16 March, 2010

Health Care Reform and 30 Million Uninsured

by Jorge Reyes

The health care reform seems to be gaining steam now that a final bill seems imminent.

While the news media will bombard us with intricate information about the technicalities of a possible final package (leaving many of us still in the dark about what it will cover and won't cover) absent from all this talk are the everyday, existential struggles endured by the near 30 million men and women from every walk of life without health care insurance or with little access to the health care system. 

I have often said that Middle Class America is poorer than anyone may think. Take into account huge debts, joblessness and foreclosures, and you know what I mean. On top of this, while some economic predictors seem to paint a rosy picture of the future, the greatest number of economists and analysts agree that the end of our economic crisis is far from over. In fact, just today I read somewhere that in the next two years we will see a new cycle of foreclosures.

The newly dispossed are all around you and their numbers will continue to increase. Just look around and you, too, will see.

Which is why not long ago I decided to visit Jackson Memorial Hospital, one of the largest public health care providers in Florida, and see for myself how our hospitals actually do business with our sickness. If you live in South Florida, chances are you already know about the crisis this hospital is facing. For 2010 fiscal year, Jackson Memorial Hospital will have a $229.4 million dollar deficit. Much worse for the local economy, it has threatened to lay off about 4,487 of its employees unless it doesn't get an infusion of capital from state and local governments, both of which have refused to do thus far.

Like 30 million, 4,487 is also a critically high number of unemployed people for any community to absorb at any given point.

But that's what we're facing. More people unemployed than ever before, and the cost of health care higher than ever. More people losing their health care coverage if they had any, while many more have no say in this important discussion.

According to the Center for Responsive Politics, in 2009 federal lobbyists and their clients spent more than $3.47 billion trying to influence legislation of all sorts.

Ironically, the only sector in our economic sector that doesn't seem affected by the economic crisis is the lobbying industry. I don't want to harp on more of the same, but here it is. How's this for a shock? According to the Center for Responsive Politics, in 2009 federal lobbyists and their clients spent more than $3.47 billion trying to influence legislation of all sorts. Out of that, the pharmaceutical and health lobbyists spent by far the largest, with an average total of more than $267 million.

Be not surprised, then, that whatever health care reform is passed won't be as far-reaching, as all encompassing, or as geared towards competition between a public and a private plan as it once was hoped for.  That's a shame because this health care reform could have been another truly historic piece of legislation.  Time will tell, though.  Let's not be so negative. 

But how does this, I ask, affect those many uninsured? like the many people I met the day I visited the local public hospital.

While I was pleased with the general level of caring Jackson Memorial Hospital provides the poor and indigent, what I was mostly amazed to see were so many I call "the newly poor", or people who had never experienced long-term job loss, had ever been recipients of unemployment benefits, food stamps, or had ever faced the calamity of foreclosures. 

But here they were, hundreds of people who had come with the hopes of being seeing by a physician, a nurse, anyone who could tell them what was wrong with them.  For some, this was not the first time here so they knew what to expect, a pathetic bureaucracy.  For others, this was their first time and to say that they were in for a surprise doesn't do justice to their shock. 

In more than three hours, I met and talked to a wide number of families from the South Florida community. Most of their stories were similar in nature, and none had anything nice to say about the health care system.

Take for example Miguel, a 60 something Cuban man. Ever since he came to the US in 1982, he worked as
an independent electrician but for the last two years his job offers have dwindled to almost half of what he used to make.  Right now what he makes is unsustainable.  His wife Maria is of similar age, a housewife, with that piqued look of a person who has never been exposed to so much bureaucracy and, from what I could see, she was beginning to lose patience; a futility of emotion many who had been through this hospital before had mastered with stoic resignation, but one Maria had yet to master.

Miguel had begun to bleed through his rectum. He was afraid he had cancer. At his age, anything was possible as he told me. He had gone to a local clinic which had immediately referred to a specialist at Jackson. That specialist, as he was told today, had a waiting list of about a year. Not even if Miguel's case was of an emergency, could he see the specialist before a six months period.

Their choices, of course, were very limited. They can hardly pay $200, cash, to see a private physician, much less pay for the cost of all other medical procedures that would be required. They were at a loss.  One thing was certain, though, they had to wait.

There was another woman with a pea-sized brain tumor. Her name is Ana.  Though it was best to operate the tumor as soon as possible, the waiting time was three months and not a day before. In between the original diagnosis and the day I met her, three months had already elapsed. Her symptoms were typical: she felt nauseous most of the time, passed out at regular intervals, and her headaches were becoming increasingly more excrutiating.  She lived with her 84-year old mother, whose meagre social security benefits were $182.00 a month, and a nephew she had raised as a son and who seemed to be the only breadwinner in the family.  He works at two jobs now just so that they can pay a $950 a month rent.  Ana had been fired from her job as a waitress at a local cafeteria in Hialeah (a local municipality in Miami) because she had passed out too many times and the owner of the cafeteria was afraid of a possible lawsuit. 

When I asked Ana what she intended to do, I kid you not, she told me she was thinking of going to Cuba to have the brain operation.  "At least it's free over there and I can stay with family members," she told me with a shrug.   "I already sold all my jewelry in order to buy a plane ticket to Havana."

Michael Moore may not be so much off the mark. 

So, as we discuss the reasons why we should or shouldn't have universal health care, just drive to a local hospital yourself. Talk to the people. Let them tell you their stories. And while you're talking to them be reminded that one of them could be you one day.

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