jeudi 6 août 2009

The prostitutes of our system

Are you listening yet?

Do you understand?

If you are against single-payer and you do not support a public option, you are working against not only your own interests -- for you, too, might become uninsured, or have a claim rejected, or a need for care denied, or watch a loved-one go down because he or she was not as fortunate as you -- you are working for their corporate interests.

The other day, I posted former Vice President for corporate communications at insurance giant Cigna Wendell Potter's interview with Bill Moyers, talking about how America's insurance and private health care interests are busy working for their own, at the expense of yours.

Is this what makes you proud to be American?

Of course, I also understand that the offer of "full debate" for single-payer and a floor vote in the house is merely a way to sweep it out of the way and be able to say, "See? We told you there just wasn't support for single-payer." We all know that, but that doesn't make it right. Meanwhile, Representative Dennis Kucinich is calling upon single-payer supporters to work to get his amendment, allowing the States to set up their own single-payer systems with ERISA protection, passed by the full House of Representatives.

Let me tell you, here, in single-payer France, everyone has the right to go the doctor and the hospital of his or her choice. Everyone. Some will pay a 30 euro co-pay for an emergency visit to their general practitioner, who might just come see them at home if it's too cold to being the baby to them in the middle of a winter's night. Yes. Ours does.

You want to see a private practice doctor? Go right ahead, the choice is yours. You might pay 50 euros, probably less, above what the health system pays for you. And, if that doctor also practices at the public hospital, he or she also sees patients on the public lists, delivering the very same care for no extra for the visit.

You worry that public hospitals are the scourge of medical delivery? Here, you have to pass additional exams to be qualified to practice in them; you are considered the medical elite. Other doctors, who haven't taken or passed those exams, will seek to practice a couple half-days a week in those public hospitals for less than you pay your cleaning lady for a morning's work. Why? Because they consider it a medical duty, and because they can associate themselves with the best in their specialties, making sure to keep abreast of the very latest in diagnostic and treatment care.

Ask me. I know. One such removed the melanoma from my toe. My husband, a public hospital practitioner these last 25 years, who only began seeing "private" patients about 5 years ago, and that only 2 half-days a week, and none in surgery (he and his colleagues all agreed that there would not be private surgery in the hospital because it compromises the system and best care for all, at a cost to them), thanks him for seeing me at a moment's notice and for my life.

Waits? No. Not if you have a problem, a need for care. I know it. I see it on a daily basis. It's the conversation at our dinner table.

Can't get pregnant? Don't worry, the government will pay for treatment for you and your partner, and you will be seen by one of a handful of accredited doctors at a fertility clinic that has had to have regular, demonstrated success rates. Leave your checkbook at home. Just be sure to bring your carte de Sécu. I know this, too, because my husband is one of them.

Worry that your doctor went to a "top tier" medical school? Here, it doesn't matter. Here, doctors are shocked by the diplomas on the walls, attesting to education at a "top" medical school. Here, all medical students pass rigorous exams to continue their training, few of the many who start out making it to the end, and even fewer making it to the prestigious "postes" in the public hospitals and the title "practicien hospitalier". All who make it through medical school receive the same quality education and training.

It's that simple. I am embarrassed when called upon to explain our American system.

If you doubt me, come live in France. Pick a smaller city, or a village outside one of the smaller cities. Now, start feeling vertigo, nausea, experiencing disorientation. You'll do what we all do at first, seek out Americans near you to ask where to go, what doctor to see. They will tell you what they have all learned, "Go to the nearest emergency room and tell them what is wrong." You will receive "top tier" treatment, wherever you are. And what's more, if you are not covered by the government health system, don't worry about your final bill. My husband operated on a friend from LA living in Paris for a year.

She had a fibroid tumor the size of a grapefruit on her uterus. In LA, she was told that she didn't qualify for surgery (they had the money, everyone, to pay for a furnished apartment near the Eiffel Tower and work from home for a school year, and they were insured). Hormone therapy was recommended, long after the tumor had exceeded the size that can hoped to be treated by hormones. She suffered bleeding, discomfort and pain during intercourse. She called a friend in Paris, who suggested she call me, since my husband is an ob/gyn. She came out to see him, he recommended surgery -- remember, it's part of his salary; he earns not a centime plus for recommending surgery, but when he does, the hospital takes it on, no questions asked --, and she and her husband opted to have her operated on by him.

The final bill, for the appointment and diagnosis, the appointment with the anesthesiologist to take her medical history (they don't do that in the US), surgery, three days hospitalization and all medications, right down to the last asprin?

1,200 euros.

She received the bill, and they called to ask if there was an error, was there not a zero missing?

They paid out of pocket. It was less than their deductible back in the States, and much less of a headache.

Still doubting the single-payer or a public option for a system like congress enjoys -- and do we hear them complaining? I didn't think so --? Ask yourself, why do you think that the USA knows better than every other industrialized country? Why is it alright for the USA to rank 37th in the world based on objective measures of medical outcomes "behind Colombia and Portugal" and 44th in infant mortality? Guy Saperstein, past president of the Sierra Club Foundation and previously one of the National Law Journal’s "100 Most Influential Lawyers in America", writes in AlterNet:
The United States ranks 44th in the world in infant mortality, behind many impoverished Latin American countries. Although infant mortality in the United States is skewed toward poor people, who have rates double the wealthy, the top quintile of the U.S. population has infant mortality rates higher than Canadians in the lowest quintile of wealth.

Why is this alright with you?

Why are you not demanding more?

Why are you continuing to chose to collaborate with corporate America and the "prostitutes of our system" rather than demand that our representives act like The People's representatives t our federal government?

Why are you not demanding campaign finance reform to take corporate control out of our chambers of law?

You call that "socialism"? We call that democracy.

Feel free to send your questions my way, and meanwhile, thank you, Mr. Olbermann, for saying it. The list is growing of those willing to speak.

Are you listening?
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