by Mary Pitt

"They came in their thousands, queuing through the night to secure one of the coveted wristbands offering entry into a strange parallel universe where medical care is a free and basic right and not an expensive luxury. Some of these Americans had walked miles simply to have their blood pressure checked, some had slept in their cars in the hope of getting an eye-test or a mammogram, others brought their children for immunisations that could end up saving their life." - The brutal truth about America’s healthcare

While our president is involved in dealing with the many emergencies in which our nation is now foundering, he fails to see the most urgent one.

The dead numbered 137,000 per year through the years of 2000 to 2006, according to the Institute of Medicine of the National Academy of Science and, as the depression continues to worsen, the numers will climb even higher on an annual basis. The problem? Simply a lack of health insurance and the inabilty to obtain the needed care on an individual basis!

Granted, these people are the working poor and, thus, are "The Others". We all know who "The Others" are. They are the people who are not in "our neighborhood", the unseen people who keep our streets, our clothing, and our children clean, who cook and serve our food, who do the myriad of tasks that we are too busy to do or too comfortable to do for ourselves. They people our back rooms, out of sight, except on the streets where we hardly notice their presence.

They are not the elderly because the elderly have, at least, Medicare with which to maintain their simple lives. The people who are dying for want of care are not the young, healthy people but those who continue to work hard, working through the pains of incipient illnesses such as diabetes and cancer because they have neither the time nor the money to seek medical care.

Suggesting that they should carry private-pay insurance is futile because they simply do not have the funds to pay up to $15,000 per year that would be necessary for a family policy and the idea of fining them for not doing so would also result in further health problems with their undernourished and, possibly, homeless children. We proclaim our care for children by passing the S-CHIP legislation which will allow them medical care but their empty bellies receive nothing but good wishes if their parents work too hard and earn too little to provide them an adequate diet. The dental and eye care provided for them are rudimentary and all medical appointments of any kind necessitate a cash co-payment.

Even before the onset of the "recession", bankruptcies due to medical expenses were a ballooning problem not necessarily caused by the lack of insurance but by the deductibles and co-payments that those policies require. An elderly person in the United States must live on about $1200 per month, less the deductions for premiums for Medicare Parts B and D which combined total well over $100 per month. From the remaining $1,000 dollars or so, these people are required to pay an additional deductible for their medications, for each doctor's appointment, and for necessary hospitalizations.

In addition, they face the feared "donut hole" which causes them to end each year with the problem of whether to buy the medication upon which their very lives depend or to pay for their rent, utilities, and food. At this level of Social Secureity, there are few states which allow them assistance from Medicaid.

Every elderly person lives with the fear that they will have a "dizzy spell" or a minor fall which will prompt some kind-hearted person to transport them to an emergency room where a caring physician may decide to keep them overnight for "observation". Upon release from the hospital the next day, they know they will be burdened with a bill, which they must pay, in excess of $2,000 after Medicare.. (This would be another two months' Social Security allowance that must be taken from theiir necessary expenses.) Hard as they may try and regardless of their own desire to avoid it, bankruptcy and total devastation looms as an inevitability.

There are those who are obsessed with the possibility that single-payer medical insurance will cause an increase in taxes. However, if they were to add to their annual tax bill the amounts that they now pay for insurance premiums on a private basis, they would realize that the question should be given further consideration. The government already pays 60% of the health care bills in this country while there are many with no coverage at all. If the amounts that are paid to private insurance plans were added to this amount, there would be little or no tax increase to provide complete coverage to all the rest. In addition, the employers who have been paying for medical insurance might be amenable to increasing wages and improving the amounts in the paycheks.

Rather than the "competition" which has been touted as a way to cut the cost of medical insurance, the companies are in contstant negotiations as first one company and then another embarks on a plan of conquest They buy up or take over smaller companies. It would not be much of an exaggeration to compare the insurance situation with that of the nation's major banks, and for the same reason. The point of the endeavor is to create a monoply wherein one or two major corporations control health care and can name their own price.

However, a single-payer plan could roll together the amounts presently spent in Federally-funded health care along with the subsidies reserved for those providing Medicare Part D, the amount paid for private insurance premiums, and 30% charged out by those companies for administrative salaries, advertising, and profits, there would be a net increase in available funds of some 350 billion dollars per year to apply toward services for the uninsured. Any actual increases in taxation beyond rolling in the money now spent on insurance premiums would not be a great burden but would literally save the lives of many Americans and create the healthy citizenry that will be required in the rebuilding of our nation. As regular examinations, preventive care, and early diagnoses are available, the cost would go down over the years, relieving the taxpayers of much of their burden.

If the President would verify these facts through the Washington number-crunchers and convince the Democrats in Congress, the answer would truly be a "no-brainer". The question would arise as to the effect on the economy of the loss to the insurance companies. Then, as now, they could contract with the government to administer this Federal program in order to mitigate their losses. However, keeping the current system to protect the private insurance industry can only duplicate the results of the "too big to fail" bank bailouts. If they have become so greedy that they must continue to fatten their pockets with the life-blood of the people of America, perhaps their "failure" would benefit the future of America.

Much has been said and written about "the polls" which show a loss of support for the "health reform" effort in Congress. This is far from that which the people envisioned when they turned out in record numbers to assure the election of Barack Obama. It was begun timidly and fought blindly by the opposition who were not yet recovered from their Rovian trance of "every man for himself". They recite by rote the right to "own your own insurance policy" when, in fact, they know that they are only renting them for so long as they pay the ever-increasing premiums and don't have a serious illness.

We can only urge President Obama to "get real" and prepare to proclaim this National Emergency and to exercise his executive powers much as President Bush did to deal with the National Emergency in his time. This crisis is every bit as serious as that faced by the nation in the aftermath of September 11, 2001. It must be treated as seriously before many more people die as the result of it.

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This writer is eighty years old and has spent a half century working with handicapped and deprived people and advocating on their behalf while caring for her own workung-class family. She spends her "Sunset Years" in writing and struggling with The System.