It has been two years since the gaming practices of the largest financial institutions in our country torpedoed our economy. Wall Street’s unsupervised shenanigans forced millions to lose their homes and millions of others their jobs. Lack of regulation inflicted unprecedented financial pain on most Americans. It seemed that all of us who were not “too big to fail” needed protection from those that were.
In my own health care workplace, I’d seen for many years similar vulnerability in my patients, as they were gamed with equal impunity by the country’s largest health insurance companies: patients denied insurance because they weren’t healthy. Healthy patients losing their insurance when they got sick. Insured patients with serious illnesses finding they didn’t have the insurance they thought they’d paid for. Patients, insured and uninsured, facing dizzying out-of-pocket costs for medications made by drug companies who could charge whatever they liked.
So when the country got upset watching Wall Street abuse Main Street, I thought that was a good sign. Maybe it would be a small, commonsense step for people to conclude that the health care industry shouldn’t abuse patients, either. Maybe long-awaited help was on the way.
The administration opted against a “Medicare-for-all” option, then against any public option at all. It left the business of health insurance in the same hands of private companies who already ran it. In return, a health reform bill insisted on the most basic constraints on companies’ behavior: Insure everybody, not just the inexpensive healthy. Don’t drop their coverage when they get sick. Spend the money from your premiums on patient care, not on marketing your products or padding executives’ salaries.
To help patients afford insurance, the government would subsidize families who couldn’t afford the cost. In turn, those families would be able to pay these private insurers.
Sensible, I thought, if not earth-shaking changes.
Yet what followed was the most culturally violent firestorm in recent memory. As a menacing tornado sweeps up all the debris in its path and hurls it in vicious circles, rage came flying from out of nowhere. Throughout the summer we watched tea party-ers at town meetings shouting down their elected officials. For months we saw demonstrations against “Totalitarianism,” “Socialism” and “Fascism,” heard warnings of “Armageddon.” Hitler mustaches appeared on photos of the president’s face.
Then in the halls of Congress as the bill neared passage, a representative yelled “baby killer” at a pro-life leader. From the Capitol balcony, anti-reform representatives gin a jeering crowd gathered below. One representative is called a “nigger,” another a “fag.” A demonstrator spits on the face of a third. After the vote, bricks fly through office windows of some who voted “yes.” Death threats to congressmen follow.
How much of this toxic spectacle is genuine grass-roots fervor? How much is orchestrated by industry-funded organizations like “Americans for Prosperity” and its most recent faux grass-roots front group, “Patients United Now”? How is it that such groups have worked to redirect popular anger from the banking and insurance industries that betrayed the public trust toward the government trying to regulate them?
How much does the fact that zero of 219 Republicans in both Houses of Congress voted for health care reform reflect each lawmaker’s most principled vote? How much do these votes reflect party discipline to try to create a “Waterloo” for the president, as one Republican senator put it?
I’m not pundit enough to answer these questions. What I do know is that little of the political cyclone that has recently passed for a national health care debate has had much to do with the realities of the health care world I inhabit with my patients.
Because in the quiet eye of this storm, things remain as they have been for years: Patients without insurance continue to get sicker, die sooner and suffer more than those with insurance. Patients with insurance continue to contend with the insult-to-injury of insurance company denials and disqualifications when they are ill, weak and distracted. People with and without insurance still can’t afford the medicine prices drug companies are free to charge. It is painful to watch and worse to experience. I hope it never happens to you or to me. Perhaps with this heath care reform, it won’t.
Meanwhile, maybe we can all take a deep breath. And at least in terms of basic civility, maybe we can all begin to “take our country back.”
Dennis Chinoy is a physician assistant in Bangor.