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Over Coffee
I drank two cups of coffee during the informative talk by Dr. Pat Crow at the Aug. 21 People, Places & Things forum at Sun Towers in Sun City Center. As most area residents know, the programs are free and open to anyone who wants to attend, not just residents of the retirement community.
When I heard the subject would be the history and changes in the American health care system, which Dr. Crow titled, “From Colonial to Corporate,” I knew I had to attend. Too many people are affected by the state of health care access – including myself– to let an opportunity to learn as much about our system as possible pass by.
Whether you have insurance or not, you can still be victimized under today’s U.S. system, even if you “think” you have good insurance. Like the person Dr. Crow cited who had insurance to pay for 12 radiation treatments but his cancer required 20. This person had to go to Mexico to get his treatments as U.S. hospitals (would have) required him to pay several thousand dollars upfront (that he didn’t have) when his coverage ran out.
“It’s hard for some of us in our generation not to think of the kindly man who came to our homes carrying a little black bag,” Crow said. “But today, account managers at insurance companies have made medicine about business.”
Phil Lange, who books the guests for People, Places & Things, described the small town where he grew up. “Everyone knew that even the orphans that were dropped off there (during the Great Depression) would be cared for. That was just the way things were then.”
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| Penny Fletcher PhotoDr. Harold “Pat” Crow, at left, talks with Phil Lange, director of the People, Places & Things forum presented free every Monday at 1:30 p.m. in the Sun Towers dining room in Sun City Center. Dr. Crow had just completed a talk titled, “Our U.S. Health Care, from Colonial to Corporate,” explaining the changes in the delivery of services that have taken place over the years. |
Crow described what has changed, and why.
The two things that stood out foremost in my mind when he had finished were things he stated almost immediately: One, that health care in the United States is a “commodity” to be bought and sold on the open market like a pound of let’s say- coffee; and that every idea to give all Americans the right to have health care has been consistently killed because of the use of one word: “socialized.”
“Care is not a right, it is a privilege that many do not have, or may think they have but then they get sick and find out they do not have enough (coverage for care),” he stated.
There are a lot of tiers of management and a lot of money to be made by keeping the system we now have in place, he explained. Even for those who think they have good insurance, their “care” is no longer dictated by physicians, as in days past, but by dollars and cents in rooms where auditors and “case managers” decide who gets what according to how much it will enlarge their bottom line.
“In colonial days, there was little curing and more caring because little was known of science and quackery reigned supreme,” he said. “People did not go to hospitals to be cured, but to be kept comfortable and away from the rest of society.
Midwives delivered babies at home and bone setters traveled and did their work. Since there was no anesthesia, there was little surgery, and people died from infections every day that are now easily cured with antibiotics.”
Then, in the 1950s, things began to change because of new scientific discoveries, and by the 1980s (wow, I thought- just that recently?) doctors began using “diagnosis.”
“They started asking questions of patients. Taking medical histories.” This practice, along with the fact that earlier ether had been discovered and that they had found that germs caused infections, changed the physician’s role from “caring to curing,” he said.
Health insurance was born in the late 1920s in Texas when a hospital offered its teachers 21 days a year (free) in a hospital as part of a benefit plan. “This plan only covered the hospital, not the doctors, and only involved 1,500 school teachers. But it was there that things began to change,” he said.
Very quickly doctors learned they would be paid in money when the transaction was handled by a third-payer. Where many physicians had taken eggs and chickens and all kinds of barter before, now, people who had a “third-party payer” was sure to have his or her bill paid in cash.
This system grew and grew, adding many tiers of account management, and Dr. Crow says he believes it costs the American public more in premiums (and for the uninsured, who are charged as much as three times more than an insured person for many procedures) than covering everyone in the country would cost us.
“In the 1920s and 1930s companies were so desperate for workers they had to start giving benefits to attract them,” he said. “Health care was a primary benefit they could offer.” Then, after the development of the insurance system, this easily migrated into what we see today.
“Health care is big business. It’s about money,” he stated. “The USA is the only industrialized nation in the world that has employer-based insurance. Other industrialized countries have universal (available to everybody) insurance. Here, they scare us off with the word ‘socialism’. But universal care isn’t socialism.
“When Medicare (a program for those over 65 years old) and Medicaid (a program for those below the poverty level) came into being in 1965, senators Lyndon Johnson and Wilber Mills managed to push them through despite all the lobbyists and drug companies and the AMA (American Medical Association) fighting it,” he said.
As a physician, it seemed to me that Dr. Crow took a rather anti-AMA position as he continued. Anyone listening knew he was concerned chiefly with patient care.
“Medicare turned out to be one of the most efficient systems until 2003 when the Congress enacted the Medicare Modernization Act,” he said. “Until then, it was a single-payer system (like universal health care is in other countries). But at that point it became privatized and now there are multiple payers. Just look at all the Medicare choices you get bombarded with.
“You can kill a program in two ways,” he added. “One, you can under-fund it, and secondly, you can overspend it.”
Under this “modernization” act, Medicare is no longer permitted to negotiate with drug companies, although others, including the military and private businesses, can negotiate prices with them. Because of this, Medicare drug profits are huge, estimated at 30-to-40 percent. “And the HMOs (who sign with Medicare) are guaranteed a profit,” he added.
According to Dr. Crow, a medical professional who for many years has also taught classes on how the health care system works, the system is no longer “care based” but “financially based.”
He predicts that in the coming years citizens will hear universal care “demonized as socialist” and “single-payer system” used like a four-letter-word.
“I predict things will get much worse before the people insist they (our elected representatives) do better,” he said. “You will see changes in the 2009 Medicare program that will basically insure that you will pay more of your own costs for coverage.”
Dr. Crow will deliver another talk at People, Places & Things Sept 22 at 1:30 titled “Medical Insurance Issues for 2009,” and will (again) teach a six-week course at Community Church College in Sun City Center (which is open to others who live outside the retirement community) in the spring on how to survive the health care system. His course covers the gamut from keeping your medical records straight and being sure you are not overcharged to exactly how to determine what care you need.
I plan to listen to him again on Sept. 22. This issue is too important to the survival of our country to continue to sweep real data under the rug.
*Perhaps you have something you’d like to share. Or maybe you’d rather tell the community about your favorite charity or cause: or sound off about something you think needs change. That’s what “Over Coffee” is about. It really doesn’t matter whether we actually drink any coffee or not (although I probably will). It’s what you have to say that’s important. E-mail me any time and suggest a meeting place. No matter what’s going on, I’m usually available to share just one more cup. Or maybe you’d like to tune into the new radio show I’m hosting, “The Uncensored Reporter.” It’s available across the country on both AM and FM radio but so far I haven’t found out the call numbers for our area so I just direct everyone to
www.themicroeffect.com on their computers Tuesdays and Thursdays from 3-to-4 p.m. It’s a call-in show so maybe you’ve got some ideas or comments you’d like to share on the air. Just click on “Listen Live” and give it a whirl.
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