A View On Health Care From 2028

NOTE: When it comes to social change, to get where we want to go, we need a vision of what that looks like. Chet describes the differences between the current healthcare system and what it will look like when we win Medicare for All.  – MF

I just had my third heart attack.

Let me tell you about my previous two.

The first was 16 years ago in 2012. After wasting 15-20 minutes with an ER admitting clerk demanding my “insurance information” before I was allowed access to care, a triage nurse hustled me ‘backstage’. I was diagnosed with a “minor” MI stopped by doses of nitroglycerin.

The following day the artery that had closed up was stented. The day after that I was kicked loose to the street. The ‘retail’ cost for my two day stay in the hospital and the procedure was around $250,000. My insurance “negotiated” that down to $22,000, co-pay was $2,200 plus $300 per month for prescription drugs over the next year.

During the procedure, they found that my major heart artery (LAD, the “widow maker”) was over 70% closed. Because of policy decisions designed to maximize corporate profits they did NOT open it up and place a second stent. I was not allowed to weigh in on that decision and instead was left to carry the information about a time bomb in my heart for the next 6 years.

The LAD finally completely closed a little after 7pm on June 9, 2018. The EMTs showed up at my rural farm and did a fine job delivering me to the closest ER within the critical first 2 hours.

But since no ER’s in our area are equipped to deal with serious cardiac problems and thanks to being “out of network” at that ER (only in America), I was warehoused for additional hours awaiting permission from my insurance company for further transport to care. After another ambulance ride to the airport and a helicopter ride to the hospital lawn, I finally signed a release form about 12 hours after the onset of the attack and the artery was opened and stented. The following day I was overdosed with blood pressure meds and nearly expired again. This all resulted in a miserable, sleep deprived 6 day stay in the hospital before I could go home and begin healing. Over the next few months, I received bills for co-pays and uncovered charges that exceeded $6,000 and my heart function was measured at 50% of normal thanks to 12 hours of ‘transport’ killing heart muscle.

In 2021, things began to change.

As advocates have maintained for years, “Would you give up the insurance you now have if the new public plan was guaranteed for life, always providing you with your choice of physicians and hospitals, providing all essential benefits, including drugs, dental, eye, mental health, and long term care, had no out-of-pocket costs whenever accessing health care, and was paid for by progressive taxes that you could afford because they are based on your ability to pay instead of being based on the high costs of care?”[1] Congress and the President were finally forced to reflect our collective answer, “Hell, Yes!”.

Thanks to a People’s Lobby energized by the #ForceTheVote Movement[2], Social Media and various excellent books[3] and financed by $27 per year donations from around point 2 percent (0.2%) of the electorate, HR1384 Style Expanded and Enhanced Medicare for All was finally given a set of honest hearings and floor votes in the House and Senate. Comprehensive, affordable, accessible Health Care as a Human Right was passed in both houses in 2021 followed by President Biden’s signature.

In 2023, we received our Medicare for All cards that completely covered all necessary medical, dental, vision care.

Our victory has had numerous positive effects on our lives.

Due to decreased administrative expenses, cost controls and a fair, progressive tax the total most people pay for Health Care is significantly less than before HR1384. Those former costs included wage increases NOT received, co-pays, deductibles and hidden, surprise charges for “out of network care”. Now all of the additional penalties we were forced to pay for getting ill, injured or older are gone.

The fortunate few who are rich enough to be required to pay a little more have experienced no change in their lavish “lifestyles” but also experience better, more comprehensive care while being free to pay more for more luxurious surroundings.

Now in 2018, there’s only one network as we’ve removed the insurance corporations who were blocking access to care, micro-managing doctors and skimming huge amounts of the “health care dollar” for overhead and profits from the equation. By having one completely accountable payer, we have the big hammer needed to control the corporate greed of the drug companies, medical providers and equipment and supply manufacturers who remain in the system.

For doctors and nurses the oppressive, massive administrative load, costs and pressure to choose the “correct” codes, maximize “throughput” and accumulate billing points for the corporation was removed and they are allowed to practice Medicine full-time.

Those who used to suffer by working on jobs they hated in order to retain their “health insurance” were finally free to find employment that suited them. As a result of this new found freedom, worker owned Co-op businesses have flourished.

In 2019 an estimated 66 million employees and family members “lost” their health insurance due to “losing” their jobs. Now “losing your health care” by losing a job is a thing of the past.

In addition, thanks to decisions now being made by health professionals accountable to the public with the goal of Health Care as a Human Right and needs-based financing of facilities and NOT by corporate CEOs, CFOs, lawyers and bean counters whose goal is ever-increasing quarterly profits, decentralized, full-spectrum health care is more widely available in formerly neglected rural areas and urban neighborhoods.

Another significant result of the success of #ForceTheVote and the People’s Lobby it helped organize and finance was empowering We the People to demand more existentially important, popular improvements.

We were able to force the 279 votes and a signature necessary to cut the Pentagon budget down to an actual Defense Force that equals that of our perceived “enemies” as we negotiate with them to cut global military expenses even further. We also forced the end of the Forever Wars that ‘justified’ the previous bloated military machine.

We forced Congress to rescind most of the tax cuts for the rich that had been passed over the past 41 years. The extra trillions of dollars per year that was added/freed was more than enough to ‘finance’;
1) Tens of millions of Living Wage jobs in the REAL Green New Deal
2) Free college to join Free pre-K to 12 education
3) A Department of Peace engaged in global and domestic Restorative Justice. Creating Friends and healing wounds instead spreading death and destruction to create enemies.
4) A massive reform of the transportation infrastructure from fossil-fueled trains, cars and trucks to sustainably powered electric, solutionary rail and localized shared transportation. This also included replacing most air travel with high speed rail using the old interstate system for right of way.
5) A massive conversion of the built environment away from wasting energy produced by fossil fuels to conservation of the energy produced by cleaner, renewable energy sources. Half of the requirements to deal with AGW/Climate Change; reducing fossil-fuel burning by at least 50% by 2030.
6) A massive reform of replacement of fossil-fueled, chemical infused, carbon emitting Big Ag/Big Meat with Regenerative Agriculture and restoration of wilderness and watersheds to sequester carbon that provides the other 50% of the effort to reach carbon neutral by 2030.

As for my third heart attack. Thanks to better lifestyle choices and easier access to preventive care, it was another ‘minor’ attack (heredity). This time the the EMT’s were able to transport me to a full- spectrum cardiac facility within the critical first 2 hours and as a result I experienced no addition damage to my heart. This time there were NO additional bills for transportation, co-pays, deductibles, “out of network” or the drugs needed to allow the new stent to stabilize.

It’s pretty amazing how much has been accomplished from 2020 to 2028 by recognizing our power to force necessary changes and flexing our collective muscles. But we must remain diligant and maintain the pressure necessary to keep our “representatives” honest and retain the gains we’ve made.

Notes:
[1] https://pnhp.org/
[2] https://forcethevote.org/
[3] Bibliography:
The Systemic Disease: Connecting The Dots: A Roadmap for Critical Systemic Change, Dave Ewoldt
The New Human Rights Movement, Peter Joseph
The Real Revolution: Choosing Earth, Duane Elgin
The Dandelion Insurrection, Rivera Sun – radical is the new sensible
Hate, Inc. Matt Taibbi