Walter Carpenter: Vermont Health Care – Your Money or Your Life

This comment is from Walter Carpenter of Montpelier, who works in the Vermont tourism business and is a writer and health activist. In 2006, he nearly died at the hands of the health care system and has been an activist ever since, fighting for health care as a public good. He is on the advisory committee of the Green Mountain Care Board.

There has been a lot of commentary lately about the sickness of our health care system. Bill Schubart, Julie Wasserman, Mark Hague, Dr. Paul Manganiello, and most recently Lee Russ, all of whom have written eloquently and knowledgeably at about our costly and deadly healthcare dysfunction and offered ideas on how to potentially cure it – that is, of course, if we have the moral, social and especially political courage to do so.

We have not had this courage until now. This is evident in the continued suffering under our healthcare system (it’s generous to call our healthcare chaos a system, but I’ll stick with that word for now for the sake of brevity and clarity) which causes so much unnecessary agony.

The patient’s point of view is missing from most healthcare discourses. It’s easy to get lost in the quagmire of health geeks, tossing around terms like “all-payer model,” “value-based care,” and a thousand others that make people’s eyes glaze over.

All of this obscures what this dysfunctional health care means to ordinary people. As a single-payer health care activist for the past dozen years, I have been bombarded with an unknown tonnage of acronyms, charts, graphs, percentages, and more than enough data to reach the moon and back.

None of this has any bearing on the experience of being inside the system for which we pay so much and get so little in return. A system that’s supposed to take care of us when we need it too often feels like it’s victimizing us for its own benefit. Take a moment, for example, to read what medical debt means to the lives of many Vermonters on the Vermont Medical Debt website.

In many years of health care activism, I have heard our administration, our legislature, and “experts” refer to patients as “consumers.” It makes me pale with suppressed fury. Someone who is yellow with jaundice and turning ashy because of it, as I was 16 years ago, is not a “consumer” who chooses to buy a $10,000 iPhone.

We have turned our health care into a business relationship where health care is simply a product that the consumer buys from a system selling it to the highest price it can get for it.

Lee Russ said it best in his Digger commentary, “How much inaction does it take to cause a disaster?”: “Health care represents a huge economic pie. The public supplies the ingredients: money in the form of insurance premiums, co-payments, deductibles, taxes and the cost of services not covered by insurance. The healthcare industry is feasting on the pie.”

This was true even before the dubious advent of OneCare. When my liver was shutting down and poisoning me 16 years ago—a condition that could have been fixed in 15 minutes but dragged on for months because of our insurance system—I was asked for my insurance card as often as I was asked how I was feeling. I was forgotten in doctor’s offices, hospital waiting rooms and surgery prep rooms as if I wasn’t there at all. I quickly learned that in the jaws of this machine, if I didn’t fight for myself, I might not survive.

This is usually not the fault of the floor staff, who are themselves treated as raw material to be used for profit, while the many layers of administration and abundance of management are considered assets. I am always in awe of how the underpaid and overworked floor staff manage to deal with dozens of patients like me rushing through the system as if we were in an operation aimed at creating more and more claims. A completely exhausted nurse fell asleep on my arm while sticking the needle of an IV into me.

These staff people are the human face of what our health care should and should be if it were a public good instead of an industry that feeds on consumers and human “resources.” This is the doctor who took a few hours out of a much-needed day off to come to the office, coordinate the retrieval of the scan results, and personally call me to tell me with relief that I don’t have bone cancer, a possibility raised from the initial tests.

My last healthcare experience still treated me like a “consumer”. A request for my Medicare and Medicare cards for “billing purposes” was the first question I received at the admissions desk at a Vermont hospital on a recent test visit.

It was almost like a hotel asking for a credit card to guarantee the reservation. It’s incredibly dehumanizing. It reduces health care almost to a skit by the famous comedian of the last century, Jack Benny, who was asked by a thief during a mock robbery: “Your money or your life.”

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Tags: being inside the system , health care , health care is just a product , patients as consumers , the patient’s perspective , Walter Carpenter


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