Health "Care" and Profit Are Not Interchangable Words

Good morning good folks, it is the start of the week and almost every news story, and on the front pages of most news publications is the latest buzz about President Obama's Health Care reform package and it's purposed cost savings of two trillion dollars over the next decade. Though if you read past the headlines, as nyceve did and then wrote on DailyKos, the headlines maybe all hype with no substance. A person writing under the name of National Nurses Organization talks also about the anger directed both at Obama, but with Max Bacus (D-Neb), chairman of the Senate Finance Committee being the main target of rath for his exclusion last week of any real health care experts at his hearing for health care reform. His so called panel of "experts" all were representatives of health Corporations and insurance industry shills, the very same folks who brought you a Bush Administration "drug plan" which does not allow for price negotiations.

Most disturbing of all was Senator Bacus' lead off expert, Rick Scott, Chairman of the group Conservatives For Patent's Rights. For those of you that don't know Rick Scott, he is a lawyer who was George Bush's friend, and co-owner with him of the Texas Rangers. He also started Columbia HCA, which he ran until 1996 when he was forced out by the Board of Directors, just two years prior to Columbia HCA being investigated and fined $1.7 billion dollars for fraud against medicare. In addition to that, as reported in today's Washington Post, this same Rick Scott is heading up the effort to sink the health care reform effort started by the White House. That's right, Rick Scott is using $5 million dollars of his own money, and another $15 million dollars raised by supporters to "stop any effort for a government run health care program". He has just hired the PR firm responsible for the "Swift Boat" ads that ran against Kerry in the 2004 election, and you remember that darling American couple on TV in the 1990's called Harry and Louis right? The couple that basically sank health care reform under the Clinton Administration.

The spin coming out of Congress and the White House lately is a complete smoke screen and belittles the idea of any real health care reform. The idea that you can have a greedy health care profiteer testifying as a so called "expert" on reform is assine. The same person though never charged basically led his company into one of the biggest health care rip offs ever known, is now telling us what to do to cut costs and change our policy so that health care is nor available to everyone? Yet in this hearing no doctors, nurses or actual health care providers were there to present their ideas for health care reform, and there was no consideration even given to "universal health care". What we are seeing here is the actual dressing up of a pig with lipstick, and with no real goal of change or reform.

Along that same line of thought is to see the lead legislative effort in the Senate on health care reform is not through any committee or subcommittee that deals with health care issues, it is being directed by Senator Bacus, Chairman of the Senate Finance Committee. Is the plan here to insure that health care is legislated into being a completely for profit industry? Depending on which article you read Senator Bacus has been bought and paid for by the Pharmaceutical industry, and the Health Insurance industry having received any where from the most campaign contributions from this group, to the third most contributions from this group.

So out of curiosity, I looked up the definitions of both care and profit. What I found (but already knew) was the two words were by definition mutually exclusive. Webster's online dictionary defines care as:

Main Entry: 1care Pronunciation:
'kerFunction: nounEtymology: Middle English, from Old English caru; akin to Old
High German kara lament, Old Irish gairm call, cry, Latin garrire to chatter1 :
suffering of mind : GRIEF2 a
: a disquieted state of mixed uncertainty, apprehension, and responsibility b :
a cause for such anxiety3 a : painstaking or watchful attention b : MAINTENANCE
4 : regard coming from desire or esteem5 : CHARGE, SUPERVISION (under a
doctor's care) 6 : a person or thing that is an object of attention, anxiety,
or solicitude.

Webster's then defines profit as:

1prof·it
Pronunciation:
\ˈprä-fət\
Function:
noun
Usage:
often attributive
Etymology:
Middle English, from Anglo-French, from Latin profectus
advance, profit, from proficere
Date: 14th century
1: a valuable return
: gain 2: the
excess of returns over expenditure in a transaction or series of transactions ;
especially : the excess of the selling price of goods over their cost3: net
income usually for a given period of time4: the ratio of profit for a given year
to the amount of capital invested or to the value of sales5: the compensation
accruing to entrepreneurs for the assumption of risk in business enterprise as
distinguished from wages or rent.

Of special note was the second definition of profit, "...the excess of selling price of goods over their costs." That says it all right there. As a professional health care worker my job is not so simplistic. Theoretically if I was in this profession for the money, I would do for my patients what is minimally called for in as little time as possible to increase my profitability. The more patients I cared for the more i would make. Conversely the least I provided them would also affect my profit margin. This of course is what is going on in today's health care system and why it is so broken in the way things get done. Insurance companies are for profit so they will many times deny, try to downgrade quality of care and use any tactic that will ensure a greater profit for themselves and their share holders. This of course impacts on the bonus compensation the chief executives get as well. So in the end you are getting bargain basement care so that several folks who have nothing to do with your health care get huge pay offs. These are the people you expect to lead the way in health care reform? Surely you jest.

Where are the people who work in health care? These are the one's who know and can give you both sides of the picture. Who do you think submits the forms for reimbursement from the insurance companies. Who do you think works the case management for both sides of care in this picture? Both for the insurance companies and the insured? Nurses and physicians. Who do you think has watched a love one suffer from a debilitating illness, only to have their claim denied for treatment by an insurance company? Why a family member or even the patients themselves. Yet where are they in the "round table" of planning? No where, no where at all.

There is another piece of this discussion that is also missing, a piece that was brought up by a physician I work with just last week. Medical malpractice. That in and of itself is an industry for the legal profession, and contributes a great deal to the rising cost of health care. Need a clear example? Look at what has happened to the practice of OB/GYN. Many areas you cannot find an OB doctor because of all the frivolus law suits that have been filed against them. Mommy has a crack cocaine addiction, bay is born with birth problems and your lawyer knows "for sure" that at least one of those problems they can lay at the doctor's feet. Never mind that mom was getting to high to make it to nutritional classes, it's the doc's fault for not educating her.

We are not talking about gross negligence here such as a patient going into surgery for amputation of their right leg but ends up getting the left leg amputated instead. We are however talking about serious tort reform and the weaning from a culture that looks to "get rich quick" through the courts. While we are at it perhaps and standardization of all medical forms required by both the hospital and insurance company? Wouldn't that help lower operating prices? This all comes from administrative and legal beagles, not licensed health care professionals. As my doctor friend noted, lawyers think they can regulate and to some degree practice medicine, yet when you look at the cases of Judge Bybee, and John Yoo, lawyers can't even regulate themselves.

Lies and misrepresentations are being put forth by the Conservatives for Patients Rights when it comes to single payer health care. No, that model is not perfect, but health care wise with successful patient outcomes it is better then the system we are under now. When you use scare words like "socialistic" to degrade and discredit something that all people should have a right too and access to, then right there you have shown yourself what a filthy greedy, lying, money grubbing SOB you really are. Health care is not a "business model", it is a "people first model" because the area we deal with are in the terms of "peoples lives" and has no measurable monetary value.

Any discussion of health care reform without that acknowledgment up front is a discussion of a fantasy story where things happen with the wave of a magic wand, and people living "happily ever after". We know those stories are fairy tales, and that is what is happening now before our very eyes. People like Senator Bacus need to be taught a very basic lesson, and I include Mr. Compromise, President Barack Obama as well. An industry may fill your pockets with plenty of cash, but that cash does not represent the people who pull the lever to vote. We are the one's you are leaving out of your "planning" and yet it is us to whom you are answerable and serve at our pleasure. Keep it up Senator Bacus, go ahead President Obama forget you campaign pledges. Both of you can become quickly unemployed in 2012.

From someone who loves his profession,

May 11, 2009

Richard R. Mayfield, RNC, MS