We Need Medicare for All Because For-Profit Health Care Destroys Lives

The following is adapted for Common Dreams based on remarks at the Ohio Statehouse earlier this month.

I am honored to have served 45 years in emergency medicine as a paramedic in the streets of Cleveland, as an emergency nurse and as a physician. The ER is the only place where those abandoned by our profits-before-people health care system can go. My server at Bob Evans, my barber who cuts my admittedly few hairs, the guy who fixes my car and the woman who cleans my hotel room, these are all good Americans and my neighbors. They deserve care. US healthcare treats them like worthless throw away parts, like they are garbage. Many Affordable Care Act health insurance plans have completely out of reach premiums, co-pays and deductibles. They come to see me in the ER as they have nowhere else to go.

Tim arrived by EMS unable to speak or move his right arm. As is so often true Tim can say simple automatic things like “Hello” and “Yes” or “No”. Tim’s attempts to say more result in frustrated flailing of his good arm. It is too late for the stroke busting drugs. Tim’s stroke will likely be permanent.

Tim’s wife arrives. She remembers me. Turns out I treated Tim two months earlier when his heart began beating irregularly. Tim’s wife says “I’m glad you are our doctor—you were so good with Tim last time.” Two months earlier Tim had wanted to refuse hospital admission knowing his insurance had a $10,000 deductible. He was worried about dental braces for their two teenage girls. Tim’s wife and I convinced him to stay that time, to see the cardiologist and get his heart beat under control, for the sake of her and the girls.

Tim’s care for his irregular heartbeat financially devastated his family. Tim could not afford the follow-up doctor appointments or the “Eliquis” that kept blood clots from forming in his damaged heart.

A preventable blood clot caused Tim’s stroke. Tim’s life as breadwinner for his family is over. He had been worried about braces for his girls, now he can’t even talk to them. His girls arrive at the bedside with tears streaming down their faces.

Tim’s horror has a name, has a cause. It is US profits-first corporate health care. We are the only nation in the world that believes pin-stripe suited boardroom bean counters are concerned about our care. Tim was a human sacrifice offered up to the false God of “American Exceptionalism”, to the false God of “the market”. I could tell you many, many more tragedies like Tim’s. My professional association, the American College of Emergency Physicians, reports that 81% of its members report regularly seeing patients seriously harmed by lack of affordable access to health care.

The evidence, the hard data, the numbers are overwhelming, clear and inescapable. US health care is the most expensive and yet consistently among the worst-performing in the civilized world and repeatedly ranked dead last for equity and fairness. The US has the highest financial barriers to care, the highest rates of inability to afford medications, treatments and follow-up care once they have left my emergency department. 60% of all bankruptcies are due to medical expenses.

The profits of the health insurers, Big Pharma and medical device makers are enormous. We are dying. I have very little tolerance for armchair Ayn Randian schoolboy theories about the role of the markets and limited government. Bad ideas have consequences. My patient Tim and his wife and teenage daughters were destroyed by markets, profits and pin-striped MBAs. We need improved and expanded, compassionate and cost-effective Medicare for All. Future generations shall regard us as barbarous a people as we regard the slave holder, that we allowed our neighbors to live or die based upon their economic status.

I close with three quotes:

Martin Luther King Jr.: “Of all the forms of inequality, injustice in health care is the most shocking and inhumane.”

Marcia Angell MD, former editor of the New England Journal of Medicine: “We’ve engaged in a massive and failed experiment in market-based medicine in the US. Rhetoric about the benefits of competition and profit-driven health care can no longer hide the reality: Our health system is in shambles.”

Poet Wendell Berry: ”Rats and roaches live by competition under the laws of supply and demand; it is the privilege of human beings to live under the laws of justice and mercy.”

As a soon to be retired emergency physician dedicated to my patients, I am running as a Democrat for the Ohio House of Representatives District 12. Democrats need to stand up, be bold, be counted, and pass the Ohio Health Care Act. Together, we can do great things. Democrats enacted Social Security and Medicare. We can pass improved and expanded, compassionate and cost-effective Medicare for All. We should never allow another tragedy like Tim’s.