Author John Green explains why healthcare costs in America are so out of control:
h/t Patheos Progressive Christian Channel with a good commentary about the video here.
Opinion writer Matt Miller had an interesting article in The Washington Post recently quoting entrepreneurs in Canada saying how bewildered they are over American resistance to expanding access to health care. These Canadian businessmen say they love “Canada’s single-payer system for its quality and cost-effectiveness,” and don’t understand America’s confusing patchwork of health plans and administrative bureaucracy.
And this healthcare battle is threatening to take down the entire United States economy. Two weeks ago, the so-called “Tea Party” wing of the Republican Party, led by Rep. Eric Cantor of Virginia and Sen. Ted Cruz of Texas, engineered a shutdown of the federal government after the White House rejected GOP demands in Congress to defund the Affordable Care Act. Now, Congressional “Tea Party” members are refusing to agree to raise the federal debt ceiling unless their specific demands are met. If the crisis isn’t resolved in the next two days, the U.S. will default on its debts. All this over helping millions of Americans gain access to affordable health care! Such a situation would be unthinkable to our friends in Canada.
But what the Canadians perhaps don’t realize is that for opponents of universal health care (who see the ACA as a terrifying step toward single payer), a dysfunctional system is all about maintaining control. Take “job lock.” Canadians can easily quit a job they no longer like without fear of losing their health care. Before the ACA, that wasn’t the norm for Americans. But universal healthcare opponents, especially those who lead large corporations, don’t like the fact that Americans can now more easily leave their jobs, and have the option of setting up new companies that will compete with their former employers. Second, the big health insurance companies also like to maintain control over how much profit they make. They certainly don’t like all the new nonprofit health insurance companies that are now cropping up on the state ACA exchanges. Finally, health care is wealth. Sick, desperate and poor people make an easily manipulated and exploited population for multinational corporations seeking a cheap labor force. So, universal healthcare opponents aren’t crazy. They know exactly what they’re doing and what they want.
Millions of Poor Are Left Uncovered by Health Law
By Sabrina Tavernise and Robert Gebeloff
The New York Times, October 2, 2013
A sweeping national effort to extend health coverage to millions of Americans will leave out two-thirds of the poor blacks and single mothers and more than half of the low-wage workers who do not have insurance, the very kinds of people that the program was intended to help, according to an analysis of census data by The New York Times.
Because they live in states largely controlled by Republicans that have declined to participate in a vast expansion of Medicaid, the medical insurance program for the poor, they are among the eight million Americans who are impoverished, uninsured and ineligible for help.
Those excluded will be stranded without insurance, stuck between people with slightly higher incomes who will qualify for federal subsidies on the new health exchanges that went live this week, and those who are poor enough to qualify for Medicaid in its current form, which has income ceilings as low as $11 a day in some states.
The 26 states that have rejected the Medicaid expansion are home to about half of the country’s population, but about 68 percent of poor, uninsured blacks and single mothers. About 60 percent of the country’s uninsured working poor are in those states. Among those excluded are about 435,000 cashiers, 341,000 cooks and 253,000 nurses’ aides.
“The irony is that these states that are rejecting Medicaid expansion — many of them Southern — are the very places where the concentration of poverty and lack of health insurance are the most acute,” said Dr. H. Jack Geiger, a founder of the community health center model. “It is their populations that have the highest burden of illness and costs to the entire health care system.”
The disproportionate impact on poor blacks introduces the prickly issue of race into the already politically charged atmosphere around the health care law. Race was rarely, if ever, mentioned in the state-level debates about the Medicaid expansion. But the issue courses just below the surface, civil rights leaders say, pointing to the pattern of exclusion.
Every state in the Deep South, with the exception of Arkansas, has rejected the expansion. Opponents of the expansion say they are against it on exclusively economic grounds, and that the demographics of the South — with its large share of poor blacks — make it easy to say race is an issue when it is not.
Blacks are disproportionately affected, largely because more of them are poor and living in Southern states. In all, 6 out of 10 blacks live in the states not expanding Medicaid. In Mississippi, 56 percent of all poor and uninsured adults are black, though they account for just 38 percent of the population.
Dr. Aaron Shirley, a physician who has worked for better health care for blacks in Mississippi, said that the history of segregation and violence against blacks still informs the way people see one another, particularly in the South, making some whites reluctant to support programs that they believe benefit blacks.
By Don McCanne, M.D.
When the Supreme Court relieved the states of the requirement to expand their Medicaid programs as a condition of continuing to receive federal Medicaid contributions, it was understood that, in those states that did not voluntarily participate, many low-income people who were not eligible for plans to be offered in the exchanges (since they were to have been covered by Medicaid) would now also remain ineligible for Medicaid. Thus the most vulnerable are to be left with no coverage at all. What this New New York Times analysis adds to our understanding is that the sector hardest hit is poor blacks, especially those living in the South.
State politicians must carry much of the blame for this egregious health care injustice. If they agreed to participate, the states eventually would be required to fund only ten percent of this expansion, and none of the costs at the beginning. These politicians fully understood the demographics of the populations they refused to cover. So why did they refuse to authorized the quite modest expenditures that would bring health care to these people? Was it because they are poor? Or is it because they are predominantly black?
Regardless, we can blame not only these politicians, but also the voters who keep them in office. It is heartbreaking to realize that that so much of Martin Luther King’s Dream remains only a dream.
We still desperately need reform that is truly equitable and egalitarian. The Affordable Care Act didn’t get us there.
Re-posted with permission from www.pnhp.org.