Psyched Out

The only problem with the govt. purchasing health care from private medical providers is that the privatization of medical care is the main problem. Until the 1980s, medical providers were almost exclusively nonprofit. Insurance had been around for years, but when push came to shove the nuns did not ignore patients bleeding at the threshold as profit hospitals literally do. Much of what is blamed on managed care was in place well before the idea was even developed, let alone impossible to avoid. I saw the for profit take over close up - my mom was a nurse.

The first thing that happened was that doctors had to pay for attendance privileges.

The second thing was that the management required the hospital to RUN OUT of medical supplies before re-ordering. Oh, you needed a stent in your heart NOW? Too bad, we used the last one yesterday and we only order stents on Mondays. As long as your insurance or sister is willing to pay for you to stay another week, you *probably* won't die before next Thursday. Either way, we make more money.

The third thing was drastically cutting nursing care. Patient:nurse ratios skyrocketed. In the newborn nursery, the ratio went from 3 newborns to one nurse (can I get a shout out from triplets' parents on this one?) to 10 to one. Better pray your baby doesn't get sick suddenly - there's nobody with time to notice before that breathing problem causes brain damage.

Laws HAD to be passed mandating for profit hospitals to provide lifesaving (only) treatment to anyone who came in. My mom's hospital literally caused the deaths of refused patients. As long as elderly black people were dying, that was okay with the Quad Cities leadership and press. However, when a white woman pregnant with twins experiencing life threatening complications was told to go to the (nonprofit) university hospital 50 miles away if she wanted treatment, and she died on the way (meaning so did the twins) the press took notice. Again, before managed care. Greed ruined health care all by itself.

Not that managed care has been a good idea - I'm a psychiatric social worker who has watched patient care deteriorate horribly. People transferred from the medical hospital after nearly successful suicide attempts get 3 or 4 days inpatient at most. Antidepressant drugs don't kick in for 4-6 weeks (despite the claims of pharma that it's 2 weeks with newer meds). I'll defend big pharma for a minute though - I don't think Prozac causes suicide. I think releasing suicidally depressed patients after 3 days with a prescription that can't possibly help for another month, and no follow up care, causes suicide completion. Our local community mental health - which privatized under the Bush administration and renamed itself something so vague that nobody could possibly know what they do - doesn't even have a listing under that heading in the phone book.

The vaguely christened a big utilization review committee that challenges every day in the hospital even for INVOLUNTARILY COMMITTED VIOLENT/HOMICIDAL PATIENTS. Homicidal people can't be involuntarily committed unless they have a coherent and workable plan to kill (a) specific person(s) and the realistic ability and tool(s) to do so. Community mental health won't buy meds even for potentially lethal patients. These people are typically way too ill to work, so they seldom have insurance. Antipsychotic medication costs $800-1200 in typical doses to prevent suicide or homicide. Mentally ill people taking medication are less violent than the general population, but untreated psychosis can and does lead to violence and even homicide.

I guess if you're a Republican in a gated community with a gun under your pillow, this doesn't affect you. At least until your son goes to college at Virginia Tech. Or your niece has cancer surgery that removes most of the skin on her back and torso and sent on a trip across the state three hours after general anesthesia because she doesn't have $5000 up front in cash. From a university hospital taken over by for profit investors. Or your 28 year old receptionist dies alone in her apartment of pneumonia after being sent home by the ER, and is found by her 10 year old kid coming home from his weekend with dad.

For profit medicine is a bad idea. For profit insurance/managed care is too. These companies ration care as surely as the Soviet government did. They kill people every day. For money.

It's immoral. It needs to end.

Health care isn't just a human right, it's good for our society. That "illegal" little girl might be the next Jonas Salk and invent the HIV vaccine - if she lives through the leukemia that will only be caught in time if she has access to medical care today, regardless of her parents' immigration status and poverty.