, only the bottom line, which better lead to ungodly profits.
Now the right wing is trying to muddle the waters with fear and hatred. Just listen to these facts, but don't try to tell them to a "Ditto-head" or a Glenn Beck watcher:
In New Mexico alone, 80 people lose their coverage every day. And for those with insurance, yearly premiums will hit $22,238 in a few years if we don't act. Across the U.S., 14,000 people lose their coverage each and every day, and that same $22,000 will be their premiums within the decade if nothing is done.
If the current legislation passes, we will see 37 million currently uninsured people here in the U.S. get their insurance by 2019. A public option, or single-payer (often confused with single-provider, which it is not) will spur competition and force insurance companies to reduce costs while increasing coverage. Soon, the term "pre-existing condition" will be a thing of the past. Want proof it can and will work? Look to New York, where the insurance industry is forced to cover everyone. It has worked for almost two decades. Now we need a federal law that says everyone can get affordable health care and medications in every state in the union.
So read the facts, stop listening to the fear- and hate-mongers, and support something that will help everyone. Even Sarah Palin has withdrawn her loony comment about "death boards," as this provision is about funding consultations with your doctor about end-of-life decisions regarding yourself or a loved one, such as whether to have a Do Not Resuscitate (DNR) order or a Living Will. Such consultations are not covered under existing insurance policies. In 2001, I had to go through this painful process when my father was terminal, and it would have helped if we could have consulted with our family physician.
All in all, we need reform, even if it isn't full universal coverage today. Out-of-pocket costs for individuals, families and businesses are outrageous and all too often lead to uninsured people who have to go to the emergency room for common colds, overtaxing our hospitals like UNM and ultimately costing everyone more in taxes and premiums. Remember how we all felt on Sept. 12, 2001? We came together as one nation, one people, caring for everyone. In that spirit, let's all come together once again to care for everyone and eliminate as much suffering of our fellow people as possible.
The Next Generation
There are so many arguments about health care reform that the opportunities are in danger of being lost. But our country has a great opportunity to fix at least two serious problems. The first is we need to make sure that every woman can get maternity coverage. For example, if pregnancy is defined as pre-existing, then a woman might not be able to afford needed maternity care. A second reason to improve the current system is to make sure that children who are born with a birth defect or serious condition, including disabilities caused by being born preterm, can get the quality, affordable and comprehensive medical care they need to survive and thrive. This is not about special interests; it's about our families. As a March of Dimes volunteer, the health of women, newborns and children matters to me. I hope that our leaders in Washington remember this and don't lose sight of what this generation should be doing to ensure healthy future generations.
Can We Have a Conversation, Please?
I remember learning as a late teenager of then-President Ronald Reagan’s plan to destroy Nicaragua by funding a group of mercenaries known as the “Contras.” With CIA money, they killed, rampaged and blew things up. I remember noticing how easy it was, how little effort it took to destroy something, how undermining a small nation was like child’s play, when your only goal is to create havoc.
It’s very easy to tear things down, to kill an opportunity for honest change, to destroy a fragile alliance, to shut out the truth by telling dramatic lies for the cameras and repeating them day in, day out. Even if people don’t believe your lies, they’ll be confused enough to not act on the truth you are trying to defeat. It’s very easy to blast your way into the headlines and become the de facto winner of any argument, just by sheer firepower. The man who killed a handful of women at the gym the other day discovered this. His sick rant is now publicized all over the nation, thanks to his murderous rampage. Had he merely tried to argue his points, standing up in a discussion reasonably and making his case, he’d be a nothing. Now that he claimed the lives of other human beings in a fit of violence, he’s a national figure.
The tea party town hall protesters have learned this lesson well. They’ve discovered that there is no need to put forth good arguments for their points or to meaningfully debate their ideas at the congressional town hall meetings set up just for that purpose. Why should they do that, when they can go on a rampage, yell and scream, intimidate and threaten, even bring guns to the meetings? Such activity guarantees the presence of TV cameras. News organizations will report these activities as “passion” for a cause and not as the lunacy that it really represents. The Republicans in charge of the town hall mayhem have learned a valuable truth. It’s very easy to destroy someone else’s effort, to denigrate the fragile progress of those sitting at the table trying to work out a common goal. Like Republicans everywhere have learned, all you have to do is shout and swear, wave guns and flags, threaten and rant, and they can get their way. Not by converting anyone to their cause, but by simply making politics so unpleasant that most people just go home and hide.
Thomas L. Creed
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