Welcome to America, the only industrialized nation without universal health care

It's situation critical
Sun, November 23, 2008 | Lisa Van Dusen | Sun Media

On the morning of last June 19, in the waiting room of the psychiatric ward of King's County Hospital in Brooklyn, Esmin Green slumped from her chair to the floor. She lay there for almost an hour, ignored by other patients and staff, before dying of causes still undetermined.

The hospital's closed circuit security cameras produced a video so disturbing (www.youtube.com/watch?v=OA29VwnZ4cE), that when it was released two weeks later it got worldwide attention.

Green was a 49-year-old mother of six. In the days before her death, she lost her job in a day care centre, then lost her apartment: One version of a story that will happen more and more as the economic meltdown trickles down every Main Street.

That the video of Green's death surfaced in the middle of the presidential campaign seemed like a cry for help from a system that works for fewer and fewer people at higher and higher costs.

The United States health care system is a spaghetti junction full of toll booths set up by private insurance companies that provide coverage for care in the form of HMOs (health maintenance organizations), PPOs (preferred provider organizations) and POS (point of service) programs. Most Americans (60%) get health coverage from these companies through their employers.

There are government programs such as Medicare and Medicaid for people without private insurance but roughly 15% of Americans remain uninsured. The ones who are insured interface with doctors and hospitals using a business lexicon of deductibles and co-payments and non-network treatment and paperwork unfathomable in both volume and content.

The system costs more per capita than any other on earth and represents a greater chunk of GDP (15%) than any other UN member except the Marshall Islands. The United States is the only wealthy industrialized nation that doesn't have universal health care.

When I moved to the U.S. in the early 1990s, I spent a lot of time explaining that the Canadian health care system wasn't a choice-less socialist nightmare of back-alley quacks and deadly wait times to people who couldn't believe universal health care could be so straightforward.

The most rattling culture shock then was getting used to a health care system that had the same creative accounting scandals, advertising schemes and class divides as any other business. The amount of money floating around it -- from liability insurance and personal injury attorneys to $500 bedpan suppliers to fly-by-night providers who post hand-scrawled ads on utility poles -- is staggering.

The horrors of the system chronicled in news accounts about people such as Green and by Michael Moore in the documentary Sicko happen every day and will be happening more and more a the economy worsens.

Money question

But Americans make decisions involving health coverage all the time that you never think of when it all comes down to one card in your wallet: Career choices, personal choices, where to live, what to do on a Saturday afternoon with your kids, whether to go to an emergency room.

The Canadian system has been strained in the past decade and we're a lot less self-righteous about it now, but when Canadians talk about the merits of changing it, the bottom line isn't so much the bottom line as a consensus on the value of fairness.

U.S. polls conducted before the economy dwarfed all other issues showed that most Americans share that view.

Fifteen years ago, when the Clintons tried to overhaul the U.S. health care system, resistance from the insurance lobby proved fatal.

Now, even the health insurers are admitting that change is needed (last week, two insurance lobby groups agreed to cover sick people as well as healthy ones, if they really have to) and that health care is becoming a huge economic problem.

New presidents can only focus on so many priorities and Barack Obama is a new president at a time when the things that need fixing seem outnumbered only by the obstacles to fixing them. But his reported choice of former Senate Democratic leader Tom Daschle, who wrote the book, Critical: What We Can Do About the Health-Care Crisis, as Secretary of Health and Human Services, means this is a priority.

While the economy, energy, education and climate change need fixing, people aren't dying in classrooms or in gas stations because of a system that seems based on the very un-American idea that some lives are worth more than others.

The simple truth: With Obama we get health care and education reform - With McCain, we don't!

Ohio Hospital Contests a Story Clinton Tells: This time Hillary fabricates tales about health care to exploit your emotions.

From the new York Times | April 5, 2008 By DEBORAH SONTAG

Over the last five weeks, Senator Hillary Rodham Clinton of New York has featured in her campaign stump speeches the story of a health care horror: an uninsured pregnant woman who lost her baby and died herself after being denied care by an Ohio hospital because she could not come up with a $100 fee.

The woman, Trina Bachtel, did die last August, two weeks after her baby boy was stillborn at O’Bleness Memorial Hospital in Athens, Ohio. But hospital administrators said Friday that Ms. Bachtel was under the care of an obstetrics practice affiliated with the hospital, that she was never refused treatment and that she was, in fact, insured.

“We implore the Clinton campaign to immediately desist from repeating this story,” said Rick Castrop, chief executive officer of the O’Bleness Health System.

Linda M. Weiss, a spokeswoman for the not-for-profit hospital, said the Clinton campaign had never contacted the hospital to check the accuracy of the story, which Mrs. Clinton had first heard from a Meigs County, Ohio, sheriff’s deputy in late February.

A Clinton spokesman, Mo Elleithee, said candidates would frequently retell stories relayed to them, vetting them when possible. “In this case, we did try but were not able to fully vet it,” Mr. Elleithee said. “If the hospital claims it did not happen that way, we respect that.”

The sheriff’s deputy, Bryan Holman, had played host to Mrs. Clinton in his home before the Ohio primary. Deputy Holman said in a telephone interview that a conversation about health care led him to relate the story of Ms. Bachtel. He never mentioned the name of the hospital that supposedly turned her away because he did not know it, he said.

Deputy Holman knew Ms. Bachtel’s story only secondhand, having learned it from close relatives of the woman. Ms. Bachtel’s relatives did not return phone calls Friday.

As Deputy Holman understood it, Ms. Bachtel had died of complications from a stillbirth after being turned away by a local hospital for her failure to pay $100 upfront.

“I mentioned this story to Senator Clinton, and she apparently took to it and liked it,” Deputy Holman said, “and one of her aides said she’d be using it at some rallies.”

Indeed, saying that the story haunted her, Mrs. Clinton repeatedly offered it as a dire example of a broken health care system. At one March rally in Wyoming, for instance, she referred to Ms. Bachtel, a 35-year-old who managed a Pizza Hut, as a young, uninsured minimum-wage worker, saying, “It hurts me that in our country, as rich and good of a country as we are, this young woman and her baby died because she couldn’t come up with $100 to see the doctor.”

Mrs. Clinton does not name Ms. Bachtel or the hospital in her speeches. As she tells it, the woman was turned away twice by a local hospital when she was experiencing difficulty with her pregnancy. “The hospital said, ‘Well, you don’t have insurance.’ She said, ‘No, I don’t.’ They said, ‘Well, we can’t see you until you give $100.’ She said, ‘Where am I going to get $100?’

“The next time she came back to the hospital, she came in an ambulance,” Mrs. Clinton continued. “She was in distress. The doctors and the nurses worked on her and couldn’t save the baby.”

Since Ms. Bachtel’s baby died at O’Bleness Memorial Hospital, the story implicitly and inaccurately accuses that hospital of turning her away, said Ms. Weiss, the spokeswoman for O’Bleness Memorial said. Instead, the O’Bleness health care system treated her, both at the hospital and at the affiliated River Rose Obstetrics and Gynecology practice, Ms. Weiss said.

The hospital would not provide details about the woman’s case, citing privacy concerns; she died two weeks after the stillbirth at a medical center in Columbus.

“We reviewed the medical and patient account records of this patient,” said Mr. Castrop, the health system’s chief executive. Any implication that the system was “involved in denying care is definitely not true.”

Although Mrs. Clinton has told the story repeatedly, it first came to the attention of the hospital after The Washington Post cited it as a staple of her stump speeches on Thursday. That brought it to the attention of The Daily Sentinel in Pomeroy, Ohio, which published an article on Friday.

Neither paper named the hospital or challenged Mrs. Clinton’s account.