The Human Faces of For-Profit Health Care

To put a human face on our health care problem, I will share some stories with you to bring home the reason why we are so desperately in need of a nonprofit, people-funded, people-managed, private, single payer system. I have been in medicine for 40 years and have lots of stories to share.

Case one. A close family member of mine had a lower back pain shooting to the side of her thigh. A neurologist, together with a neuroradiologist, took X-rays, etc., and recommended spinal fusion (an expensive operation that would lay her up in bed for some time). A friend gave her the name of a therapeutic massage therapist who diagnosed a spasm of a muscle in her buttock. After two massage treatments (cost: $200) she was relieved and has been free of pain for the last 15 years.

Case two. A middle-aged woman came to my dermatology office (she had full insurance coverage) with a wart the size of a pea on her third finger asking for treatment. I asked her if it had been treated before. She said, "Yes, doctor. I have been going to Dr. X for eight months. Every two weeks he freezes the top and shaves it, but the wart is still here." I froze the wart with liquid nitrogen deeply and in two weeks it was gone (cost: $75. The previous doctor's cost: $1,200). Dr. X was so busy with repeat visits that he could not accept a new patient for at least three months.

Case three. A 62 year-old man, married father of four adult children, has been a member of one of the largest HMOs for many years. Many times he has told his HMO physicians that colon cancer runs in his family. Indeed, his father died at 50 of colon cancer. He has asked every year for a colonoscopy, a procedure that is absolutely necessary in such cases to catch an early cancer. All along he was told it was not necessary. Finally, at the age of 61, he took a photo of his bloated belly to the doctor and demanded action. Then he was diagnosed with colon cancer, which had spread throughout his body, including his brain. This will torture and kill him. His family is devastated and the final cost, in human terms and dollars, is much higher than it would have been if had been diagnosed earlier. Why, then, this catastrophe? Because, as I have written in my book, Universal Health Care System for the United States of America (available for free download here), HMO doctors are graded on whether they keep costs down, which affects their future pay within that HMO.

If you multiply these types of stories by 250 million patients in the hands of a for-profit health care system, is it any wonder that our health care cost per person is double that of all the developed countries and we rank 37th in the world in quality of care? With a nonprofit, people-funded, people-managed, private, single payer insurance agency we can do even better than those countries because our proposed, single payer system avoids the inefficiencies of the government-run systems of those countries. We can save over $1 trillion (1/3 of our national budget) and improve the quality of our care. In addition, we also keep 1.7 million jobs within our economy.

It is time to call it as it is. Everyone is tired of beating around the bush on the issue of health care. We need fundamental and bold action. Together we should all tell our president: Sir, you have given us the "audacity of hope" and the promise of change.

We expect no less.

Our health care services need a human face. I request that my readers please share your stories in the comments section or e-mail them to [e-mail] so that I can share them for you anonymously.

Comments

[jacobomorales]

The word profit and health care were not meant to go together in the same sentence, but your examples as in the man who died of colon cancer, the issue there was not so much greed as stupidity. The family should sue the HMO for as much as they can.

[odyssey58]

Another aspect of the health care issue that isn't always discussed is the freedom that we give up in order to maintain our current system. We are not always free to pursue any job we want because of the health care benefits. Either we can't leave a job that we hate (and may be killing us) because we can't afford to give up the health care (and we have a loved one whose life depends on the insurance) or we turn down jobs that we would enjoy because the benefits aren't good enough.
In my case, I needed to retrain after leaving the work force to raise my son. I went to school to become a Licensed Practical Nurse. This program required health insurance. I was able to get medical assistance. But it was taken away half way through the program. I continued anyway without telling the school. But I can only continue my education through distance learning since all of the local nursing schools require health insurance and I can't afford to spend about 20% of my income to buy it.
I am currently doing a job I love but the health insurance is completely unaffordable. I'm choosing a job that I love over health care, I left a job that I hated but had affordable health insurance to take this job.
We are slaves ( and even w h o r e s) to our current for profit system in more ways than one.

[Behzad Mohit]

Dear reader,

The predicament that you describe and find yourself in is shared by several million people. It is technically referred to as “job lock.” Job lock occurs when people stay at their current job solely for the health care benefits. For example, in California, in 2003, 2.3 percent of the workforce (179,000 people) would have changed jobs except that they had to stay at their current jobs because of the employment-based health care. Job lock accounts for $772 million in lost productivity each year.

This issue and many others are described in the book “Universal Health Care System for the United States of America,” freely downloadable at http://uhc.helpeachother.com/

[TheIndependenceParty]

On the walls of each of the hundreds of hospitals I've worked in and visited over the last forty years are plaques in appreciation to beds "Dedicated in perpetuity to the free care of the sick". While those dollars might have been spent, or squandered. the land and the many other resources dedicated to not-for-profit hospitals by the communities that supported them have been GIVEN to the for profits that gobbled them up. There has never been an accounting of those assets to my knowledge, and the linking of hospitals across the country in failed or failing chains simply puts multiple communities at risk of losing their hospitals, even when their local hospital might be well managed and solvent. Ther for profits are like a virus to one another.

[TheIndependenceParty]

Many things need to occur for our health system to be salvaged.

First, ... any for profits that fail must relinquish their institutions to the community they serve, rather than liquidate them as bankruptcy assets. Replacing them in those communities would be prohibitive in this economic environment.

Second, cases such as the young man riddled with terminal colon cancer must be allowed to go to trial without artificial limits on damages and suffering. Think of this as "behavior modification therapy" for the doctors who practice under cost-reduction mandates by for profits. Just as with threats of criminal prosecution to the mother who took her son away from necessary chemotherapy, denial of essential diagnostics such as the colonoscopy he required, should be grounds for criminal prosecution of for profits and payers who deny reimbursement of these critical tests. Regulation is required to prevent these abuses.

Hill-Burton and the commitment of every institution to delivery some free care must be mandatory, and the reimbursements from payors must be a foundation to allow it.

Or, ... and this is my preference, that we go to single payor now. Look to Europe and Singapore as viable models. Our current model of care is dying slowly and needs replacement.

[jmpurser]

So, we create a giant corporate monopoly and put them in charge of our health care? Why? Because the current corporate health care companies are doing such a bang up job WITH competition?

The ONLY argument for private health insurance is the idea that competition will somehow produce miracles in terms of efficacy and efficiency. We kill thousands of Americans every year proving this isn't true in the real world. Your solution TAKES COMPETITION OUT OF THE PICTURE so now what do we have? Corporations with NO competition AND the ability to lobby (buy) congress? Loverly!

Forget the "inefficiencies of government run health care". It's a GOP boogey man designed to scare Americans away from any real changes.

We need public, single payer health care and we desperately need it NOW.

[Behzad Mohit]

Dear reader,

I absolutely share your concern. It is true that a government­-sponsored­, single payer system such as an extension of Medicare that covers everyone is preferable to the present FOR-PROFIT system. At present this is off the table because 1) the FOR-PROFIT pharmas, hospitals, health insurance companies, etc., have spent millions of dollars for years to DEMONIZE “SOCIALIZED MEDICINE.” 2) This people are fearful of a single payer, financed by government, perceived as bureaucratic, inefficient, with tax increases. This is not factually true. The government-run systems of the developed countries cost half as much per person.

There is a more efficient way: a NON-PROFIT, SINGLE PAYER, REGULATED INSURANCE AGENCY mandated by legislation, similar to other INDEPENDENT AGENCIES SUCH AS THE FEDERAL RESERVE with the difference that it is funded and managed by its policyholders and immune to politicians and lobbyists. The policies may be paid for by individuals, their employers, Medicare or Medicaid. However, the individual policyholders, regardless of the source of the payment for the policy, will elect the board of directors and managers. These directors and managers will have term limits of four years, staggered every two years, to create continuity. Their salaries and bonuses will be capped and set by the vote of the people. Doctors’, nurses’ and other providers’ compensation is set by the managers.

Please see the book “Universal Health Care System for the United States of America.” Free download at http://uhc.helpeachother.com/.

[schatsie]

The only reason we have Medicare is because of ADVERSE RISK selection... That is the for profit companies operating in a FREE MARKET could not make enough off of the elderly....and the elderly were too poor to afford their products...

The FREE MARKET, for profit insurance companies failed with the population that needs health care the most...

The Free Market is also supposed to provide savings to it's customers because of competitition and yet we are paying 100% more for our healthcare than any other industrialized country... There have been no cost savings, only profit gouging by the CEOs...I refer you to the retired president of United Health Care who makes as much as anyone on Wall STREET....

[ncmom54]

This needs to be on the front page! These and many stories like them should be everywhere in the media... this is a one time opportunity and the American Citizens who are victims of such a horrible, greedy system deserve a louder voice. A tab for Health Care Reform would be great.

After our "Stepford Congress" favored the Banking Industry over American Citizens.
Health Care Reform is moving the same way.

It would be nice if the tax payers could vote for what we want.

http://www.pnhp.org
Physicians for a National Health Program

www.healthreform.gov
Speak up! for yourself and then stand up for someone who is no longer able.

Why shouldn't we have the the same publlic funded plan we provide Congress?
(any who vote against it, should explain why they deserve it and we don't)

stay focused... this isn't going to be easy

I agree with you, I want to do it, now make me do it." FDR

[MikeMarks]

1) My friend was schedualed for surgery to remove cancerous uteris. She telephoned me frpm her hospital room to take her home. She didn't have the surgery. Now 25 years later she has no cancer 2) I was in a car accident. Doc said he needed to but alotta stitches in my scalp. I refused. He asked if he could put just one stitch, I said ok. Hair didn't grow back where he put the stitch. I assume if I had let him put all the stritches in I'd be bald 3) I had hives. Doc did exams. Sent me to specialist. Had me on $5 per pill med. After weeks of suffering druggist recommended Bendryl instead of refilling the script. A couple of days later with the benedryll I was cured 4) about 10 occasions I found my mother unconscious on the floor. I'd shake her awake. She didn't want to go to hospital. She revived on her own. Mothers Day 2008 I found her unconcious again. Enough was enough. I called an ambulance and she went in the hospital. Five days later she was dead.

[mlaiuppa]

The specialist doctor at Kaiser said I had piriformus syndrome. I asked if my muscles were too weak because I was so flexible. He said no and sent me to physical therapy. The physical therapist gave me exercises to do for flexibility. When my leg started to go numb and I started dragging my foot I went to a friend's chiropractor.

The chiropractor said I had piriformis syndrome. She said my I was too flexible and my muscles were weak and needed strengthening. She gave me totally different exercises. I improved immediately but still had some pain. She suggested an MRI.

Asked GP at Kaiser for MRI. 9 weeks later: I have two herniated discs in my lower back, causing my sciatic nerve to spasm my piriformis.

I'm trying to get Kaiser to switch me from Synthroid to Naturthroid. I'm going to have to go outside the HMO.

In 2001 the allergy Dr said I had asthma. In 2003 he said I didn't have asthma. (You 'catch' asthma and then are 'cured'? I thought you either had it or you didn't.)

I've been complaining of being tired for 10 years. My first doctor said "Well, you are getting old". I was 43. My current doctor says "Well, you are overweight". I am NOW. I've been gaining 10 lbs a year for the last 10 years.

[TheMellowFellow]

Well to be fair, you can get asthma later in life, you aren't always born with it.

...But no, you cannot be spontaneously cured of it.

[DMGMD]

I think this is a good example of why we need a system that takes best evidence into consideration not just dollars and cents.

Of course nobody online can really comment on the actions of your physicians. However, sending home a patient presenting with chest pain and an abnormal EKG sends shivers down my spine.

Dr. Mohit, are you familiar with the EMBRACE plan http://www.healthcare-reform.org/TheHPfHRSystem5-4-8.pdf ?

[petef59]

Why can't anyone comment online about the actions of their physicians? Another special class of people not responsible for their actions?

[PlaceboStudman]

I think he meant that no one can comment on the actions of someone else's physician, because someone sitting at the computer reading doesn't have nearly enough information to make a proper and correct assessment of a situation that has already happened

[DMGMD]

Because you can never know all of the details. And unless I've actually done the physical exam, heard the entire history, and analyzed the EKG, I can never know all of the details. Anything else is a guess.

[HST]

"is it any wonder that our health care cost per person is double that of all the developed countries and we rank 37th in the world in quality of care? "

That is the whole crux of the matter. People will say my coverage is fine, everyone else can go fend for themselves, it's socialized medicine, the government will be making your healthcare decisions for you (vs. insurance company "utilization" reviewers) etc etc., but it all comes down to the fact that every American's access to healthcare is being rationed based on their ability to pay. Americans ARE NOT getting what they pay for when it comes to healthcare services.

[PlaceboStudman]

Here's the thing though, people without insurance are telling those with insurance "I have no coverage, go fend for yourself", despite the fact that people WITH insurance and WITH easy access to even the "best medicine in the world" are still getting medicines and procedures and treatments that often do more harm than good (see my story below)

[Behzad Mohit]

You are absolutely right.All the other developed countries have a largely government run system that costs half as much as ours,covers everyone and give better quality healthcare­.However,o­ur FOR PROFIT operatives have spend years and tons of money to demonize the"SOCIALIZED" medicine.That is one reason our politicians shy away from it .Another is the public perception of more government spending and"tax increses" Although if you cut the cost to one half ,like in other countries there would be no tax increase.But there is a third and much better way open to us: A NON PROFIT,SINGLE PAYER,PRIV­ATE,PEOPLE FUNDED,PEOPLE MANAGED INSURANCE AGENCY,mandatetd by legislation as a regulated agency and run by policy holders,thru the management elected by them.the policys bought either by people ,their employers or by the government for people on medicare or medicaid as it is now. except the cost for all parties would be less than half with complete covrage ,perventive care and prescription drugs with no co pay plus good quality control.More detail is outlined and freely down loadable at"uhc.hel­peachother­.com

[PlaceboStudman]

I was born in 1972 with myelomenin­gocele/hyd­rocephalus­, aka Spina Bifida. I was fortunate enough to have been connected to one of the pre-eminent neurosurgeons in the country who was a specialist in dealing with Spina bifida. He treated me for everything from broken toes (incurred because I am paralyzed and could not feel when I banged toes against a bath tub) to a spinal fusion to attempt to correct scoliosis, to the insertion and 5 revisions of a cranial shunt to manage symptoms of hydrocephalus. I have been relatively healthy for the last 36 years, and I have to confess, as much animosity as I'm going to get for saying this, I have had very good coverage for nearly every surgery, treatment and medication I have ever needed. I have gone through at least 60 surgeries (we stopped countng at 60), and literally hundreds of X-rays, MRIs and CT scans in my 36 years. And, although I have been relatively healthy my entire life, I have now come to discover that the 36 years of prolonged stints on medications have caused irrepairable damage to my kidney (I only have one, lost the other to infection and stones), and heart.

I have been told within the last year that I am essentially terminally ill, with 5 years to live --at most--, regardless of what or how much insurance coverage I have or will have.

[RTIII]

Well, make the best of it!
.

[PlaceboStudman]

You bet your @ss I'm making the best of it. And I'm doing so by fighting, yelling, screaming, shaking a few people if I have to, to make sure people fully comprehend the idea that having insurance is not the end all be all magical cure for all that ails us, when literally millions of people like myself die needlessly, not from a lack of care, but from the lack of quality of the care we do receive. It is offensive and insulting that there are people dying from a perfectly fixable flaw in the system, a side effect of the for profit system that has allowed BigPharma and the FDA to give us substandard to dangerous synthetic drugs that are doing more harm than good, and even often killing us

And all you can say in response is "Make the best of it!" ??

[eciaccio]

Unfortunately, Big HMO & Big Pharma already have their greedy hooks into Obama, Max Baucus, and so many other Dems & Repugs who are slavishly, greedily following their corporate masters' orders: single payer is off the table.

My Congressman told me to my face he won't co-sponsor H.R. 676, but would vote for it if it came up for a vote, knowing full well that wouldn't happen in this Congress and with this president.

As long as our government is corporate-run, we will not have single payer health care, nor a sensibly small "defense" [war] budget.

[Guitarsandmore]

In May of 1996 I went to my doctor complaining of chest pains. He did an EkG in the office and told me I had problems with my heart. Then he told me to go home and in two weeks they would send me the name of a cardiologist with whom I could make an appointment.

My wife was livid and told me to go to the emergency room. My fellow employees told me to go to the emergency room. So I did. I went in with chest pain and the cardiologist told me had I waited another 5 hours to come in I would have passed away. I had 3 arteries 90 percent blocked.

Once that was determined my HMO was refusing to pay for the surgery. They wanted to try to treat it with medication first. The cardiologist at the hospital refused to listen and went ahead with the surgery which saved my life.

The HMOs are only interested in keeping costs down and making money.

I talked to an attorney who said I had a good case but the fact that I did not die took something away from the case. It sounded like I could win the case but the rewards would not be there for me so I dropped it. looking back I wish I had sued anyway.

[Behzad Mohit]

Thank you for sharing your story.This is a good example of HMOs trying to save cost.Or your for profit doctor exagerationg your problem to make some money.Did you show your per operative angiogram or C T scan to a another specialist,not connected to first one for a second opinion?Unless you did ,you will never konw.I have had experience with cases where the patient was rolled into open heart surgery ."they saved his life" except on futher review it was totally unnecesary.your case ,clearly shows the problem with the FOR PROFIT health care.You are damned if you do damned if you don,t. It is basically flawed.for now I strongly suggest to all of you that before you do any major procedure or treatment get a second opinion from a source NOT connected to the first.Second just for your own curiosity, sir, you may want to pass your pre procdure scan or test by a third not connected specialist. The bottom line we need a SINGLE PAYER NON PROFIT ,PRIVATE,PEOPLE FUNDED ,PEOPLE MANAGED system

[Behzad Mohit]

thank you for bringing the 3 tier insurance policies advocated in that example.however the fundamentat prolem with our health care is that it is the only FOR PROFIT system among the developed countries.thus high cost and poor quality ie 37th in quality.The 3 tier system of coverage that is presented in thereference you named is also outlined in my book "A UNIVERALHEALTH CARE SYSTEM FOR THE UNITED STATES OF AMERICA"freely downloadable at uhc.helpea­chother.co­m. However there is a difference.in the non profit system there is no board to decide who gets what .The government provides the essetial care for indigent .people and their employres buy whichever policy they chose, simple.IT is A NON PROFIT,PEOPLE MANAGED,REGULATED INSURACE AGENCY There is no billing,no skimping on care, no unnecesary testing or treatments just to make money.

[DMGMD]

I think this is a good example of why we need a system that takes best evidence into consideration not just dollars and cents.

Of course nobody online can really comment on the actions of your physicians. However, sending home a patient presenting with chest pain and an abnormal EKG sends shivers down my spine.

Dr. Mohit, are you familiar with the EMBRACE plan http://www.healthcare-reform.org/TheHPfHRSystem5-4-8.pdf ?