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The White House Wants My Healthcare Disaster Story

3/17/2017

20 Comments

 
Pictureსაქართველოს რესპუბლიკის (Republic of Georgia)
“დილა და როგორ გრძნობ თავს?” inquired our host, when Rich and I stumbled out of bed and down the stairs.
 
We were in a farmhouse in the Republic of Georgia on the morning after a very long night involving wine, food, wine, dancing, wine, and more wine. Even if our host had been speaking English, I’m sure it would have sounded like “დილა და როგორ გრძნობ თავს?” to my befuddled ears. Assuming he was asking how we were feeling, I managed a sickly smile.
 
Our “translator” used dramatic gestures and his eight words of English to convey that we’d feel much better after the traditional Georgian pick-me-up breakfast. This, I was aghast to discover, involved bowls of garlicy broth overflowing with entrails and various unspeakable animal parts. Cooked, thank heavens, but still . . . Luckily the grandfather was entitled to the choicest bits, so his was the portion with the whole cow’s hoof. When asked if I would like a glass of vodka with breakfast, I said “დიახ!” (Yes!”).
 
These warmly hospitable Georgians were clients of ours in the 1990s, when Rich and I undertook a couple of three-month volunteer assignments to help develop much-needed strategies for revitalizing deteriorating hospitals and clinics. The transition from socialized medicine to private pay had turned out to be (surprise!) complicated. ​​


​In those post-Soviet years, civil war, massive corruption, and economic crisis had left the infrastructure hanging by a frayed thread. Once-fine hospitals had no heat, food, or medicine; patients’ families provided all meals, blankets, and drugs — mostly outdated, black-market pharmaceuticals sold in booths near the hospital. I went there to buy capsules for a cold, but my clients advised instead a folk remedy made from quince fruit; it cured me in 24 hours.
 
Home remedies come in all forms and degrees of efficacy, but when you’re seriously ill or injured, let’s face it, you want modern doctors and reliable pharmaceuticals. Which is why it’s so dismaying to learn that if the American Health Care Act (aka “Republicare”) manages to pass this month, next year 14 million Americans will be without healthcare coverage, and by 2026 that number will increase to 24 million. Ouch!

​“I don’t know how you could live, knowing that a single serious illness or injury could cost you everything you own,” a Spanish friend said to me. “I would be terrified.”
 
Many of us are. 

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​The Affordable Care Act is far from perfect, but it’s a first step toward providing American citizens with health coverage that every other developed nation already considers a basic right of citizenship, like paved roads and police protection. This week the White House, seeking to drum up support for its new plan by throwing Obamacare even further under the bus, sent this email to millions of Americans:
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​So I decided to tell the White House my Obamacare story. I wrote that I love the Affordable Care Act because it provided low-cost coverage for my brother Steve — a working man, a fine musician, and one of the kindest, funniest people I ever knew — during the final phases of his terminal cancer. No one in the family had to sell their house or take a second job to cover his six-figure medical bills. I know, that’s not a very dramatic story. But living through it really taught me what’s at stake. 
 
All UN member countries have agreed to try to achieve universal health coverage by the year 2030. If Republicare passes, the USA will once again be the only one of Earth’s thirty-three developed nations without it.
 
At the heart of the proposed bill are flat tax credits that would leave most people — to use comedian John Oliver’s metaphor —  as horrifically under-covered as a middle-aged man in an ill-fitting thong. (And no, I am NOT going to share his favorite graphic for this; you’ll just have to use your imagination.) 

The only clear winners in the plan are the wealthiest Americans, who would see tax breaks of between $33,000 and $197,000. I’m sure we all find it comforting to know that under this plan at least something in America would be healthier: the wallets of billionaires. 

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Recent protest in New York

​I doubt that the White House is going to read or appreciate my response to their request for Obamacare disaster stories. But writing it made me pause and reflect on whether healthcare is a right or a privilege. Should medical treatment be reserved for those who can pay for it — a sort of Darwinian, survival-of-the-economic-fittest?
 
I saw what happened in the Republic of Georgia in the 1990s; money allocated to hospitals wound up in the pockets of the rich and powerful, and bribing a doctor to ensure better treatment was routine. Is that what America is becoming? Or do we define healthcare as part of the community’s social contract, like roads, firefighters, and schools? The UN and thirty-two of the world's thirty-three developed nations say one thing; the new Republican plan says another. If Republicare is put into effect, that truly would be a healthcare disaster story.
​

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20 Comments
Mike Rose
3/17/2017 06:17:41 pm

Well said

Reply
Karen McCann
3/17/2017 06:24:14 pm

Thanks, Mike!

Reply
Dorothy Valerian
3/17/2017 07:07:26 pm

From your blog post to the ears of Paul Ryan. I wish.

Reply
Karen McCann
3/18/2017 08:44:35 am

Somehow I don't think Mr. Ryan is going to listen to my logic, Dorothy. But perhaps some others will. We can always hope.

Reply
Jean Nush Guerin
3/17/2017 07:07:49 pm

Very well said, Karen. Thanks for insight into collapse of the Georgian system as well as sharing your brother's and family's story.

Reply
Karen McCann
3/18/2017 08:49:35 am

Thanks, Jean. I don't normally talk much about my family in my writing but hey, if I was willing to share Steve's story with the White House, I figured I could also share it in the more congenial environment of my blog. As for Georgia, our time there was pretty wild, although I have to say no wilder than the times we're living through now.

Reply
Steve McC link
3/17/2017 07:10:39 pm

I really enjoyed the article Karen,... astounding photos! Wow! Thanks for sharing.

I too wrote and shared my story for the White House. My wife and I have two young adults just starting to be independent in the States, and healthcare is so important. One little accident could set them back for decades. They both have Obamacare insurance plans with a maximum out of pocket. Chances are they will never use the coverage, but if something bad happened, they wouldn't lose their future. This new TrumpCare proposal seems to take many steps backwards. I hope it doesn't come with a sacrifice of the future of our young adults, so that health care companies can further pad their pockets.

Reply
Karen McCann
3/18/2017 08:59:29 am

Glad you liked the post, Steve. And I'm glad that you, too, wrote to the White House with your story. It's up to each of us to remind our representatives that without universal health coverage we are all at risk. The UN says that every year 100 million people are pushed into poverty and 150 million people suffer financial catastrophe because of out-of-pocket expenditure on health services. A scary thought in these uncertain times.

Reply
nativityscene link
3/17/2017 08:13:27 pm

Asa practicing physician in the US, I can assure you that we are on the road to Georgian level facilities and care if we continue on the current course with the failing so-called Affordable Care Act. The solutions presented are not draconian and are the CBO predictions have been way off on predicting how much the current mess would cost. Do not despair with change in a currently flawed situation, but I see it on the front line as being a plan that is doomed without some serious change in course.

By the way, if you need medical attention in Tbilisi--I highly recommend the skilled, friendly and readily available staff at the American Consulate. Two young Georgian women came to our hotel equipped with all the necessary remedies for salmonella poisoning.

Reply
Karen McCann
3/18/2017 09:17:26 am

I appreciate your perspective and agree the Affordable Care Act needs lots of improvement. I would love to see it fixed or replaced with something better. Like you, I love my country, and want the best possible healthcare for all our citizens. And I truly wish that I could share your optimism that the proposed plan would be a step in that direction.

Reply
Genie McCoy link
3/17/2017 10:26:31 pm

Karen, I enjoyed your books. However, your posts are taking a political turn lately. I am one of the millions of voters who voted for Donald Trump after losing any trust in the Obama administration. We lost trust in the IRS, the Department of Justice, the FBI, the CIA, and NSA. I watched the debates on NAFTA and we have seen the devastating results for our country. I know firsthand of the total destruction of the textile industry in the South. You can hardly find a product that doesn't say MADE IN CHINA and that has been a fact for many years. Factories and jobs have left the country.
As for the Afforable Care Act, it was predicated on lies and manipulation. We watched Obama say over and over how you could keep your plan and your doctor and prices would be lower. Nancy Pelosi (Democrat from California) implored her fellow congressmen and congresswomen to vote yes on the ACA so that we could find out what was in it. Jonathan Gruber counted on the stupidity of the American people to pass the bill. I'm assuming that would be the Democrats who fell right in line with Pelosi, and passed it in the dark of night. Now we know what is in the bill, but I doubt many who voted for it have read it yet or could comprehend it if they did. That would include Maxine Waters. Not one Republican voted for it. It is in a death spiral, but that was probably the plan from its inception.
Many American voters are not happy with events in our country or the world. I suppose it is common knowledge that ICE and the Border Patrol endorsed Donald Trump, which was a unique event. They knew what was allowed to happen by the Obama administration and we are feeling the effects of it all over the country. As for the Resist/Obstruction movement being funded by George Soros and his ilk, I assure you that millions of us will resist that effort.
Chicago, the previous home of the Obamas, is a national disgrace with the murder rate, gangs, and strict gun control laws. It has been controlled by the Democrat mafia for as long as I can remember. We voted for Trump because we have been watching and we remember. I am sorry you were blindsided by the results of the last presidential election. Republicans now hold the presidency, majorities in the Senate and the House of Representatives, and 33 out of 50 state governorships. One poll, which cannot be counted on to be accurate, showed that 70% of Americans wanted our country to change direction.
I' m glad Spain let you back in the country.

Reply
Nancy L Solak
3/18/2017 03:25:59 am

Genie McCoy,
It sounds as though you are quite passionate about your support of President Trump. I respect your right to that opinion although I disagree with it.

I'm afraid for the people in the south who have lost their jobs, and my heart goes out to them. Now, should the "repeal and replace" legislation go through as proposed, those people you care most about will be put into an even more precarious position.

To Karen, condolences on the loss of your brother. At least with the ACA he had one less thing to worry about. I'm happy to pay taxes to help people who have not been as lucky as I have been with regards to education and health care.

I've had an operation (broken leg) in Italy where the care was superb and inexpensive. I've also been to a Baltic country's medical clinic whereby my guide was able to get me in (ahead of some 60 other people waiting in a dilapidated corridor) by bribing the doctor. I am not proud of that moment, but I didn't realize what was being done until I got into the doctor's office. Your column sheds light on a possible side effect that I hadn't thought of before, and I thank you for it.

Reply
B. Murphy
3/20/2017 04:40:02 pm

This is a good read with another perspective to your own personal one about FCA. http://www.americanthinker.com/articles/2017/03/what_african_airports_taught_me_about_obamacare.html

I too lived in Spain for 6 years and saw socialized medicine from many different prospectives. From the Dr's prospective, if they were excellent Drs they were mostly private and took paying customers, i.e. The wealthy. From the wealthy prospective, they only saw private Drs and were seen muy rapido. For the middle class, one older woman I know sewed just to put money aside for medical so that they would not be "left with" only the one government option. Their biggest fear. And lastly, the poor working class. One very dear lady that worked for me, found a lump in her beast, she saw a local dr many, many weeks later, her only choice. He said yes, you have a lump, it's probably cancer, and you need a biopsy. She was scheduled for that more than 3 Months Later in a town 1 hour drive from her home, she does not drive, no money to pay for the head of the line-to ignore that is to ignore reality! To me, socialized medicine comes down to the equal sharing of nothing worth having among everyone but the wealthiest of people. You seem to forget, that there are plenty of "sweet, funny" brothers out there in the US who now have a $3-5,000 deductible before any of the $1000+ a month they pay in insurance even will work for them. Many now can not afford their own care. With your system, they would be better off playing gigs in the band than working all day in a business job making their country run. In my opinion, based on what I've seen, the government is very poor at running a healthcare system.

Jackie Smith link
3/18/2017 07:06:28 am

While I am not advocating elimination of Obamacare, I am advocating the need for making it Affordable as the title of the Act claimed. Thankfully Joel is on Medicare now -- with a Part B payment of just under $200 a month. Prior to ACA our healthcare premiums were $550 for major medical with a large deductible for the two of us. Since Obamacare my deductible is $5,000 and my monthly premium is $719. In applying for our entry visa to Greece the Consul looked at my medical coverage and said, "It appears you pay a lot and get nothing." Yep, that pretty much is it. It would be nice if the R's and D's put politics aside for a bit and really did come up with a plan for Affordable Health Care.

Reply
Karen McCann
3/18/2017 09:28:53 am

You're so right, Jackie. Wouldn't it be great if politicians on both sides of the aisle could get together and come up with a plan that really worked — for everybody? I'm glad Joel now has Medicare — a single-payer, national social insurance program administered by the US federal government since 1966. Let's hope the current administration doesn't decide to repeal that any time soon!

Reply
Sandra Kuns
3/18/2017 10:57:56 am

I agree it would be best to leave three common topics that cause emotional distress for many readers out of your blog. That would be political opinions, religion and sex. Otherwise I really enjoy your blogs Karen. Happy travel writing!

Reply
Steve McC
3/19/2017 06:07:35 pm

I agree that you nailed the 3 topics that should not be included in regular conversations. I am teetering on how to respond to in this new world. I think I am failing on the politically correct register. I can't help but be concerned for the future.

Reply
Sage
3/20/2017 09:59:30 pm

Sandra, I have to disagree. In the current climate of political turmoil, I think it is nearly impossible, if not irresponsible, to maintain an appearance of neutrality. We have entered into a realm where people are attempting to redefine TRUTH (didn't we all used to agree we knew what that was?) and to challenge the basic tenets of the US Constitution. Finding common ground is imperative, but so is calling a spade a spade.

I appreciate Karen's willingness to venture into this new space. Having studied world history and spoken with the humans who experienced it, her perspective is invaluable to me. I wish more of us could speak to the survivors of fascist regimes, we would surely see the dire necessity of this moment more clearly.

Respectfully,
Sage

Reply
Dom
4/1/2017 06:43:43 am

Very interesting Karen, and sorry to hear of you losing your brother.

In discussions of healthcare, repealing/replacing ACA etc I often wonder whether Americans who haven't traveled much or lived overseas have any real idea of how healthcare works in other countries. Or how unusual (dare I say 'exceptional!') the USA is in not having some form of universal healthcare - 'single payer' as it is often known.

I know there are many issues with Obamacare and that the single-payer systems in other countries are not perfect, but I can assure you as an Australia who has also traveled widely that the thought of having a US-style healthcare system is a terrifying prospect for those of us who do not have to worry about loss of coverage, medical bankruptcy etc.

We have had a universal system called 'Medicare' since 1984. Even though our conservative party killed off an earlier version of this scheme, it has now been in place long enough that even the conservatives (who in principle don't agree with universal healthcare as a right) have realized that abolishing it would be political suicide!

Every election here when there are proposals for minor tweaks or cutbacks to our health system, the other side screams about 'American style healthcare' or 'a two tier system, just like the US'. Or 'you'll need to bring your credit card to the hospital, not your Medicare card, if you vote conservative'. It is a very effective scare tactic as most people have heard horror stories about US healthcare and have no wish to see us go down that path.

Healthcare here has nothing to do with one's employer. A few years ago when i left a secure government job to become an independent contractor, one of the things I did not have to worry about was how my family would maintain health insurance coverage. Not sure I'd have been able to make that change in the US - though maybe with Obamacare it would have worked OK...

Anyway, I know it's a complicated topic with many different views, and I know every country has its own culture and traditions - what works for Sweden may not work for the US etc. However it is interesting that the conservative side of US politics are about the only people left in the developed world who haven't yet accepted that some form of universal healthcare system is the best option.

I guess it's possible that everyone else in the developed world is wrong, but I'm betting the US will eventually join the rest of us when it comes to healthcare...

Reply
Karen McCann
4/1/2017 08:09:58 am

Thanks so much for your kind words about my brother and for your many insights about universal health care. It is terrifying for so many in my country to think that a single accident or illness could cause medical bankruptcy. And it's incredible to me that the conservatives are still fighting bitterly maintain America's status as the only developed nation without universal coverage. I hope you are right and that the US will eventually come around to accepting it.

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