Our Healthcare: Greed and Sleaze or Choice and Freedom

By Donna Smith
GuaranteedHealthcare.org
July 3, 2009

Ah, Independence Day.  We Americans love our freedom and our freedom to choose.  But when it comes to our healthcare system, it seems we’ve forgotten that our choices are most limited and our freedom most restricted under the broken, for-profit, private health insurance model that has been outdoing itself on greed and sleaze for decades.

Kids, women, all non-white ethnic groups, seniors, sick folks – all of these groups have been among those discriminated against by the high-cost, high-profit U.S. healthcare system.  Periodically when the abuses became just too egregious politically and socially, our government would struggle to put programs in place to address the disparities and quiet the storm.  But profits must be paid under this system, and Americans are not free to choose either their doctors or their treatments when the bottom line is the top priority.

When I wrote a piece earlier this week about a $7 laboratory charge holding up blood work for my husband, I did not expect the outpouring of stories from other Americans who have experienced similar problems over small medical bills.  From coast to coast and in every state of insurance, un-insurance, under-insurance and in poverty, in middle income or in wealth, it seems many of us have had our medical care interrupted and sometimes prevented by providers holding many of the keys to the kingdom of our healthcare system.  Heart attack, cancer, bleeding disorders, stroke – none of these potentially life-threatening conditions have prevented patients from being asked for money before being treated.

One family I heard from, Nathan and Sonji Wilkes of Colorado, have had a nasty experience with the same laboratory company I did – while their past due bill was for $17 not $7, as mine was, they also were forced to take more action.  Some of you may remember the Wilkes family.  Their young son, Thomas, was born with severe hemophilia, and a year later developed a resistance to treatment. “Basically, Thomas needs treatments that can blow through a $1 million policy in as little as a few days or as long as a year,” dad Nathan reported.  So lab work is essential to Thomas’ care and to his life.

After paying the $17, Thomas’ mom was told they’d have to have a credit card on file before services for her own lab work could be rendered, and she signed a paper giving the lab permission to charge the card if insurance didn't pay.  What should she do?  Risk that Thomas will need a test and have it stopped like my husband’s was, as he was being treated for heart attack?  Nope.  These are equal opportunity greed and sleaze mongers… 5 year olds and grandpas alike.  Money talks.  Pay in advance and live.

I guess we could see this coming – first we all have to pay co-pays and deductibles in advance of receiving any care or treatment at all and now we’ll have to have credit cards and deposits on file to anticipate future needs. 

Yet I keep hearing this asinine talk about single payer healthcare putting bureaucrats in-between patients and their providers.  Come on.  Public funding and private delivery does not put more people between me and my docs – it strips folks with purely profit motivations away from the relationship. 

We all know the system right now has several layers of folks in between patients and doctors.  Insurance companies decide who we can see and how many times and what those folks can do for us.  Employers decide which insurance companies will sell us plans and at what cost.  Finance companies set up credit lines for medical care.  And providers have effective and efficient financial gatekeepers to make sure we don’t get through the front door without money. 
Freedom to choose our doctors and our treatment is not foremost in this U.S. healthcare system, just in case you were under the illusion that it is somehow.  Money and greed is first.

We also all are required to sign forms that hand away our legal rights – those assignment of benefits forms and assumption of risk forms?  You’ve seen them.  You sign for the provider to bill your insurance company and then you sign for the provider to go after you for any balance unpaid by insurance.  The risk is all yours.  Insurance may or may not pay, even after giving prior authorization to treat. And there isn’t a damned thing you can do about that legally.   The provider may or may not help you get well.  But by God, you will pay that bill or you’ll not saddle up on that pony again.

My legal rights as a patient are non-existent or ignored – except for some touchy-feely privacy issues --and my legal rights to contract with full disclosure and consideration are absolutely blown apart by the system Congress may actually expand very soon.  To get care, I must give up my legal status and protections.  Talk about being under duress when making decisions…

So, I am waiting to hear how the new bills Senators Kennedy and Baucus, Grassley and Dodd and friends will help give me more freedom from this one-sided, greed driven system.  And over in the House?  How about Representatives Waxman and Rangel or Pelosi and Hoyer?  Are we getting some freedom and choice there?  Freedom from the oppressive system we all must navigate to access care?  Nope.

All of them want to make sure when the Smith or the Wilkes families sit down to look at healthcare options, we’ll have to weigh unknowns and unmeasureables in order to keep the big money interests happy and hopping in the healthcare system.  The insurance industry has staged an almost complete coup over the nation’s healthcare system and all of its subjects, er, patients.  And the providers aren’t far behind as they post those signs about “payment expected at the time service is rendered” as they actually collect before one ounce of healthcare is ever offered, considered or accepted.  This system breaks every informed consent and contract law concept we could ever imagine, and we’re about to have our leaders tell us we are forced to buy into it or be punished for not doing so.

This is freedom?  This is choice?  Not hardly. 

I’ll take a publicly funded, privately delivered system any time over this burdensome mess or the monstrosity they’re laying out now.  How about progressively financed, guaranteed single standard of high quality care for all?  Nice.  Then maybe Thomas Wilkes and Larry Smith can get their blood work done without fear and without paying before a needle pierces their skin.
 
Healthcare is a basic human right.  And we ought to start acting like it. And we ought to legislate like we knew it and meant to protect it.  

Donna Smith appeared in the Michael Moore documentary, SiCKO with her husband Larry. She now works as a community organizer for the National Nurses Organizing Committee out of the Washington, DC office as a public speaker and well-known healthcare blogger.