Health Care as Wealth Care in America

For-Profit, Indeed

By Bill Astore

It’s not always better to run things for profit and for maximum return on investment. Consider this snippet I saw in my email feed this AM from CNN:

Private equity firms have been taking over hospitals, nursing homes and other health care delivery systems in recent years, and a new study finds the trend is making care riskier for patients. Researchers examined how often patients experienced certain adverse outcomes at hospitals before they were bought by private equity firms and after — and found that rates of hospital-acquired complications for patients increased by 25% at hospitals after they were purchased. The study doesn’t answer how exactly private equity ownership diminishes care, but one of its authors said that previous research shows these kinds of acquisitions are often linked to staff cuts and replacing doctors and nurses with lower-paid employees.

Who knew that cutting doctors and nurses and replacing them with lower-paid, less experienced staff might have an impact on health outcomes? Color me shocked.

Meanwhile, roughly 100 million Americans struggle with some form of medical-related debt, and medical debts remain the leading cause of personal bankruptcy in America.

Back in 2013, I wrote the following article on the joys of health care in America. A decade later, matters and outcomes are only getting worse.

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Americans generally, and politicians in particular, proudly proclaim that we live in “the greatest” country. But how should we measure the greatness of a country? I’d suggest that quality of life should be a vitally important measure.

And what is more fundamental to quality of life than ready access to health care? When you’re sick or suffering, you should be able to see a medical specialist. And those costs should be — wait for it — free to you. Because health care is a fundamental human right that transcends money. Put succinctly, the common health is the commonwealth. And we should use the common wealth to pay for the common health.

Here’s the truth: We all face the reality of confiscatory taxation. If you’re like me, you pay all sorts of taxes. Federal, state, and local income taxes. Property taxes. School taxes. Social security. State lotteries are a regressive tax aimed at the poor and the gullible. We pay these taxes, and of course some for health care as well (Medicare/Medicaid), amounting to roughly 30 percent of our income (or higher, depending on your tax bracket, unless you’re super-rich and your money comes from dividends and capital gains, then you pay 15 percent or lower: see Romney, Mitt).

Yet despite this tax burden, medical care for most of us remains costly and is usually connected somehow to employment (assuming you have a good job that provides health care benefits). Even if you have health care through your job, there’s usually a substantial deductible or percentage that you have to pay out-of-pocket.

America, land of the free! But not free health care. Pay up, you moocher! And if you should lose your job or if you’re one of the millions of so-called underinsured … bankruptcy.

Health care is a moral issue, but our leaders see it through a business/free market lens. And this lens leads to enormous moral blind spots. One example: Our colleges and universities are supposed to be enlightened centers of learning. They educate our youth and help to create our future. Higher Ed suggests a higher purpose, one that has a moral center — somewhere.

But can you guess the response of colleges and universities to Obamacare? They’re doing their level best to limit adjunct professors’ hours to fewer than thirty per week. Why? So they won’t be obligated by law to provide health care benefits to these adjuncts.

Adjuncts are already underpaid; some are lucky to make $3000 for each course they teach. Now colleges and universities are basically telling them, “Tough luck, Adjunct John Galt. If you want medical benefits, pay for health insurance yourself. And we’re limiting your hours to ensure that you have to.”

So, if Adjunct John Galt teaches 10 courses a year (probably at two or three institutions of “higher” learning) and makes $30,000, he then faces the sobering reality of dedicating one-third of this sum to purchasing private health insurance. If that isn’t a sign of American greatness, I don’t know what is.

I groan as much as the next guy when I pay my taxes. But I’d groan a lot less if I knew my money was funding free health care for all (including me and mine). Commonwealth for the common health. With no death panels in sight.

As “Dirty Harry” said in a different context, “I know what you’re thinking.” Free health care for all is simply too expensive. We say this even as we spend a trillion dollars a year on national defense and homeland security, to include the funding of 16 intelligence agencies to watch over us.

A healthy republic that prides itself on “greatness” should place the health of its citizens first. That we don’t is a cause for weeping — and it should be a cause for national soul-searching.