Igniting a reaction

As we reflect on Dr. King’s words, let us ponder what he was referring to when he proclaimed “injustice in health care is the most shocking and the most inhumane”. What exactly, does “injustice in health care” look like? It looks like this:
 

A 41 year old mother of three, who paid health insurance premiums since she was 18 years of age, was diagnosed with cancer in her late thirties. One day, in the middle of her treatment, she was told by her insurance provider “sorry, you’ve reached your lifetime maximum for benefits so you’re cancer treatments will no longer be paid for, you’ve been dropped from your insurance plan” and therefore, in essence, dropped from care. So as she prepared to die, she worried not about leaving behind three young children who will grow up without their mother, but she died with guilt - guilt because her family spent their entire savings including the children’s college fund as well as their retirement fund to try and save her life - she died worrying about leaving her family in financial ruin.

It also looks like this - Nikki White died at the age of 32. Nikki had lupus, a chronic inflammatory disease that went untreated because she could not afford health insurance. Nikki was a slim and athletic college graduate who had health insurance when she worked in the health care field. But at 21 years old, Nikki was diagnosed with systemic lupus, a chronic inflammatory disease that gradually left her too sick to work. And once she lost her job, she lost her health insurance. Nikki tried everything to get medical care, but no insurance company would accept someone with her pre-existing condition. She spent many months painfully writing letters to anyone she thought might be able to help. She fought tenaciously for her life. Finally, Nikki collapsed at her home in Tennessee and was rushed to a hospital emergency room, which was, of course, required to treat her, with or without payment until her condition stabilized. The hospital performed 25 emergency surgeries on Nikki, and she spent six months in critical care. But by then it was too late. In 2006, Nikki White died at age 32. Her doctor, Amylyn Crawford, said "Nikki didn't die from lupus, Nikki died from complications of the failing American health care system."

And it looks like this - Nataline Sarkisyan was a 17 year old teenager with recurrent leukemia, first diagnosed at age 14. Nataline received a bone marrow transplant from her brother in November of 2007. She subsequently developed complications leading to multiple organ failure, including liver and kidney failure. Nataline was covered under the insurance company of her parents, Cigna. Cigna rejected the request for Nataline to receive a liver transplant on December 11, 2007 claiming her insurance plan did not cover "experimental, investigational and unproven services." This claim led her doctors at the UCLA medical center, including the head of its transplant unit, to write a letter to Cigna protesting that the treatment proposed was neither experimental nor unproven and called on Cigna to urgently review its decision. UCLA had already declined two livers while waiting for insurance approval from Cigna. Nataline’s family was informed that they could proceed with the transplant if they could make a down-payment of $75,000. Eventually Cigna offered to pay for the transplant itself making an exception to their policy. Cigna's reversal of its policy came too late, just hours before Nataline died.

And finally, injustice in health care looks like this – 45,000 Americans dead every year due to a lack of ability to purchase health insurance and access to care while those same health insurance companies have seen their profits increase over the past decade by more than 400%. With approximately $.30 of every dollar spent on our current health care system going to administrative waste, profit and exorbitant CEO salaries and $1.4 million of our premium dollars, per day, being spent to lobby against health care reform in Congress, Dr. King’s claim of “injustice in health care” is demonstrated to be “shocking and inhumane” indeed! And it remains to be seen whether or not the current legislation being crafted in Washington DC will in fact, do anything to address these inequities and injustices.
 

It is hard to fathom that Dr, King’s sense of injustice as it relates to what I call our “illness treatment system”, as opposed to our health care system, was centered on a belief that the solution to that injustice would be to force people to buy an expensive health insurance policy that may or may not cover various health maladies. We know only too well that insurance coverage does not necessarily equate to health care. In fact in far too many cases it is quite the opposite as individuals like Nataline Sarkisyan are denied care for various inhumane, bottom line reasons.
 

The truth is we will never contain costs and improve quality while our system continues to operate under a “for profit” model that is shrouded in secrecy. When the number of administrators hired in the health care system between 1970 and 2009 increased by over 2500% while the number of physicians entering the health care system during that same time period increased by approximately 100% it would seem our system is seriously out of balance. It is immoral to treat health care like a commodity – health care is not a consumable good like a computer or an automobile or a house - there is no choice between illness and health and no one should profit from another person’s suffering.
 

Dr. King saw health care as a human right. Article 25 of the Universal Declaration of Human Rights states, “Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control”. In his famous letter from a Birmingham jail, Dr. King wrote “whatever affects one directly, affects all indirectly”. Here in the United States, unlike the other industrialized nations in the world, we do not recognize health care as a fundamental human right – we instead treat it as a commodity based on ability to pay allowing the “free market” to determine who lives and who dies. In reality, that “free market” isn’t really free, it costs lives and that is far too high a price to pay. Yet where’s the outrage? Where’s the passion for our fellow Americans who live in pain and anguish every day because they can’t afford to see a doctor? I would ask, under what government structure, under what ideology, under what religion, is that acceptable? Who are we as a people? Who do we want to be? The health care debate has produced some very complex questions, arguments and concerns, but the central issue isn't really a technical one, it is a moral one.

Our elected officials need to see that health care is a public good, it is about protecting the public’s health and they must have the political will to invest in needed services for the whole population. Americans generally want three things from their health-care system. First, they believe that everyone has a moral right to get care when they need it; that would suggest care should be universal. Second, they want choice; they want to select their doctors and they want their doctors to determine their treatment. Finally, people want costs controlled; health care shouldn't consume all private compensation or taxes. According to the Constitution, government has a social purpose, “to promote the general welfare” of its citizens. That general welfare could easily be promoted when it comes to health care if only Congress would have extended Medicare to cover all citizens of this country, regardless of age. By in turn increasing the Medicare payroll tax by a mere 3.3% all Americans could have chosen their doctor without restriction of a “network”; they could have been treated at the hospital of their choice; they could have received treatment and medication as prescribed by medical professionals based on evidence based medical standards and they could have done so without fear of bankruptcy for having the audacity to become ill. But the truth is we didn’t do that in the recent and ongoing debate about how to reform our very sick health care system. Instead they nibbled around the edges, producing some important policy changes such as no longer allowing insurance companies to deny people for “pre-existing conditions”, no longer allowing insurance companies to charge women more money than men for a policy and providing financial subsidies for some to purchase the newly mandated health insurance plan but we did not see our elected leaders take on the issue of greatest concern to Americans when it comes to health care and that is controlling it’s cost. The current bills do little to reign in the high costs of health care which is increasing by three times that of wages and regular inflation. These costs cannot be sustained and as such they are dismantling the middle class. As Dr. King demonstrated throughout his leadership in the civil rights movement, social movements cannot compromise which is why incremental reform in health care can’t work.
 

Health care is a truly patriotic issue – Americans care for one another and it is patriotic for our nation to guarantee health care for its people. Again, as Dr. King wrote in his letter from a Birmingham jail “human progress never rolls in on wheels of inevitability; it comes through the tireless efforts of men willing to be co workers with God, and without this hard work, time itself becomes an ally of the forces of social stagnation. We must use time creatively, in the knowledge that the time is always ripe to do right.” Here in California we have an opportunity to do right on health care and lead the way on real reform by working to educate one another and support passage and implementation of Senate Bill 810 which would establish a Medicare for All, doctor/patient, single payer health care system for all Californians. SB 810 would provide maximum efficiency with increased quality of care. A doctor/patient health care system pools money and pays for health care directly. We all, along with our employer, pay a flat payroll tax, similar to how we pay into Social Security and Medicare, no more insurance premiums, co-pays or deductibles and everyone gets whatever health care they need when they need it. There is more than enough money in our health care system to take care of all of us – we just need to reallocate that money to ensure efficient use of our health care dollars. SB 810 assumes health care is a public good and invests in the needed services for the whole population. SB 810 would pool money and pay for health care directly. SB 810 would provide for an efficient allocation of health care dollars by getting rid of fragmentation and administrative waste. And if you fear that what I am talking about is socialized medicine, fear not because this kind of doctor/patient health care system is no more socialized medicine than police are socialized crime fighting. We have a publicly financed military to protect us; we have publicly financed police and fire to keep us safe; we have publicly financed education to provide education to all children; why don’t we have publicly financed, privately delivered health care to provide health care to all? Does that not bring about the equality and justice that Dr. King speaks of? I believe it does.

Reverend Dr. Martin Luther King fought for righteousness, fairness and equal opportunity for all regardless of race, religion or socio-economic status. Forty plus years later, when we look at Dr. King’s claim that “of all forms of inequity, injustice in health care is the most shocking and the most inhumane” we know that it is not only true of his time, but that it still continues today. We can do better, we must do better. The Declaration of Independence promises us the right to “life, liberty and the pursuit of happiness” but is life, liberty and the pursuit of happiness truly possible if you don’t have your health? They are not, you cannot be a productive citizen if you are sick and in pain. It is in all of our interest to achieve a health care system that is economically sound for individuals and industry while ensuring that we are never again shocked by inhumanity as it relates to health care.

As did Dr. King, I too have a dream. That one day health care will be recognized as a human right and that no man, woman or child in this great nation will ever again be without the care they need when they need it. It is the civil rights issue of our time and it is our moral imperative to do all that we can to ensure no American suffers in illness or death because health care was economically out of their reach. Together, that dream, like that of Dr. King’s, is unquestionably possible.

I hope you will join me in making that dream our collective reality.

Thank you.

AFL-CIO Convention Endorses Single-Payer!
Unanimous Vote for Medicare-for-All Reform

September 15, 2009 by Healthcare-NOW!
PITTSBURGH - In a historic vote that adds the nation's leading voice of American workers to a broad national campaign, the AFL-CIO voted unanimously at its national convention here today to endorse the enactment of single-payer, universal healthcare for all Americans. [more]