Politics for the People Book Club Recordings — A Conversation with Dr. Elisabeth Rosenthal

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On Sunday, December 2nd the book club had the pleasure of spending an hour in conversation with Dr. Elisabeth Rosenthal, the author of An American Sickness: How Healthcare Became Big Business and How You Can Take It Back. You can listen to our full conversation at the end of this post.

Dr. Rosenthal is a graduate of Stanford University and Harvard Medical School.  Dr. Rosenthal practiced emergency medicine before joining the New York Times where she was a senior writer. She is currently editor-in-chief of Kaiser Health News, an independent non-profit DC-based newsroom focusing on health and health policy.

In the introduction of the call, you can hear Dr. Rosenthal and P4P founder and host, Cathy Stewart, discuss Dr. Rosenthal’s journey from the emergency room to writing about healthcare reform, thinking she would one day be able to return to her calling as a doctor. Twenty years later, Dr. Rosenthal decided to write An American Sickness and told us that in working on the book she “…dug into each area of healthcare to see for myself really how it came to be that we put profit on the front burner and health on the back burner.”

Give a listen here or below:

 

Steve Hough of Florida Fair and Open Primaries kicked us off by asking what Dr. Rosenthal’s views were on the demand for the U.S. to move to a single-payer healthcare system. You can hear Dr. Rosenthal’s response and how she feels that the solution to our healthcare crisis is a political decision here or below.  On the role of the insurance industry, Dr. Rosenthal thinks “…much of what we get from the insurance world, or from a lot of the layers in our healthcare system, has nothing to do with health care, it adds layers of complexity and cost…”

 

Our next question came from Cynthia Carpathios of Independent Ohio. Cynthia asked about part two of Dr. Rosenthal’s book—Diagnosis and Treatment: Prescriptions for Taking Back Our Healthcare—specifically how she sees us changing the culture of healthcare and how can we transform our healthcare system into one where patient care is the primary concern. Listen here.

 

Harriet Hoffman of New York, a consultant who helps people understand the Medicare system and make the best, most cost-effective and access-friendly decisions, raised the push by some for ‘Medicare for All.’ She asked if Dr. Rosenthal thinks a ‘Medicare for All’ system would be viable or even desirable as it is now. Hear her answer or check it out below.

 

Dr. Jessie Fields pointed out that though the healthcare industry spends $3 trillion a year, our life expectancy is going down in the United States. Dr. Fields went on to talk about how the medical industry is the country’s biggest lobbying force, which requires political reform and the removal of profit incentives from healthcare. Despite all of this, Dr. Fields asked Dr. Rosenthal what glimmers of change she can see. An enlightening discussion followed where Dr. Rosenthal shared her view that “…there’s great hope for a kind of physician-patient alliance to bring change.”

 

Reverend Carl McCluster, an independent organizer in Connecticut, spoke of how many of his parishioners are suffering from high medical and drug costs. Reverend McCluster asked Dr. Rosenthal for three suggested steps that advocates could take to push back against the medical industry. Listen to how to fight back here.

 

Susan Massad, a retired physician and a clinician educator of over fifty years, worked with young physicians on their listening skills and their abilities to respond to patients. Susan asked if there are things that Dr. Rosenthal thinks patients should be doing that will amplify their voices and could be helpful to challenge the system. Hear the response.

 

Cathy and Dr. Rosenthal wrapped up the conversation on a note of hope for change and reform. “I tell everyone when I go talk to hospitals,” Dr. Rosenthal said, “just do something. Do something in whatever space you exist to start changing things because I think that’s how empowerment starts.”

 

You can listen to our entire conversation below:

 


For easy reference, from An American Sickness:

Dr. Rosenthal’s

Economic Rules of the Dysfunctional Medical Market

  1. More treatment is always better. Default to the most expensive option.
  2. A lifetime of treatment is preferable to a cure.
  3. Amenities and marketing matter more than good care.
  4. As technologies age, prices can rise rather than fall.
  5. There is no free choice. Patients are stuck. And they’re stuck buying American.
  6. More competitors vying for business doesn’t mean better prices; it can drive prices up, not down.
  7. Economies of scale don’t translate to lower prices. With their market power, big providers can simply demand more.
  8. There is no such thing as a fixed price for a procedure or test. And the uninsured pay the highest prices of all.
  9. There are no standards for billing. There’s money to be made in billing for anything and everything.
  10. Prices will rise to whatever the market will bear.

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STAY TUNED
We will announce our next selection soon.

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Reminder: P4P Conference Call with Dr. Rosenthal TONIGHT!

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TONIGHT 

Join us on a conference call with
An American Sickness Author Elisabeth Rosenthal

Sunday, December 2nd
at 7 pm EST

Call in and Join the Conversation  

Phone number: 641-715-3605   

Passcode: 767775#

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Reader’s Forum — Lou Hinman and Jeff Aron

Lou Hinman 

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The runaway inflation in the cost of living in America is worst in precisely those sectors of the economy that the 99% can’t live without — higher education, housing, and healthcare. In An American Sickness, Dr. Elisabeth Rosenthal describes in excruciating detail how American healthcare has been hijacked.

How did this happen?  How did we Americans get so divided that a plastic surgeon dares to bill $50,000 for 3 stitches – just one of the many examples that Dr. Rosenthal sites.  (I also read a story not long ago in the New York Times about an “out-of-network” surgeon who ambushed an unsuspecting patient, sewing him up after his operation, and then billing him for a quarter of a million dollars!)

Medicare has become a vast, publicly owned resource  – a huge accumulation of money, automatically withheld from the paychecks of working people for their entire working lives – that is ripe for systematic looting by private interests.  In exactly the same way, private insurance companies don’t complain about extortion by the drug companies, and the newly privatized “not-for-profit” hospitals and their incorporated medical practices, because they can pass the extortionate billing on to their tens of millions of subscribers – you and me.

The corruption of the American system of healthcare has become institutionalized.  Indeed, our healthcare system now fits Irving Goffman’s description of a “total institution” – an institution that, whatever its original or nominal purpose, has as it’s real priority perpetuating itself and benefiting its hangers-on.  Such total institutions are, as Dr. Rosenthal suggests, a sign of a culture in decline.

When President Eisenhower left office in 1961, he warned us about what he called the “military-industrial complex.” In the decades that followed, military production did, in fact, become a juggernaut of profit-making for private interests and, simultaneously, an institutionalized parasite on the productive resources of the American economy and the needs of the American people.  Healthcare in America has now become just such a parasite – the “medical-industrial complex!”

As Dr. Rosenthal astutely observes: “In healthcare, entrepreneurship outsmarts regulation every time.” In the independent political movement, we know this pattern very well.  We’ve learned, for example, that trying to stop the flow of money to Democrat and Republican politicians by campaign finance reform can’t succeed, because new regulations, written by those politicians, come with new loopholes.  The development of new corrupt practices is impossible to keep up with, in both politics and in healthcare, without addressing the question of political power.  We can’t reclaim either our government or our healthcare without creating a new political culture.

Lou Hinman lives in New York City and is an activist with IndependentVoting.org and the New York City Independence Clubs.

Jeff Aron

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I won’t say that I “enjoyed” reading An American Sickness by Dr. Elizabeth Rosenthal. It corresponded too closely to experiences of my family and friends – not merely the illnesses and deaths but the difficult engagements with all aspects of a system that creates economic and existential insecurity which have nothing to do with “health.”

Whether based on personal interviews or other research, the stories Dr. Rosenthal shares help us to understand and are devastating critiques of the (mis)organization of healthcare in the United States. So many people are failed by this “system”. I kept wondering what those who supported it might say in its defense. More to the point, I wondered what we as a country would need to do to produce a system(s) other than what we have. What can we do about the overweening power of hospitals, insurance companies, and pharmaceuticals — all of which have enormous political leverage as well as economic incentive to keep things as they are? Would it be possible to build partnerships between those who currently profit from this state of affairs and those who are not served well by it? How might that be organized?

I really appreciated Dr. Rosenthal’s suggestions about what individuals can do. However, I feel similarly to Susan Massad and others who have written that something bolder — more grassroots and more challenging of the larger system of which healthcare is a part — needs to be undertaken.

As I read An American Sickness, from my location as an activist in the mental health arena who also has been a community organizer, I thought of areas of concern and contention in healthcare which might have been more fully explored, e.g., severe mental disorders, aging, and lack of access and education for marginalized groups. While addressing these may not have strengthened the very strong case Rosenthal makes, including these populations as resources would be powerful elements of a movement for change.

I also thought about my brother, my mother, my life partner — all of whom died of serious illnesses — the challenges we faced, the diversity of people we met, the pharmaceuticals that were prescribed, the offices, clinics and hospitals we entered — and how all of us were shaped (deformed) by the economic and political forces that organize the practice of medicine — and everything else in our society. We can and must do better.

Jeff Aron has been active in independent political efforts in New York City and nationally since the late ’70s. He is a passionate supporter of IndependentVoting.org


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Politics for the People

Conference Call

An American Sickness

With Author Elisabeth Rosenthal

Sunday, Dec. 2nd at 7 pm EST.

Call in number:  641-715-3605 

Passcode 767775#

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Reader’s Forum — Maureen Albanese and Helen Abel

Maureen Albanese

Maureen Albanese

Elizabeth Rosenthal lays out in clear language why our healthcare system got in this sorry state and what we can do to help ourselves get better and cheaper care — but that is not enough.  We must also start electing politicians who will get us to a better healthcare system.  Healthcare should be a right — not a privilege as it is now.  We need to organize our fellow Americans around this issue as we are all but one illness away from homelessness.  This book will be a great conversation starter, but more people need to read it and work together to get the system we deserve.

We can look to France, which has the best healthcare in the world, to help us formulate a better healthcare system.  This healthcare system is not sustainable and until a major overhaul is done America itself will be bankrupt.

Maureen Albanese is an administrative assistant and activist. She lives in Manhattan.

Helen Abel

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I found An American Sickness a provocative look at the health care industry and how big profits have been substituted for humane patient care.  Elisabeth goes into great detail about how this has happened and definitely makes a case for the Canadian or Great Britain models of health care.  She also gives tips on how to find out how your hospital rates nationally, where to get drugs more cheaply, and a host of other information.  A good go-to also if you are dealing with a difficult medical situation.

Helen Abel is a Life performance coach and political activist.

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Politics for the People

Conference Call

An American Sickness

With Author Elisabeth Rosenthal

Sunday, Dec. 2nd at 7 pm EST.

Call in number:  641-715-3605 

Passcode 767775#

 ***

Reader’s Forum — Dr. Jessie Fields

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Dr. Jessie Fields (center) with Carrie Sackett, Alvaader Frazier, David Belmont and Nardo Reyes –  New York City Independence Club Activists in Harlem doing street outreach.

Health Care Should Be About Health 

I am a community primary care physician. I grew up seeing the effects of social isolation and poverty in the black community and I became a doctor because I wanted to help improve the life conditions of the black poor. Practicing in the poor community, initially on the West Side of Chicago, I soon realized that I had to go outside the walls of the clinic and outside the institution of medicine to be able to work on improving the community’s health.

This lesson is also relevant to the book, An American Sickness: How Healthcare Became Big Business and How You Can Take It Back by Elisabeth Rosenthal. The book is a revealing analysis of the high costs of for-profit medicine as well as an activist guidebook for the American people and patients to confront and change a system that impacts all people.

Those outside the system in partnership with caring health providers I believe can and are making changes. I look forward to our discussing efforts to change the system when we speak with Elisabeth Rosenthal on the conference call on December 2nd. As Rosenthal states in the last few sentences of the book’s Afterward, “…the crusade to take back our health care system…. it’s going to be a long war.”

She documents how American medicine became the highly expensive, wasteful, inefficient complex business designed to generate profit that it is today. Rosenthal tells the story of the beginning of health insurance with Blue Cross and its partner, Blue Shield, which were nonprofit and accepted everyone who sought to sign up. “The original purpose of health insurance was to mitigate financial disasters brought about by serious illness…” Over the subsequent decades, especially through the 1970s and 1980s, “For-profit insurance companies moved in, unencumbered by the Blues’ charitable mission. They accepted only younger, healthier patients on whom they could make a profit. They charged different rates, depending on factors like age, as they had long done with life insurance. And they produced different levels of protection.”

She outlines all the components of the high cost of medicine: insurance, hospitals, pharmaceuticals, doctors, conglomerates, etc. while also focusing on how high costs impact patients.

“Nearly a third of Americans said they had problems paying medical bills, many among those forced to cut back on food, clothing, or basic household items…But will Congress head their distress call? Or will the powerful business of medicine hold sway, as it has for the past thirty years? Time will tell, but there’s a glimmer of hope on the horizon. But that glimmer comes from you, not from Washington.”

Dr. Rosenthal also discusses the benefits and limitations of the Affordable Care Act. Namely that it has increased access to coverage and care but that in the face of the insurance lobbies and partisan political dysfunction, the ACA did not address the high costs of medicine.

Of course, the high costs of medical care are not limited to the money and financial losses by patients and the larger society. The human costs are even more deeply incalculable. The health and well being of patients and families is undermined.

New approaches to healing that involve human compassion and support are needed but not pursued because the focus is how to make a profit from the latest technology. Expensive technology has replaced the hands-on art of a thorough physical examination.

Departments that do not make money such as Obstetrics, especially in medical clinics that serve poor communities, are closed. Pregnant women have limited access to quality prenatal care, resulting in the United States high infant mortality rate — especially relative to other developed countries. The United States spends more than $3 trillion a year on a health care system that is unequal and unjust. We the people have to change it and I look forward to our conversation with Dr. Rosenthal.

Dr. Jessie Fields is a physician practicing in Harlem, a leader in the New York City Independence Clubs, and a board member of the All Stars Project and Open Primaries.

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Politics for the People

Conference Call

An American Sickness

With Author Elisabeth Rosenthal

Sunday, Dec. 2nd at 7 pm EST.

Call in number:  641-715-3605 

Passcode 767775#

 ***

Reader’s Forum — PJ Steiner, Steve Guarin, and Jessica Marta

PJ Steiner

An American Sickness: How Healthcare Became Big Business and How You Can Take It Back was recommended to Politics for the People by PJ Steiner. Read on to see PJ’s response to Elisabeth Rosenthal’s book.  

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I initially heard about An American Sickness by Elisabeth Rosenthal while listening to an NPR interview with Terry Gross. Dr. Rosenthal was incredibly well versed on what the challenges in our healthcare “system” really are and how those challenges came to be. She absolutely wowed me with her excellent communication skills and journalistic chops.

But unfortunately, I became immediately worried about my own, and my children’s, healthcare future. As a Dad of two awesome autistic children, I worry about how they will be cared for throughout their life. I worry even more because our healthcare system (like public education) doesn’t really want to help them as much as it wants to profit from them.

Now that I’ve had a chance to read Dr. Rosenthal’s book, I feel the true immensity of the amoral “healthcare industrial complex” we have in this country. But I also feel some hope. There are a lot of tools and advice to be had to help the regular American fight their way to better care at a more reasonable cost.

Pick this book up. You’ll be glad you did.

PJ Steiner is the Vice President of The Utah League of Independent Voters.

Steve Guarin

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Steve Guarin (r) being presented with a 2016 Anti-Corruption Award by Juliana Francisco

If you want to learn why your wallet is getting lighter and your purse is becoming empty, read An American Sickness by Elisabeth Rosenthal. She lists and explains all the many ways medical care robs your billfold. They will even charge you for things you didn’t use. People have called the billing predatory, which is an outrageous situation to be put in by the people and organizations that are supposed to be helping you.

The subtitle of the story is, “How Health Care Became Big Business and How You Can Take It Back.” In a small part of the book I felt as if she was talking directly at me, the Compliant Patient. Up until I read this book I strived to be a compliant patient. I thought these were the people trying to make me better, but I have learned that is not true. Your family doctor is under a lot of pressure to make use of the expensive facilities of the hospital or medical group that employs him. One type of lab-test which we all get is the simple blood test. It behooves you to ask your doctor to use one of the commercial laboratories, i.e. Quest or LabCorp. It will be exactly the same test but the results from a hospital can be priced one hundred times higher.

Read this book and you will learn how medical care became a rapacious big business. More importantly, the author will teach you to be a Non-Compliant patient, and save some money.

Steve Guarin lives in the Bronx.  He is retired and an activist with the New York City Independence Clubs.

Jessica Marta

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As a health-care provider, I’m familiar with many of the issues that Ms. Rosenthal is talking about in An American Sickness. All the unscrupulous things Ms. Rosenthal mentions, particularly price-fixing by pharmaceutical companies, are happening every day.

Is single payer health-care the solution? I don’t know. The single-payer idea has been around since the ’50s. Back then the American Medical Association shot it down by hiring Ronald Reagan to do TV ads telling the American public that single-payer health-care would take away our Freedom of Choice.

If not single-payer, then why couldn’t the government set limits or standards on the price of drugs or medical procedures? Because our government still caters to powerful special interests.

As long as we live under the current paradigm, that making money is the supreme good, poor people won’t have access to good care and middle-class people who can’t afford to pay for their own health insurance will go bankrupt after paying for long-term treatment. But we just see these as consequences for “others” and hope we are never in those situations.

I feel that patients are not the only casualties of our dysfunctional system. There are many providers who go out of their way for patients, jump through bureaucratic hoops to get care, but these folks can get very weary. I don’t know what the answer is, except a shift in political power on behalf of the interests of ordinary people.

Jessica Marta is an independent activist with Independent Voting and the New York City Independence Clubs. She lives in Manhattan and is an Adult Psychiatric Nurse Practitioner.

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THIS SUNDAY

Politics for the People

Conference Call

An American Sickness

With Author Elisabeth Rosenthal

Sunday, Dec. 2nd at 7 pm EST.

Call in number:  641-715-3605 

Passcode 767775#

 ***

Reader’s Forum — Susan Massad

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A Review of An American Sickness: How Healthcare Became Big Business and How You Can Take It Back

I am a consumer of health care, a practitioner and educator in general internal medicine for over fifty years, and a lifelong advocate for health care reform–single payer, a national health care service, and health care for all.  In college, my sophomore term paper was a history of the AMA’s role in defeating Truman’s proposal for a national health service for America.

Critiques of the American medical system have been with us for decades but more recently, as our system becomes more and more dysfunctional, the level and volume of critique has accelerated. The system is too big, too bureaucratic, user-unfriendly, exploitative, bad for our health, inaccessible, and too costly.  These are some of the recurring themes that one encounters in the explosion of commentary in books, articles, political polls and in my favorites, television shows, such as New Amsterdam, and the Resident, that are chronicling the faults in our system that make it so impenetrable to both consumers and practitioners.

I was an avid reader of this literature until there were just too many articles and books to keep up with. I am grateful that I was introduced to Elisabeth Rosenthal’s An American Sickness through Politics for the People as I might have dismissed it as just another critique that I already knew what it was going to say. Even for the jaded and cynical, Rosenthal grabs your attention. I was totally engaged with the first part of the book, How Health Care Became Big Business. She brings her talents and experience as a doctor, social critic, and journalist to her writing, producing a devastating analysis of how the patient, aka the consumer, is caught in a web of confounding business operations designed to maximally exploit them and their illnesses. The book is filled with clinical vignettes that are case studies in patient exploitation, such as the shell game of adding expensive testing, medical equipment and ancillary services to the hospital bill, the charging for the extra anesthesiologist, the moving of procedures to ancillary sites where extra facility fees can be collected as providers form LLCs to increase profit. It is the patient who is left alone with the financial impact of an unregulated drug market, lack of transparency in anticipating hospital and procedure costs, and an insurance market that simply passes on the costs of this exploitative care to the consumer in the form of higher and higher premiums.

Coming away from the book one is left with a strong sense of outrage, and a much better grasp of the complexities and deceptions of the system. I have been in treatment for breast cancer for over six years and continue to be confounded by my monthly bills that quote the charge for the service as one amount, the amount the plan pays as another and the copay as another inexplicable amount and none of it adds up. Rosenthal gives us some way of understanding how these unfathomable charges have landed on our health care bills.

I was somewhat disappointed in the second half of the book “How you can take it back.”  Rosenthal provides some invaluable tools in the form of apps and sources of information and organizations that support us to become more astute consumers of health care as we shop around for the best hospitals, compare drug prices, and question the charges on our hospital bills. She exhorts us to speak up and push back; something that is not so easy to do as individual operators in a system so big and opaque as ours.

What I found most lacking was some recognition of how politicized our health care system is. The three-trillion-dollar American medical machine did not just happen to become the profit center for insurers, hospitals, doctors, manufacturers, politicians, regulators, charities, banks, real estate, and tech—or any of the many other entities that have no connection to health or health care. Much of this giveaway was accomplished through the compliance of our representatives, who vote on the legislation that has facilitated the turnover of medical care to private industry. Medicare and Medicaid were established in 1965 under Lyndon Johnson, a master of the deal. Steven Brills’s book, America’s Bitter Pill, is the sad story of the making of the Affordable Care Act, a political-mash up of deal-making and trade-offs that is the best that our partisan and divided Congress could offer the American people. I am not critical of Rosenthal for not including an analysis of the politics of health care in America in the book, and I would have liked to have some recognition of what we are being asked to push back against in challenging big business health care. I have learned in my many years as a health care activist that I could not impact the flawed nature of our health care system without engaging in changing the way politics is conducted in our country. Health care reform, like educational reform and other major reforms, is not a single-issue item. It is embedded in everything we do.

Where does one look for hope, a way out of this mass of corruption and deception that health care in the US has become? For me, one has to get out of the system and look elsewhere to a number of grassroots, community-based, and patient-initiated efforts to take control of their own health care.  A few examples of this are: Patient run self help organizations such as SHARE that provide support, education and empowerment to women affected by breast or ovarian cancer; Gilda’s Club, a community organization for people with cancer, their families and friends; Project Open Notes, an international movement advocating change in the way visit notes are managed by providing access to patient and families of their medical records; The Maven Project that is leveraging medical school alumni to connect experienced volunteer physicians with safety net clinics across the US to augment and meet unmet health care needs in underserved and uninsured patient populations; The Beryl Institute, a global community of practice dedicated to improving the patient experience through collaboration and shared knowledge, as well as my own efforts to help patients to self-organize health teams that perform as collective, social units for health and healing that is amplifying the patient’s voice in taking control of their own health care.

In An American Sickness Rosenthal eloquently chronicles how dreadfully sick our health care system is. It made me think about the advice that All Stars Project and East Side Institute founder Fred Newman gave at the Performing the World conference in 2007.  In speaking about the despair and chaos of our world, Newman says, “We have to perform the world again—and we are all involved in this—because this one stinks.”

I take this to mean that if we are going to create our way out of the three-trillion-dollar morass that health care in the US has become, it is we the people who will have to do it.

Susan Massad is a retired primary care physician educator who is on the faculty of the East Side Institute where she leads workshops/conversations exploring what it means for people to grow and develop in the face of serious illness, aging or memory loss. Susan is a long time independent activist with Independent Voting.  

 

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Politics for the People

Conference Call

An American Sickness

With Author Elisabeth Rosenthal

Sunday, Dec. 2nd at 7 pm EST.

Call in number:  641-715-3605 

Passcode 767775#

 ***

Reader’s Forum — Steve Richardson

We Need a Game-Changer

boston 0614If there is any issue that should unite our divided nation, it’s health care.  Mortality limits every one of us; even those blessed with good genes and good habits are one accident away from dependency.  And we all have relationships that change quickly – or cease to exist – if either party is seriously ill.  Most of us spend an enormous amount of money on health insurance – or earn what our employer pays for it.  Instead of appealing to our interest, the industry and our own Congress have taken advantage of us.

Dr. Rosenthal pulls no punches in applying her medical knowledge and journalism experience to exposing the collusion among health care providers, insurers, and politicians that has us in such an unenviable financial and moral predicament.  As an economist, I was impressed with her “Economic Rules of the Dysfunctional Medical Market,” which are carefully linked to examples that I could easily relate to as a consumer.  And I especially appreciated her documentation in Part I of how we got here (“The Age of”  Insurance, Hospitals, Physicians, Pharmaceuticals, etc.).  What comes across quite clearly is that it is indeed a systemic problem.  As she notes in the Introduction, the rules that govern delivery of health care in the US are no accident, and it’s up to us to change those rules.

Of course, we’re a few Davids taking on many Goliaths.  So in Part II, Dr. Rosenthal provides thoughtful measures for personal and political action to incrementally address the dysfunctional relationships we have with insurance companies and providers.  Each is worth considering and sure to benefit some of us, and taken together, they are a good start toward reform.  However, I don’t think we’ll see real change unless we amputate the “invisible hand” on the till that she refers to in the Introduction.  The Affordable Care Act was stillborn because the health care industry made sure it posed no real threat to their market power.  In my view, we will never win control of our own health care by working within a system designed and controlled by special interests.  We need something radical like single-payer, but I would prefer something that restores a free market – like eliminating tax deduction of health insurance premiums by employers and making all health care expenses (premiums and out-of-pocket) deductible for individuals.  That’s not a new idea and it’s not the only solution, but it would be a game-changer.

Steve Richardson is a founding member of the Virginia Independent Voters Association and serves on IndependentVoting.org’s national Election Reform Committee.

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Politics for the People

Conference Call

An American Sickness

With Author Elisabeth Rosenthal

Sunday, Dec. 2nd at 7 pm EST.

Call in number:  641-715-3605 

Passcode 767775#

 ***

Reader’s Forum — Jennifer Bullock

Healthcare as a Social Activity

Thank you, Elizabeth Rosenthal for An American Sickness: How Healthcare Became Big Business and How You Can Take it Back.

It is a sobering and useful breakdown of what has happened with our healthcare industry in the last several decades.  I so appreciate your helpful and insightful outline for how we can ‘take back’ this for-profit machine and put human healthcare and cost-savings into action.

As a progressive psychotherapist practicing a group therapy approach called Social Therapy, we work outside of the medical/insurance/ healthcare industry as independent collaborators with clients and communities.  I work to help clients exercise our collective power to live a more humane, less alienated life together.  From that perspective, I wonder what you think about an added recommendation to how to take back our healthcare:  Do our healthcare socially, collectively, in teams, in partnership with our support networks.  I often invite clients to take a friend to a medical appointment, have a friend on hand when doing the fun activity of calling an insurance company to clarify a bill or ask for coverage, and have a support ‘health team’ when admitted to a hospital to help navigate medical care, billing, treatment direction.  It seems to me our collective power needs to be exercised against the monstrosity of big business industries, and especially so when it comes to a vulnerable area of life called our health care.

Jennifer Bullock is the Director of Independent Pennsylvanians and a social therapist in Philadelphia.

 

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Jennifer Bullock gathering signatures in Philadelphia. 

 

*Reminder*

Conference Call with Elisabeth Rosenthal

Author of American Sickness

Sunday, December 2nd at 7 pm EST

Call: 641-715-3605
Pass code: 767775#

 

 

Reader’s Forum —Cynthia Carpathios

An American Sickness: The Commodification of Americans

“Unless you’re part of the 1 percent, you’re only ever one unlucky step away from medical financial disaster.”

Although most of us are aware that the healthcare system in America is not well, we may not have realized the extent of the illness.  If you are fortunate enough to have a job with decent insurance, you may not realize how vulnerable you really are.

Elisabeth Rosenthal’s book, An American Sickness: How Healthcare Become Big Business and How You Can Take It Back, is a History and Physical of American Healthcare.  It is compelling, sometimes funny, and absolutely appalling.

The Chief Complaint is “hugely expensive medical care that doesn’t deliver quality results.”  Rosenthal then lays out the History of the Present Illness and Review of Systems, a look at how American medicine has transformed from one based on caring to one based on profit. And in the Diagnosis and Treatment, she gives us resources for ourselves and for the broader good, what we can do to be less vulnerable to outrageous doctor bills, hospital bills, insurance costs and what kinds of systemic changes we need to demand from our lawmakers, insurance companies, providers and healthcare institutions, hospital and insurance regulators.

What is so shocking is how vulnerable we all are, even those of us with the best insurance.  All we need is a hospitalization or emergency situation in which, without choice or informed consent, we receive service from out-of-network providers or end up in an out-of-network facility and we can be on the line for astronomical charges.  The provider may just say hello to you at your bedside in the hospital. You may be taken to the nearest facility when you are in a situation where every minute counts, and you may not even be conscious. And the rest of your life you may be in financial ruin.

Increasingly certain groups of providers and certain facilities don’t sign up in networks at all and charge whatever they want.

And this is only one outrageous way to go deeply into debt to our broken medical system.

The breakdown in relationship between the medical industry and the people they serve is one that touches all of us, and I feel particularly close to it. My father was a thoracic surgeon in the “golden age” of medicine.  He accepted what people could pay. We had several beautiful oil paintings from one of his patients. One of my brothers is a physician employed by a large medical conglomerate, who has considered repeatedly whether he can bear to stay in medicine. The differences between my father’s and my brother’s experience of the medical field are enormous.

I work in a hospital, a community hospital that has recently been acquired by a larger medical entity. I do payroll and accounting for the physician practices that are under the hospital’s wing.  I see the bankruptcy paperwork coming in for patients who have gone underwater. I see what we pay for consultants, for drugs, the closing of departments that don’t bring in enough money (we no longer deliver babies at this hospital) and the struggle our little hospital has had to stay open. I see the doctors who experience that despite their big paychecks, they are stressed and unhappy, many of them feeling like drivers being pushed to go ever faster and do more in a system whose focus is on the mighty dollar.

It is riveting and distressing to read Rosenthal’s history of the moves that have been made that have been part of creating the current state of affairs where patients are no longer related to on a human level – where they have become a commodity, a dollar figure.

The medical industry is not alone in this regard.  We have seen similar breakdowns in higher education, in banking and investor relations, in the relationship of employers to their workers, in government and its representatives to the people they are mandated to represent.  Things have never been perfect, there have always been ways in which certain groups have been more privileged; this is embedded in our country’s history. But what we are now seeing is a wholesale breakdown of the relationship between the service industries and the people they are purporting to serve.

What we are seeing is something that can’t just be changed by laws or more regulation.  The creativity of those at the top of the money-making pile to work around issues is enormous.  Yes, those changes are needed, and we need to support them. And we need cultural/social/human development at the same time, without which anything else will never be fully successful.  

Despite the infuriating advantage being taken by those who have the power and money to do so, they are also victims of this system.  Their humanity has been eroded and their growth as human beings stunted. We need to support functional changes where we can do so and we need to bring growth and development into our lives and those around us, transforming the systems that underlie our medical system, our society, our economy, our political system, our country from the inside out. 

Cynthia Carpathios is a long-time political independent and a novice Buddhist monk.  She lives in Alliance, Ohio.

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Rick Robol and Cynthia Carpathios of Independent Ohio

*Reminder*

Conference Call with Elisabeth Rosenthal

Author of American Sickness

Sunday, December 2nd at 7 pm EST

Call: 641-715-3605
Pass code: 767775#

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