Profit drive ravages health care system

Scan page 18

Crowded hallway at San Francisco General Hospital. Overcrowding is comHospitals pout over lost profits Medical researchers warned last month that cuts in Medicare ordered by the federal government may force some hospitals to reduce care or refuse Dr. Eric Munoz and colleagues at the Long Island Jewish Medical Center charged that the new "prospective pay system, under which hospitals receive a fixed fee according to the type of ailment treated, does not adequately consider the increased cost of emergency treatment or caring for more severely ill SOCIALIST ACTION NOVEMBER 1985 The Wall Street Journal reports the case of an elderly woman who bought almost 50 health insurance policies at a cost of $14,000 in premiums because she did not want to be a burden on her family as her health failed.

For the final year of her life she was confined to a nursing home. Not one of the insurance companies that took her money would pay the $1000 a month the nursing home charged.

There was nothing illegal in this. The poor woman had failed to read the fine print and the exclusions that made her policies almost worthless.

Fine print and exclusions determine the true worth of an insurance policy. They also determine the true quality of the medical system in the United States-which has been described as "the finest in the world."

Massive hospital buildings, electronic gadgetry, and techniques to replace kidneys and hearts may lead an observer to believe health care in this country is the best obtainable. But the medical system's own "exclusionary clause" declares that first-class health care is available only to those who can afford it.

An index of the quality of a nation's health system is found in its table of life expectancy and its infant mortality rate. Males in the United States stand 18th in the world in life expectancy-slightly behind most Western European countries.

Fourteen nations do better than the United States in saving babies at birth. Last year about 11 babies died prematurely for every 1000 births. This compares with Sweden, where in 1978 only 7.7 died. For Blacks in Mississippi, the chances of a healthy delivery are bleaker; in 1967 about 45 babies died for every 1000 births.

Sara Rosenbaum of the Children's mon in county hospitals.

admission to many elderly patients.

patients.

"It used to be a Medicare person would walk bring $20,000 with them," Munoz stated in the can Medical Association.

Under the present system, he continued, "Thi but Medicare is only reimbursing the hospitial !

lost 10 G's and they're not too happy about it." Defense Fund said, "In America babies are dying because of infectious diseases, poor nutrition, and lack of basic medical care."

A shortage of doctors U.S. society is entangled in a contradiction. Minimum education is a recognized right of every child and an obligation of the state. But the even more basic right to health-which ultimately means life itself-is left to a health care system fueled by the profit motive.

Because of the profit motive people are denied the most basic element of a health care system—an adequate supply of doctors to treat the sick. The Department of Labor has estimated that the nation needs 14,000 new doctors a year. Medical schools graduate only 8000.

Proposals in Congress to expand the medical schools have been bitterly opposed by the American Medical Association (AMA), the doctors' job trust. They want to keep the supply of doctors down and their income up.

Part of the doctor shortage is met by about 2000 foreign doctors who come to study and stay to practice in the United States. Here the wealthiest country in the world is taking doctors from the poorest.

(Compare this with Cuba which is training enough doctors for their own needs, and enough to lend medical assistance to numerous underdeveloped countries.)

The supply of doctors is not spread evenly across the United States but is concentrated in the affluent communiMickey Plege into the emergency room and Oct. 4 Journal of the Ameriey're $10,0 ties where well-equipped hospitals and well-to-do patients are located.

Physicians have deserted the slum areas of the cities. In 1930 the East Garfield Park section of Chicago had 212 doctors. In 1970 there were only 13 left to serve 63,000 poor patients. Rural communities fare even worse. Close to 5000 small towns with a half-million inhabitants do not have a single physician to serve them.

Hospitals for profit

Historically hospitals have been charitable institutions run by religious orders. Later community hospitals were founded by non-profit organizations to meet local needs. They charged the patients who could pay but treated many indigent patients for nothing.

When hospital care consisted mainly of good nursing and simple medications, costs were reasonable. Philanthropy and community chest funds helped the community hospital to break even-which is all the non-profit hospital expected to do.

Then came the great technological revolution in medical science. New drugs that could wipe out many killer diseases and new electronic machines for diagnosis and cure have transformed the hospital into a very complex and expensive institution.

With such breakthroughs in medical science, people should be enjoying the best health ever. Instead we are facing a health care crisis that is bankrupting the middle class and reducing the poor to despair.

This is because the drug industry and medical-supply houses put profits before delivery of health care. Like the military/industrial complex that profits from the government's imperialist policies, a medical/industrial complex (MIC) has been developed to coordinate the economic interests of doctors, hospitals, druggists, and the medical-supply industry.

Drug companies ignore AIDS Profits alone determine the research policies of the drug industry. The nation is in the grip of a near panic over the AIDS epidemic. Cries for help are rising from all over the nation.

Yet not a single major drug company is researching for a drug or vaccine to fight this disease. There is greater profit in developing some variations of valium since the patent rights have just run out and there is a multimillion-dollar market waiting to be exploited.

Manufacturers of radiographic scanners and kidney dialysis machines have found a new world of profit in the sickness industry. They have found that hospitals can be profitable if you charge all the traffic will bear.

Sixty percent of the U.S. population has some sort of health insurance. This guarantees doctors and hospitals a minimum payment. Above that they can charge the patient whatever they think they can get.

"What do you think your right arm is worth to you?" they will frequently ask a complaining patient.

Federal and state funds from Medicare and Medicaid is another pool of cash the medical profiteers can tap. Conglomerates have been buying up community hospitals and nursing homes

CHECKS

En,cago Sun-Time 'How sick may I get for $537?' to run them strictly for profit. This means no more charity patients, every aspect of the institution must contribute to its profitability.

The first diagnosis of an emergency patient brought into the hospital is his financial health. If he has no insurance he is shipped as fast as possible to the nearest county hospital-the place of last resort for the indigent sick.

The commercial hospitals are so anxious to get rid of these unprofitable patients they sometimes send them out with plasma bottles and needles attached to their arms.

Elderly prey to costs A sick person with a Blue Cross card would be admitted to a hospital, but would not be immune to shock when receiving his or her share of the bill. While Blue Cross talks of covering 80 percent of the average bill, exclusions and unexpected co-payments often leave the patient thousands of dollars in debt.

The elderly who are supposed to be enjoying socialized medicine under Medicare are the most vulnerable to high medical costs. They pay the first $400 for a hospital stay plus whatever charges the doctor and hospital adds on to their payment from the government.

To bridge the gap in coverage the average retired person has to pay $40 a month for additional commercial insurance. This is out of an average Social Security income of $450 a month.

From the Black baby who is denied a fair chance of a healthy life to the aged who live in dread of the financial burden of inevitable sickness, the U.S. medical system is robbing the poor of their inalienable right to health and the longest life possible.

At best county hospitals are dreary places where patients sit for hours to obtain an interview with a doctor. At a time when county hospitals are flooded with poor patients, state and federal funds are being cut. The result is tremendous overcrowding and a serious deterioration of conditions.

In one week recently three county hospitals in the San Francisco area were declared to be in violation of minimum standards of health care. The response of hospitals to such criticism has been to close whole departments.

Hospitals have closed 15 out of 21 emergency treatment stations in highly populated West Contra Costa County (across the bay from San Francisco). Another hospital in the county is asking state officials for permission to refuse "desperately injured" emergency patients.

Earlier this year a Contra Costa man waited in a hospital emergency room for four hours while doctors tried in vain to find a neurosurgeon to operate. He was finally transferred to the county hospital in San Francisco, but died two days later-H.P.

----- pull-quotes -----

"First-class health care is available only to those who can afford it."

Closing the door on the poor