Talk for your church Health Care Justice
Health care in America has strayed from its healing roots and moved to a corporate enterprise that puts profits ahead of patient needs as we've recently seen with the hike in prices for lifesaving medicines such as the Epi Pen and insulin. Health care in America, rather than healing, creates poverty with almost 2000 people declaring bankruptcy daily with medical debt playing the major role. Medical debt is one of the leading reasons for home foreclosures and is one of the leading reasons for debt collections.
Health care in America has been politicized greatly, but in truth it is a moral issue, always has been a moral issue and always will be a moral issue.
Our health care system is not based on good public health policy, methodology, or scientific evidence. Instead it is based on ideology, specifically market ideology.
Back in the 1960's a commonly held belief was that the private insurance industry, mostly non-profits, would adapt to the changing medical economy and cover everyone in 10 years. In the 1980's, however, there was a fundamental shift in attitude that accompanied a shift to private, investor owned health corporations. Health care was then seen as a fertile field for profit seeking businesses, a commodity for those who could pay, and patients became consumers.
Healthcare, however, is not an optional commodity to be traded. It is a fundamental human need that is often not met. We can see that daily when people have trouble accessing the health care system due to cost barriers, when premiums, deductibles and co-pays skyrocket and when a prescription can make the difference between health and buying groceries. When a person is in a pay or die situation, choices are limited.
Besides financial bankruptcy, health care in America has created a moral and spiritual bankruptcy. The corporate enterprise views patients as a source of ever increasing profits. Before being a human being in need of care, we are first seen as a revenue source, as exemplified when Donna, who was taken to the ER for a pulmonary embolism, was first met by a financial counselor who wanted to know how she was going to cover her co-pay. Or Mary, diagnosed with terminal cancer, who continued to drag herself into work as often as she could, in order to preserve her employer sponsored insurance and not bankrupt her family while dying. Mary was a nurse who worked for a well known Cleveland hospital.
Health care in America often has a cold, cold heart.
But, market ideology persists and when we passed the Affordable Care Act, we bought into the notion that health care was a commodity to be bought and sold like TV sets. Yes, assistance, often inadequate, was offered to purchase insurance, which resulted in policies that were totally insufficient with networks so narrow needs could not be met and out of pocket costs that made actual medical care out of reach for many.
I recently went shopping for a health plan with my sister, who is stuck in the individual market because she does not get health benefits through her employment. Ironically, she is a health care provider. The cheapest plan available to her has a $500 per month premium, a $6700 deductible, no prescription coverage until the deductible is met, covers only 2 of the 3 medications she needs and does not include the hospital where her doctor has privileges. In fact, there was no plan in the Marketplace that included the hospital or one of her prescriptions.
The medication not covered is injectible Imitrex for migraine headaches. She often has intense migraines where the oral Imitrex does not work because she can't keep it down. Last August she had 18 days of migraines, with four of them being so intense she needed the injectible Imitrex. Those four doses will now cost her $500 out of pocket.
People became incensed over the high price of prescription drugs in the last year. The huge price increase for EpiPens and the quieter manipulation of the price of insulin are prime examples of what is wrong in American health care. The high cost of prescription drugs in the US is one of the prime factors in the overall high cost of health care. Others are outraged over Aetna's withdrawal from the marketplace exchanges and worried about the effect that will have on their premiums. Why are Americans paying twice as much as people in other developed countries?
A recent review by Consumers Union, an arm of Consumers Report, names the number one factor for high costs on unit pricing fueled by market power. In other words, the drug companies, and other health providers, charge as much as they can because they can.
In short, Mylan and Aetna are doing precisely what they are expected to do: make money and return dividends to shareholders. And, in order to satisfy shareholders, they must show growth. The only way they can do that is by increasing their profits and returning bigger dividends to shareholders. The cycle never ends.
We've seen mergers and acquisitions of insurance providers as well as health care providers, each jockeying to increase their market power. We've seen hospitals in urban areas withdraw from poorer neighborhoods and move to the more affluent suburbs. Medicine follows the money and you and I are caught in the middle.
And we may find ourselves even more behind the eight ball when the new Congress is seated come January. Every aspect of health care is vulnerable as the goal is to eventually force us all into the individual market. Congress has vowed to repeal the ACA, but has no viable plan for replacement. They want to turn Medicaid into block grants which never keep up with inflation and will ensure that many low income Americans will lose coverage. We've heard Speaker Paul Ryan gleefully say that Medicare will be gone by next Thanksgiving and the newly nominated candidate for Secretary of Health and Human Services is on board with eliminating Medicare. Even Employer Provided Insurance is under the gun as they would like to reduce and eventually eliminate the tax credits employers receive for providing insurance.
This is exactly the direction we should not take. Whether a person lives or dies should not depend on shareholder dividends. But, that is exactly what will happen if we continue to go down this path. The US has had the highest rate of preventable death in the developed world for a long time and the policy now being proposed will only exacerbate that. Now is the time to demand fundamental change in how we view our health care system and how we structure it. Health care is an essential service that we all need at some point in our lives. Health care is a public good, like fire protection and police protection.
We all have ideas on what "they" should do, but we are "they". This is our challenge and our job to get done.
We cannot continue to protect the corporate interests while dehumanizing people. We cannot continue to question the financial cost of helping people rather than the moral cost of not helping them, or we will find ourselves living in a society devoid of humanity, common decency, respect and dignity.
No one in America should face financial ruin, declines in health, or premature death because they cannot afford needed care.
Our vision for the future of healthcare should be to create a system that is built on human rights standards:
It would be truly Universal.
Equity: services and resources must be allocated to meet the needs of all of the people when they need them. Financing must be public using a non discriminatory manner.
Comprehensive: The system must provide for all medically necessary health needs, including the eyes, ears and mouth.
Transparency: All decision making must be transparent in nature and available to the people the system serves
Participatory: There must be adequate allowance for public participation at all levels.
Accountability: The system must be ultimately accountable to the people it serves.
All economic systems, public and private, must serve to meet our needs and uphold our values as a society. If they fail to meet our needs and live up to our values because they’re designed or run poorly, we must improve them. And if there is an inherent conflict in the system that prevents it from being able to meet our needs, as there is with healthcare, the only moral choice is to find a fundamentally different approach.
So, why have I come before you today, a community of faith? People of faith are in a unique position to make a difference. In compassionate dialogue, faith groups can study the issues of justice, ask the difficult questions, and challenge misinformation. Faith communities have the opportunity to build bridges and initiate collaboration among congregations, the business and labor communities, health care providers, civic groups and others. Voices of faith can bridge ideological differences and partisanship.
All faith traditions challenge believers to act with justice, engage in healing and treat people with compassion. People of faith are called to embrace this faith tradition and declare that health care for ALL is a matter of conscience and a moral imperative for the common good.