As a full time RN Care Coordinator in an acute care hospital in a large metropolitan city, I work daily with others in my department, to make sure every patient who enters the hospital is provided with a safe and timely discharge to the appropriate level of care. This can mean transferring to a nursing home (skilled nursing facility), long term care, sub-acute care, board and care, home with home health services or hospice.
For the burgeoning legions of homeless people, it means finding resources in the community for patients with medical needs plus the need for shelter and nutrition. It means protecting the right to a safe discharge for mentally ill patients and those with drug or alcohol addiction.
Recent scandals have shocked the nation, where otherwise reputable hospitals have literally transported patients in the middle of the night to homeless areas of town and dumped them on the street, leaving them alone, to suffer horribly, cold and hungry, sometimes even to die alone.
How could this shocking and disgraceful situation exist in the richest and most powerful country in the world?
The answer lies in the complex tangle of massive profiteering that leaves millions of poor and working class people without care, often homeless or bankrupt, due to outrageous costs for medications, medical supplies, caregivers, and so on. While millions of people are shut out of the system, some of the largest U.S. corporations are allowed to plunder and fragment, for profit, all aspects of healthcare delivery, with no restrictions or oversight by government agencies. They call it “free market” capitalism. We
say this constitutes denial of every person’s right to free and quality healthcare.
In order to obtain, for example, medications that were, according the physician team, needed to facilitate a discharge home for a patient, I recently had to find a way to fund a medication for a patient that cost over $20,000 a week. Where to go? What to do? The patient’s insurance company, a multi-billion-dollar giant, refused to fund the medication.
The big pharmaceutical that manufactures the medication, would not even return my pleas for help. Finally, after days of wrangling, the hospital administration funded the medication, not out of compassion, but to get the patient out of the hospital where costs were running tens of thousands of dollars per day. Thus, the patient had to stay in the hospital, away from home and family, at risk for further infection, way past their time of need for hospitalization
The end result of this all too common situation, even for the capitalists, is higher costs for healthcare system-wide. The private, for-profit insurance company, in turn, denied funding for the extended hospital stay. But it was this same insurance company’s refusal to fund the medication that kept the patient in the hospital longer than neccessary. How crazy is that?
Obamacare: A failed capitalist effort for reform in the for-profit environment
Throughout all the planning for healthcare reform, the Obama administration reached consensus with the major capitalist entities in healthcare to carve out a reformed system that could provide comprehensive healthcare to a larger section of the U.S. working class than previously known. The plan, they thought, would allow coverage for millions of workers who toil outside the realm of major corporations and government workers. This meant self-employed workers, service industry workers, agricultural workers, and workers employed by small businesses, to name a few.
At no point was single payer healthcare considered. Highly qualified advocates for a single-payer, socialist style program were
excluded from the discussion. From the start, their voices shut down in the media and across the bourgeois political spectrum.
By contrast, major capitalist players, including lobbyists from the insurance companies, big pharma and medical supply companies, were invited to help design a new program that would expand the market and profit margins for them while preserving the maximization of profits.
The result? Poor and inadequate programs with limited benefits and huge deductibles and co-pays for clients. Also, an explosion of new smaller medical group insurance companies bent on scrutinizing and denying benefits whenever possible. Not to mention, diminishing choices and rising costs for consumers.
As Obamacare has evolved over the years, healthcare costs, a result of profit gouging by all the capitalist healthcare entities themselves, are soaring out of control. Insurance companies are failing to reap the profits they thought they would have and are rushing to pull out of the market. These includes giant insurance carriers such as Aetna, United Health Group, Humana, etc.
In many areas of the country, workers seeking to purchase insurance are finding only one choice of coverage is available, where benefits are slim and co-pays are devastating
Hospitals are reeling from having to absorb the costs of care, both inpatient and post discharge. A recent study found that in 2017, 17 percent of those eligible for an Affordable Care Act plan will have only one insurer to choose from. (McKinsey Center for U.S. Health System Reform). The result is a sharp decrease in available doctors and hospitals and exchanges becoming more and more narrow, further diminishing healthcare for greater numbers of workers and their families.
As Obamacare continues to implode and break up as the insurance companies rush to exit, the system is returning to the original status quo, where only Blue Cross plans, traditionally the plans of last resort, are all that is left. Workers and their families are not able to pay the exorbitant co-pays and are not able to find primary care physicians who can oversee continuity of care and preventive medicine, thus reducing the high costs of hospitalizations.
The profit system must go. No other option.
Study after study has shown that planned healthcare, single-payer healthcare, even under liberal capitalist control, works smoothly and efficiently by eliminating parasitic insurance companies and brings down the costs of medicine, equipment, and patient care. By stunning contrast, healthcare for all provided under socialist planning, such as in Cuba, can not only provide quality comprehensive healthcare to all the people, but is able to increase research and development of healthcare modalities and even export care to people suffering from colonialism and neglect around the world.
Let’s make it clear. Under the current systemic rules of capitalism, no universal free and quality healthcare for all is possible. That’s why we need socialism. Let’s fight on for that.
