Friday, February 25, 2005

Feb 24, 2005


We have a problem. It’s a big problem too. Bigger than big, gargantuan. It’s a problem not unlike the problem Seymour had with his man-eating plant Audrey in Little Shop of Horrors. It was cute when it was little and satisfied with a few flies, then a share of Seymour’s lunch. But then Audrey grew and day and night it was “Feeeeeeed me Seymour, I’m hungry.

America’s Audrey is our nation’s healthcare system. It rate of growth has reached a point where we can no longer afford its care and feeding. The only way to keep Audrey from eating entire federal, state and local budgets is to slip her a lethal dose of weed killer and start over.

How hungry has Audrey become? Well let’s see. Within nine years she will require the federal government pay half her food bill. That’s nine years from now. You should still be around to see that, unless of course you should be without health insurance and get very sick. Then you are likely to miss that meal call.

Total health spending will double in a decade, to $3.6 trillion in 2014 from $1.8 trillion last year, while gross domestic product, the total output of goods and services, grows more slowly. As a result, health spending will constitute 18.7 percent of the economy by 2014, up from an estimated 15.4 percent last year – and those are numbers supplied by the Bush administration. Since we know better than to accept anything they say as fact, you have to believe matters are probably worse than that.

Nevertheless administration after administration has found it easier to shut Audrey up by increasing her portions than replacing her with a system that works for everyone. So far they have gotten away with it. But that’s only because the public has devised ways to cut their own consumption of drugs and medical services, a kind of self-rationing. My wife is a family nurse practitioner in private practice and she comes home daily with tales of little old ladies who are getting sicker only because they cannot afford the pills she prescribes.
Then there are those golden oldie bus tours to Canada to buy drugs made by US companies for half what they cost in the US.

But that’s all just a drop in Audrey’s chow bucket. A huge healthcare crisis looms and even folks in the Bush administration are beginning to look for ways to once again rearrange the deck chairs in the hopes they can keep the system afloat at least until they get out of Dodge four years from now.

Enter Michael O. Leavitt, Bush’s new head of Health and Human Services (how’s that for an oxymoronic name for a Bush administration agency?) Leavitt’s solution is to ration healthcare at its source by providing low-cost health coverage for the uninsured that would cover routine emergency room visits but nothing for catastrophic care.

"Wouldn't it be better to provide health insurance to more people, rather than comprehensive care to a smaller group? Wouldn't it be better to give Chevies to everyone rather than Cadillac’s to a few?" Michael Leavitt.

You can ignore that. Those who can afford it will still get Cadillac-care. And if you believe the rest of us will get shinny new Chevies I have a bridge you can buy to drive it across.

Leavitt was not talking about the only real solution to America’s ever-growing healthcare gap -- universal health insurance -- into which everyone pays premiums and which in turn provides a reasonable baseline of healthcare for everyone. And that would include catastrophic care. Under Leavitt’s plan a person going to an emergency room would pay small co-pay and get seen. That would be the good news. But God help the patient if the doctor discovers he is seriously ill and must be admitted to intensive care. In that case he would still be – to put it bluntly -- shit out of luck.

There is no way to tame America’s healthcare monster. If we keep it we have no choice but to continue feeding it. And then it will continue growing and demanding ever larger portions.

Kill it and replace it. Universal, single-payer healthcare, is a plant we can live with. Despite all the anti-single-payer propaganda pumped out by the right and their healthcare industry supporters, single-payer is the only way to fairly and efficiently spread the costs and benefits of healthcare to all Americans.

Single-payer is NOT socialism. And it would not be a “gove
rnment healthcare.” It’s simply actuarially the only way it can be done without either bankrupting government or creating the healthcare equivalent of apartheid – one system for the well-to-do and substandard charity-care for the uninsured.

I challenge those who disagree to conduct a poll in Canada or the UK. First ask them if they think their system is great. A pretty good percentage will say no, it’s not, and they will provide all kinds of tales of long waits for non-critical care. Ask them if they like their jobs, their extended families or the weather, and you will get much the same. Nothing is perfect and no one is ever completely happy.

Then ask them if they would trade their system for ours.

I rest my case.


As a Canadian living in WA state on a military exchange program, the
"education" my husband and I have received about the American health care
system has been very enlightening during the 3 years of habitation in the

Your right, I wouldn't give up what we have in Canada, it makes me sick that
this country "allows" its' citizens the denial of this basic requirement.


By Stephen Pizzo
Raconteur at Large

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