Blog Housekeeping December 2008
The Pervasiveness of Corruption

Elders Lobbying for Healthcare for Others

category_bug_journal2.gif As I’m sure you remember, during a speech in Cleveland on 20 July 2007, President Bush had this to say about health care:

"I mean, people have access to health care in America. After all, you just go to an emergency room."

For the president of the country with the worst record on health care in the developed world to make such a statement is awful enough, but I think the greater giveaway is that it tells us a lot about what rich people think the rest of us are worth.

In the October 2008 issue of Annals of Surgery, Johns Hopkins trauma surgeon Anil Haider and colleagues report on a study they conducted to “determine the effect of race and insurance status on trauma mortality” which usually refers to the kind of care emergency rooms are meant for rather than what President Bush was suggesting. Their conclusion:

“Race and insurance status each independently predicts outcome disparities after trauma. African American, Hispanic, and uninsured patients have worse outcomes, but insurance status appears to have the stronger association with mortality after trauma.”

That’s a pretty clear statement, for a medical journal, but the rest of the report isn’t as easy to translate. Fortunately, there is David Noonan, a seasoned health insurance reporter for Newsweek to wade through the notoriously complex syntax of medical studies to reveal the details.

”…Haider and his colleagues analyzed almost 430,000 moderate to severe cases of traumatic injury (from auto accidents, gunshots and other causes) treated between 2001 and 2005. Controlling for age, gender, type and severity of injury, they found that, overall, uninsured patients were 50 percent more likely to die from their injuries than insured patients." [emphasis added]

It gets worse when race and insurance coverage are factored in:

“When compared with an insured white patient, black patients with equivalent injuries but without insurance had a 78 percent higher risk of dying; for uninsured Hispanics, the risk was 130 percent higher.”

These are shockingly high numbers that leave President Bush’s statement even more callous that it appears on its face. (It's not scientific, but I'm guessing one could extrapolate these figures into the world of everyday medical care with similar conclusions.)

As flawed as Medicare and Medicaid are, we elders at least have guaranteed minimum coverage for a large part of our health care which is not so for people younger than 65. It relieves us of concern for our health that the 47 million Americans without coverage don’t have, and that large number of uninsured (one-sixth of all Americans) has undoubtedly grown dramatically in the past year as millions have lost their insurance due to job layoffs, and can’t afford private coverage.

On Tuesday, in a comment response to Saul Friedman’s story here on how president-elect Obama should reinvent health care in the United States – i.e. a single-payer system – elderblogger Anne Gibert of 20th Century Woman had this to say:

“I agree with everything Mr. Friedman says, and I intend to write to President-Elect Obama and my congress people to say that single payer is the only sensible way to go. My husband, who has been a pretty conservative fellow most of his life, agrees with me.”

We are at a crossroads in governance of the United States with a president-elect who appears, more than any president in recent memory, to want to improve the lives of working people and who apparently wants to hear our ideas. We don't have the money of corporations and rich individuals to influence government, but we do have numbers.

Anne Gibert has the right idea and I think as elders who benefit from what is, almost, a single-payer system for old people, we should lobby as hard as we can for similar help for all American citizens which is not what President-elect Obama has proposed.

The Obama transition team is accepting ideas for the future of the U.S. Take a few minutes to tell them we need, as Saul Friedman put it, “the single-payer idea and Medicare for all.”

Then go to these websites to write your state’s officials in Congress:

United States House of Representatives
United States Senate

Do it now. Get your friends to do it. Write about doing it on your blogs. Maybe it will catch on. Maybe, as Arlo Guthrie sang a long time ago,

"If three people do it, three, can you imagine, three people walking in singin' a bar of [Medicare for all] and walking out. They may think it's an organization. And can you, can you imagine fifty people a day, I said fifty people a day walking in singin' a bar of [Medicare for all] and walking out. And friends, they may thinks it's a movement."

In some cases, you’ll need to wait until 2009 to write your new representatives, so mark your calendars. But you can get started with the Obama Transition Team. We can’t let George Bush’s idea of emergency room health care last a day longer than necessary.

[At The Elder Storytelling Place today, liloldme tells the tale of a tale in How I Began Writing and The GoodKnight Story.]

Comments

I love this blog for many reasons... content, style, community, values. This post exemplifies all. In this post, you are not lobbying for yourself, for your cohort of elders. Rather, you remind that "I" doesn't exist without "we", and your call to support healthcare for everyone is why you, Ronni, rock!

I have two friends who were in accidents when in their 40s in which they experienced brain trauma.

One had a metal file cabinet fall on him. He's white, well educated, and was employed by our city so had insurance, and has never been truly employable in the 15 years since. The city was desperate to avoid taking responsibility for the accident which happened in their offices. They denied his claims for disability, had him followed by private investigators to prove he should be able to work, and wouldn't offer any settlement until he sued. Getting elementary coverage was his full time job -- all the while both in some pain, but also at the edge of confusion.

My other friend was thrown head first through a car windshield in an accident 17 years ago. She is native American and was unemployed and uninsured. Somehow she ended up at a university hospital where, for nine months, they managed to get her ambulatory, though some confusion never cleared. She lives on state disability, food stamps and a patch work of California Medical and various programs -- all of which are a full time job to keep strung together. The latest wrinkle is that, starved for cash themselves, these "assistance" programs randomly send her letters saying her benefits will be cut as she has been on the program too long. So far, she has managed to get her lifelines restored each time. Too often, she wonders why they saved her "life."

The country is rich enough to do better. Health care for all would completely change the lives of these individuals and of those who love them.

After reading all of the many news stories and blog comments regarding health care, I've decided that when I know it's my time to depart...I'm not going to a doctor or a hospital, I'm going to the halls of government and die right there. My body will finally make it their problem. They will have to clean it up or just step over me. I think they will do the latter.

Another great post, Ronni.
Tamar, I agree totally with you and really like your reinforcement of the "I"/"we" concept.

I've written my post, written Obama and marked my calendar for January.
Thanks for the encouragement to do so.

Steven, your idea is great! Serves 'em right. But I want to be burned and sprinkled on my Russian sages and the purple Clematis.
ttfn

I was just laid off at age 62. I can pay for my own insurange through COBRA for 18 months at $500+ per month, but if I don't get a job that covers my insurance then, I will be out of luck until Medicare kicks in at 65. Thanks for the post. I did write to the Obama/Biden team.

To be competitive internationally we need single payer health care for all. Our companies, including the auto companies, can't be competitive with international companies as long as health care is such a huge cost.

Great advice, Ronni. As someone who has the privilege of Medicare and good secondary insurance, I always feel the need to more. Was in the midst of another of my postings/nudges for Elderbloggers to blog about single-payer, a/k/a Medicare for All, when Obama's news conference on White House health care czar happened.

The work ahead continues!

I think it's laudable to push ahead for a single payer insurance system and the pressure for one does need to continue. I thought I recalled some health care experts dedicated to such a system suggesting progressive incremental steps would likely be necessary in order to gain all the support needed for passage of any health care system changes. I hope we actually see some movement in that direction with the new administration.

On another health issue, I wonder if some medical reporter might be interested in researching some sort of tracking record or figures on how many E.R. stroke patients are assessed to determine if they are candidates for TPA (a medical treatment to minimize stroke effects for some patients.) Age group comparison figures would be of special interest. Are older/elder patients recipients of the assessment and treatment as readily as younger patients? If not, why not?

I have a great idea Ronni, host a discussion on your blog about health care change. President Elect Obama is inviting people to host health care reform discussions and providing materials. You actually register and then report on your results of the discussion group. I was thinking of doing it but I do not have the response rate you have and we should have as many elders participating as possible. It is a lot of work I guess and whatever I can do to help, I will do. Go to change.gov and click on host health reform discussion

In the past few years my husband has chalked up over $150,000 in care center costs and payment for health aides needed at home.

He was unfortunate enough to have a brain hemorrhage and later a broken pelvis which required him to lie in bed in a care center during the healing process. Medicare does not pay for care center costs while a patient is healing his/her own brain and pelvis and so we had to assume thousands of dollars during that time until he could begin recovery in physical therapy.

Now he is home and needing 16 hours care during the daytime but Medicare does not help with payment for custodial care which he needs now. We are being punished for living frugally and saving for our old age as we do not now qualify for Medicaid which would have paid for the health aides in our home.

It is time for government to support the health care needs of all citizens who pay taxes instead of paying for war and bailouts so that corporations can continue to make profits from health care which should be supplied like we now provide schools, water systems, sewers, roads,police protection and fire departments.

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