By Jim Smith

No matter what happens in Congress this year, the fight for real health care reform is just beginning. This year we are likely to see a bill that only the health insurance corporations can love. It will give them windfall profits by creating a true monopoly where everyone in the country is forced to become their victim. It doesn’t really matter which insurance giant carries your health care insurance. They are all owned by the same ultra-wealthy crooks on Wall Street. At the very least, this has been a lesson for the public of the vast power the corporations have over our elected representatives.

If a public option is included in the bill, it will likely be a watered-down version that takes the corporations off the hook for insuring the ill. When Wall Street crapped-out in its high-stakes gambling, Congress was there to reimburse them for their losses. Why should they be an less benevolent to the health care corporations who give them millions for their votes.

But health care reform means a lot more than who is going to carry the insurance. If those are correct who say America has the best health care in the world, if you are insured, then pity the rest of the world. Anyone who has been hospitalized or know some one who has been caught up in the health care system would not agree. In some ways the health care system is so bad, it is scarcely better than the criminal justice system (don’t go there, either).

Rosa’s strange adventure in a sick health care system

Here’s one example. A friend, who is a senior – we’ll call her Rosa – fell off a ladder on Sept. 5. She knew she had probably broken some bones. She crawled the length of her house into her bedroom where she called 911. The Fire Department paramedics promptly picked her up and took her to the hospital. This being Venice, the nearest hospital is in Marina del Rey. Rosa doesn’t recall being asked if she wanted to go to any other hospital.

After some time in the emergency room, where she was given morphine, she was taken to a hospital room. X-Rays and an MRI showed that she had a broken heel and fractured vertebraes in her back. A doctor told her that the heel could not be set until the swelling went down. She was given a body brace for her back. Rosa was unable to see her regular doctor since he works out of Cedar-Sinai Hospital, and the Marina hospital is off limits.

For the next few days, Rosa lay in her hospital bed, often in excruciating pain. She had a call button for the nurses by her bed, but most of the time when she would press it to ask for medication, no one would answer. Once, when I visited Rosa, her roommate, who had also buzzed for a nurse in vain, asked me if I would go to the nurses station, which was about 20 feet away, and ask someone to come to help her. I walked up to the station were an assorted crew of RNs, LVNs, secretaries, lab techs, etc. all seemed to be doing their best to ignore me. Finally, I said in a loud voice, “A patient in room so and so has been calling for assistance.” One of the nurses looked up from her pile of paperwork and told me, “We’re aware of it.” I tried to explain nicely that being aware of something and actually doing something were two different things.

I don’t believe the nurses and other health care personnel are the evil ones. In most cases, they are understaffed, and overwhelmed with paperwork. The hospital is owned by Doctor-Investors who are looking for a profit. How do you make a profit in health care – cut staff and raise fees.

The on-line ratings website, Yelp, gives MdR hospital two stars out of five. Here is one of the comments on Yelp, from Gail: “The people are very nice — but the bill you get later will make you feel like they had a gun to your head the whole time!!!  Buyer beware!!  I’m up to almost $2000 for a tiny cut that required 2 drops of superglue and one band-aid.  The band-aid alone was $90.  This is what’s wrong with America’s current medical system — too much unethical profit taking.”

Needless to say, Rosa was not happy with the care at the hospital. Little did she know that there are worse places than a hospital. They are called nursing homes, and sometimes they are called rehab centers/nursing homes. Rosa was shipped out to the Playa Del Rey Care and Rehabilitation Center, also known as Sunbridge Care & Rehabilitation, which is owned by the SunBridge Healthcare Corporation, a Wall Street firm. Well, Rosa took one look around the facility and promptly wheeled herself out to the street and caught a taxi home.

The next morning, she pressed the reset button and started over by having her son drive her to the Cedars-Sinai emergency room. After a few hours of extensive tests, she was assigned a nice room with nurses who came when they were buzzed. It should be pointed out that Rosa was still in a great deal of pain since she hadn’t yet had any treatment of her broken heel and back. The good times at Cedars only lasted two days. She was again sent to a rehab/convalescent facility. This one, The Rehabilitation Centre of Beverly Hills (in Los Angeles) is a much more impressive building inside and out. Its claim to fame is as the place where actress Shelley Winters died (see http://www.rehabcenter.com).

Curiously, integration seems to have failed in our schools and in convalescent homes. Nearly the entire staff were Filipinos and the doctors were Russians. A cynical mind might think that immigrants are hired because they can be paid less. This is one of the dirty secrets of the health care “industry.” It could not run without immigrants. A Filipina friend, who regularly visits the Philippines, tells me that health care in that former U.S. colony is declining due to lack of medical personnel. Many nurses receive their training there, and then immigrate to the U.S. where they gain employment through referrals by friends or relatives already working at health care facilities. The pay is much better than in the Philippines even if it is substandard by U.S. measures.

Despite its highfalutin name, the Beverly Hills facility is not accredited and it received the worst possible rating – one star out of five – in a U.S. News & World Report survey. Of course, it is another for profit operation. So far in her adventure, Rosa has encountered only one nonprofit facility, Cedars-Sinai, which is undoubtedly the best of the bunch.

At the Rehab Center, the staff naturally wanted to do rehab on Rosa. When a doctor forbid rehab on Rosa’s injuries until she had her operation, the staff protested. Apparently rehab treatments are a lucrative business. When the staff was frustrated in their attempts to rehabilitate a broken foot, they began working on Rosa’s arm, which had not been injured in her fall.

A Russian doctor gave Rosa a referral, at last, to an Orthopedic Surgeon at Cedars. Unfortunately, he was a hip specialist and didn’t do heels. But he knew someone who was a heel doctor. A week later, Rosa had her consultation and arranged for an operation two weeks later. By now, Rosa had had enough of institutionalized life, and again headed for home. But she had to go back again for the operation and a couple of days recuperating in a hospital room at Cedars. Then it was back home again. Rosa’s bandage around her foot cast is coming loose, and she still hasn’t had a consultation on her cracked vertebrae, but Rosa is happy to be out of the clutches of the health care facilities. She hasn’t seen the bill yet, which she hopes will be covered by Medicare and Medical, and she is in a three week waiting period to receive authorization for a homecare worker who can help her in and out of bed and wheel chair. Meanwhile, Rosa has to pay for a home care worker out of her own meager pension.

What can be done to cure our health care system?

In 2007, I worked with a statewide group of doctors, nurses and health care advocates to draft a ballot initiative called the Health Security Act. This proposed California constitutional amendment would have gotten rid of the big corporate insurers, in favor of a state government billing and payroll system, the so-called single payer, which could have saved Californians billions of dollars while improving health care.

The single payer initiative would have provided for medical care for all California residents without premiums, co-pays and deductible. In other words, free health care. What’s more it would have fully paid for all treatments, prescription drugs, devices, emergency care, preventive measures, rehabilitative care, longterm care, mental healthcare, dental care, vision care, women’s healthcare, and work-related injuries.

Like the Baucus bill in Congress, the state legislature wanted to know how much it would cost. The Attorney General’s office did an analysis and reported that this initiative, which provided for free health care in California would cost “the low tens of billions of dollars.” If it cost $20 billion, this could have easily been raised by taxes on the filthy rich, on food and drink that are unhealthy, and on big corporate landholdings in the state.

Unfortunately, the state Democratic Party machine would have nothing to do with the initiative, preferring to back the doomed Sheila Kuehl bill in the State Senate (doomed because they knew Gov. Schwarzenegger would never sign it). And the labor unions that had previously supported single payer bills and initiatives were involved in internecine battles. As a result we didn’t get enough signatures to put it on the 2008 ballot. Maybe next year.

In any case, the ultimate solution to what to do when people get sick is to remove the profit motive from health care. Why should anyone make a profit from your illness or injury? A single payer system works well in most civilized countries. In addition, no one should be allowed to warehouse our elders just because they can make a profit. If there is ever a time when love and caring is needed,  it is with those who cannot help themselves because they are too sick, too injured, or just to befuddled.

Don’t let anyone tell you that the giant corporations make health care better. They virtually steal new drugs, equipment and procedures from the universities, including our own public University of California. And then they sell these innovations back to us, even though they were paid for by taxpayer money. It is time for not just change, but a revolution in health care where we focus on making people well, not on making billions for corporations.