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.]