Healthcare: Critical Action Needed

Healthcare Politics Right Now

The need for a healthcare delivery system that both works and doesn’t cause major financial distress is high. As previously mentioned in The government is no longer working for us…, more than 25% of Americans say they are struggling seriously with their finances as a direct result of their medical bills.

Politicians have attempted to come up with alternatives to the current system that people would find acceptable, and so far, have been unsuccessful. While people like to blame the Affordable Healthcare Act for the increasing cost of healthcare expenditures, the fact is that they’ve been rapidly rising for decades (see image: Per capita health care expenditure 1960-2014 in the United States), something those who have been fortunate enough to have regular access to the healthcare system over that period of time would at least be subtly aware of. Even with the ACA, American’s rising healthcare expenses have not slowed.

We now have the GOP hiding behind closed doors while they develop health policies that impact every citizen in America, resulting so far in multiple leaks that illustrate their interests do not align with the interests of ordinary Americans. These are the same politicians whose leadership is prone to saying things such as, “Winners make policy and losers go home.” So far, everything that came out of this earlier in the legislative session has sounded like a disaster…and more recently, it’s even more of a disaster, finding multiple GOP members, scared about their re-election chances, backpedaling and saying they won’t be able to support it, as well as zero support from medical associations. The bill, “…represents a significant move in the wrong direction, resulting in fewer people having access to insurance, fewer patient protections and less coverage for essential behavioral health care,” according to Saul Levin, the American Psychiatric Association’s CEO and medical director.

We don’t need more politicians catering to special interests making health care policy for our country. What we need is for our politicians to deliver on something that actually works based on evidence that will actually work, modeling our system after systems throughout the world that are functional, affordable, and effective in their delivery of essential life and health services.

Some Issues a Functional, Affordable, and Effective System Would Solve

There are so many flaws with our current system that it is difficult to even begin summarizing them. Because what I’d really need to do is an entire series on the topic to effectively address the maladies under-addressed by our current situation, I am going to simply describe a handful of the dilemmas our current system does not address functionally, affordably, and effectively to help make this point.

Americans pay exorbitant rates for the services we obtain as compared on a like-for-like basis worldwide. The way we fund our healthcare, a hodgepodge system of medical plans, and the way our hospitals are consolidating care are both things that drive up costs. While there are those who say that this is just a competition thing, how is an ill consumer supposed to make choices that require a significant amount of research about things they have little understanding of in a way that they can benefit from competition? It’s more than enough for many that they have to make sense of the treatment options available to them. Even doctors having to deal with insurance companies, themselves, and bill their patients drives up costs considerably.

If you are on a health care plan tied to your place of employment, when you lose your job, you wind up paying the full cost at the same time that you have far less money to work with. Some may suggest “well, get on Medicaid.” It’s not really that simple. Consider this, people who have medical problems that result in work loss are in need of quality care from professionals familiar with their circumstances, and because the application process for Medicaid is long and complicated, people can go months without any treatment at all while they are working out their changes in coverage—resulting in them suffering more, being sicker longer, and perhaps, delaying critical treatments they depend on to save their lives. Having employment and medical insurance tied together easily can aversely impact someone’s overall health.

Having employment and medical insurance tied together can cause a host of additional problems, including, but not limited to:

  1. Chronic underemployment: employers attempting to save money while complying with regulations often keep employee hours low to avoid increased costs.
  2. Career stagnation: if a job is tied to medical, people may be unwilling to change jobs, risking changes in coverage deemed inadequate.
  3. Undo employer influence: depending on the value an employer places on various medical practices, they can negatively impact coverage for care that most people would deem necessary. A perfect example of this is the Hobby Lobby lawsuit.
  4. Marriages and Legal Partnerships: people may make the decision to marry simply to obtain better health care coverage, resulting in partnerships that may otherwise not be deemed beneficial.
  5. Abuse: Sarah’s* medical insurance was provided through her estranged abusive spouse’s place of employment. With major medical issues, she intended to transfer directly to an AHA plan when allowed to do so via open enrollment, but was unable to, because he claimed he had not removed her from his plan when he actually had. By the time she learned what had happened, the “qualifying life event” clause that would have allowed her to transfer to another plan had been exceeded. She has been stuck paying out-of-pocket for both herself and her preschool-aged daughter until the next open enrollment period. This unholy marriage of employment and medical care actually allowed her abuser one more opportunity to harm her and her child that he otherwise would not have had.

Clearly, there are major problems with tying critical medical care to employment that are not being addressed by any of the policies that have gained any traction. If employers really wanted to “sweeten the pot” when offering coverage to their employees, as some tend to do, rather than having the entirety of one’s medical coverage attached to employment, we could allow employers to simply provide an additional “Cadillac-style” policy that adds to a nationwide single-payer system and everyone would have coverage and the above problems would not exist.

In addition to the aforementioned problems, there are gaps in coverage in places people least expect. Someone needs surgery and they go to a hospital only to find that while the hospital is covered, many of its specialists are not, and there is no way to ensure the specialist working on them in surgery is covered the same way that the hospital. People postpone critical procedures until they can afford astronomical co-pays, living in pain and even somewhat debilitated until the money can be procured. People need medicine critical to their health, but the copays are higher than they can afford. Our hodge-podge system of coverage is inadequate to cover the complexity of care Americans actually need.

Lastly, it’s important to keep in mind that without a comprehensive mental health care delivery system available at no or low cost to citizens with mental health needs, we are making things more difficult on everyone, as a whole. Mental health can greatly impact both someone’s work performance, as well as their future employability, meaning that a solid mental health care delivery system is critical to maintaining better job security for employees and better work productivity for employers. Yet, it is often one of the most difficult services to obtain, because the systems in place and the funding models are both inadequate to the need in nearly every community in America. When someone is unemployed, these systems are critical to getting back on one’s feet and contributing to productivity, and yet, that is when their affordability and accessibility often becomes the greatest difficulty.


In closing, our political system is not going to solve today’s medical system problems with the “solutions” being promoted by the closeted politicking going on. Our medical delivery system needs a complete overhaul. There are too many gaps, too many inefficiencies, and there are too many capitalistic beneficiaries of this system who are lobbying these same politicians behind closed doors for legislation that does not benefit ordinary Americans.  If we want change, we are going to have to determine what that change looks like, and we are going to have to, as the American public, demand that the change that occurs will address the problems mentioned here, and that it is change that will work in our favor, not the favor of employers, or insurers whose base goals are to make money, rather than providing quality care to all Americans.


Progressives It’s Time To Bring It

I keep seeing friends of mine post Kayla Chadwick’s article, I Don’t Know How To Explain To You That You Should Care About Other People, and I have to say, I think it really doesn’t matter in the scheme of things whether others care about other people. Progressive ideals are not just for compassionate people.

Progressive ideals don’t just benefit the poor, minorities, and others who are downtrodden and disadvantaged. If you are worried because people don’t really care, you really haven’t fully grasped the strength and value of progressive policies—for all people in society.

While I agree with Chadwick that, “Our disagreement is not merely political, but a fundamental divide on what it means to live in a society,” the idea that the only way to debate this issue is based on how much empathy or compassion a person has, or not, is a losing argument.

Developing empathy for others takes time, is unlikely to get any better in adulthood without further formal education, and is deeply rooted in human psychology with some people incapable of empathy, or almost entirely so.

According to John Malouff, Associate Professor, School of Behavioural, Cognitive and, Social Sciences, University of New England, “In its most complete form, empathy involves understanding the emotion of another person, feeling the emotion and responding appropriately to it.” He also tells us that, while there can be temporary changes observable from adult students and health care workers, “…we do not know for sure whether we can increase empathy in ordinary people through formal training. We also do not know whether it is possible to help anyone make a long-term gain in empathy.”

The likelihood that there is going to be a serious redistribution of empathy in this country within the next 2-4 years is obviously dismally low. If you want to argue the value of progressive policies based on whether or not someone has empathy, or even compassion, for others, you will always lose.

As progressives, if we want to win this ideological war, we obviously have to find better support for our arguments—and fast.

I do not, however, believe we should view our position as indefensible. The problem is not where we are coming from. The problem is not our ideals. I argue that the root of our problem lies in the very way we are communicating our ideas to those who might disagree, or, at best, are still trying to make up their minds, leading them to perceive our ideas as weak, or flawed. While people are weak or flawed, progressive ideas are not.

Our job, if what we really want to do is win, is to come from a position of strength. Why on earth are we not coming from a position of strength? We are arguing for a healthier, safer, more educated, more technologically advanced society with better infrastructure that supports the well-being of all its citizens, and ensures the future vitality of the world we are proud and happy to live in.

We are not arguing from weakness. The right most certainly is. So far, we’ve let them define the battleground and we’ve putted around while they engage us in skirmishes on all fronts. This last election woke the beast, but it’s not enough. Progressives, it’s time. If we care even the slightest bit, we need to actively drive home our agenda. If we care about the future of this country, we need to stand by our values and bring the war of ideas to them.

And now, a message from one of our great leaders via her visit with Samantha Bee:


The government is no longer working for us…

If there is anything clear today, it’s that the United States government is not working for us. This is no accident. The policies in place today are the result of the wealthy and powerful taking full advantage of the middle class and the poor, engaging in the process of base erosion and profit shifting (BEPS), contributing “dark money” to elections, lobbying,  and as in the case with ALEC, working behind closed doors to generate model legislation to be distributed widely among legislative bodies to drive policy agendas (Molly Jackman, The Brookings Institution). The May 2017 Expert Survey on American Democracy dismally warns us that, “The results [of their research] give us ample reason to be concerned about the future of American democracy.”

Corporate welfare, also known as “crony capitalism,” has gotten out of control with companies in all industries and job sectors milking at the teat of city, state, and federal government benefits. Agriculture, tech, military industrial complex, construction, and the like benefit in a multitude of ways. Even companies like Walmart benefit indirectly by keeping employee wages very low and hours minimal so that their employees have no other option but to collect government benefits to make up the difference.

Rather than recognizing their value, and fighting for a more fair and equitable share of the profits of the companies they’ve worked for, workers have only gotten caught up in the promise of work in antiquated industries that are polluting our atmosphere and our water, destroying the lives of children dependent on those poisoned water supplies, and increasing the rate of global warming to astronomical levels, which is leading to what James Hansen, communicating with Scientific American to say, “We’re setting up a situation that’s extremely dangerous,” jeopardizing not only the future of our children, but the future of the human race in the pursuit of further corporate profits.

Both the wealthy and the well-to-do have spread the unsupported propaganda of “trickle down economics,” something that has been increasingly shown to be anything but, “Since the early 1990s, poverty has grown by 50 percent, leading to a doubling of the number of poor folks in places previously associated with soccer fields and shiny malls” (Michelle Chen, Why Are America’s Suburbs Becoming poorer? The Nation). Rather than trickling down, inequalities have only increased to the point that of OECD countries, only Mexico and Chile have a more dismal disparity between the rich and the poor.

While we attempted Reagan’s great “trickle down economics” experiment, the rich have been using that money to line the pockets of politicians and expand their interests and off shore holdings in a capitalistic system that no longer fairly compensates its workers.

Young people are encouraged to go to college and earn expensive degrees, graduating to start off their adult lives with mountains of debt, benefiting only the financial industries, because even with quality degrees, they can no longer expect to have a long and fruitful career within a specific company, instead, according to the Bureau of Labor Statistics “younger baby boomers held an average of 11.7 jobs from ages 18 to 48,” with this number only expected to grow among younger workers.

Medical costs have become astronomical, with over 25% of Americans citing medical costs as “a serious financial problem.” Contrary to the critics of Obama and the ACA, the blame for the increases do not come from the federal government. Companies have been shifting health costs to their employees steadily for well over a decade. So, while the average worker’s wages slowly increase, Kiplinger relays that “Companies are forecasting 3% increases,” their costs have become increasingly astronomical. This has occurred at the same time that American corporations have steadily increased the compensation to their officers, now paying in excess of 347 times their average workers.

As if these pressures on families weren’t enough, according to Fortune, in most states, child care for dependent children now exceeds the cost of sending a student through college or university, resulting in an average nationwide cost of $233,610, according to the US Department of Agriculture to raise a child to adulthood.

Both middle-aged men and women are seeing significantly increasing rates of suicide, and apparently there is no answer as to why, and yet, when you look at the results of the policies that have taken hold in this country in the last 30 years and how they’ve impacted families ability to achieve financial stability and wellness, it’s not hard to guess at some of the underlying issues.

Now that 60 million people elected someone whose values don’t align with the average Americans, much of the citizenry has had enough. From day one, millions of people nationwide, and even worldwide, have protested the new administration and the direction it is attempting to take the country. Rather than addressing the concerns of its citizens, we have politicians running, hiding, climbing onto rooftops, refusing to hold town meetings, failing to keep up with the vastly elevated number of calls and correspondence and making critical legislation behind closed doors, and trying to cram it through before people know what they are voting for, knowing that the reaction of the public will not be kind.

Even with all this energy on behalf of the populace, neither of our two major political parties have gotten the message, generally continuing to go about business as usual, confirming nominees in spite of community outrage to positions they are not qualified to hold, and, even worse, have a track record that says were selected for the specific purpose of destroying the very agencies they’ve been selected to run, and an attorney general whose track record tells us he is interested in anything other than justice on behalf of large segments of our population. With very little exception, the current opposition party has done an inadequate job of standing together against the interests of the majority party on behalf of the people and doesn’t seem to have a solid agenda for winning 2018. The purpose of this blog, then, is to address issues critical to the vitality and life satisfaction of ordinary Americans,  and offer solutions based on research and evidence to both politicians and citizen activists that can lead us to an effective transformation of our country and our every day lives.