Old? Poor? Disabled? Poor Children? Mental Health or Addiction? Our National Shame

Over the last 3 years in Seattle, Washington over 12, 000 people received $10 million dollars in free medical and dental services. The services were provided by volunteer doctors, dentists and social workers, among others. There was a modest admission fee.  Care was on a first come, first served basis only.  Information flyers were available in several different languages.  Dental and vision care were included, but could not be provided completely on the same day.  We should express sincere gratitude and thanks to hospitals, health insurers and the foundation and corporate donors that made this possible as well as the  many physicians, dentists, social workers and other health professionals who donated their time.

BUT, why should we have such events?

We have fought endless fights over health care since Teddy Roosevelt if not earlier. In 1854 when asked for some federal support for the mentally ill, President Franklin Pierce said mental health was not a national problem.  States should take care of it. In 1869 the Supreme Court ruled: “insurance is not commerce” and therefore should be regulated by the states not the federal government.   When Teddy Roosevelt called for national health insurance in the 1920’s it was labeled ‘Socialist.’  He lost that election as a third party candidate.

In the 1930’s, the AMA formed a committee to examine the rising costs of medical care during the Depression.  Doctors and hospitals were the last to be paid after food and housing.  The Committee’s recommendations, however, called for salaried doctors not the prevailing ‘fee for service’ model based on specific services provided. The Committee said the fee for service model was  a major reason for the high and escalating health care costs.  Despite having formed the committee, the  AMA rejected its recommendations, labeling it once again as ‘Socialized Medicine.’ It was not until the Supreme Court ruled in the 1950’s that it actually became legal for doctors to join group practices and receive salaries!

Also in the 1930’s FDR did not include health care in  the New Deal legislation for fear of more calls of   ‘Socialized medicine.’  Adding health care he feared would destroy his hallmark legislation, which included Social Security, among other provisions.

It took an Act of Congress to provide health care to all our seniors (Medicare) and the poor and disabled (Medicaid). It took another act of Congress for CHIP (children’s health insurance program) for poor children. It took an act of Congress to establish the Veteran’s Administration. It took an act of Congress to include mental health and now addiction coverage to be treated like any other health care condition, such as diabetes or hearth disease. We are still fighting about covering both mental health and addiction coverage!  There are even calls now to eliminate a core of basic benefits in all health insurance plans because it was the hallmark of the Affordable Care Act.  Basic benefits are not the cause of escalating health care costs.

What can be so very terrible about assuring at least a baseline of health care for all our citizens?  It is not rocket science. It can be done with both public and private money. It can even be done by having employers participate and let them add more benefits if they wish.  Countries like Germany and France have such models even with insurance companies. But their health insurance companies–like many of ours–are non-profits.

Is assuring everyone baseline benefits with a way for private and public money to pay for health care such a radical notion? Or, do we have to depend on any possibly available charity care for services for some seniors, some disabled, some  children and people who lost their jobs and their industries?

Or are these just disposable Americans who don’t deserve care? 

Kathleen O’Connor (c), October 30, 2017

Additional Readings: Medicare, CHIP, the Seattle event and some short answers to hard questions on opiod and related drug epidemic:

https://www.nytimes.com/2017/10/30/upshot/how-a-republican-idea-for-reducing-medicare-costs-could-affect-you.html?em_pos=small&emc=edit_up_20171030&nl=upshot&nl_art=0&nlid=54404043&ref=headline&te=1

https://healthjournalism.org/blog/2017/10/congressional-inaction-leaves-states-squeezed-on-chip-funding/

http://www.seattlepi.com/local/article/Free-dental-vision-medical-clinic-Seattle-Center-12305513.php?cmpid=nzltr-spi-bn-local

https://www.nytimes.com/interactive/2017/08/03/upshot/opioid-drug-overdose-epidemic.html?em_pos=small&emc=edit_up_20171030&nl=upshot&nl_art=2&nlid=54404043&ref=headline&te=1

About Kathleen

Kathleen O’Connor: 30+ year health care consumer advocate, non-profit executive and author. For more information about Kathleen, please see “About” on the main content bar above.

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One Response to Old? Poor? Disabled? Poor Children? Mental Health or Addiction? Our National Shame

  1. Mary Koch says:

    Not surprising that you’ve provided a concise history and compassionate plea. I believe we’ll slowly get ourselves out of this muddle–the passage of Medicare, Medicaid and CHIP are proof. Sadly, it won’t be a straight line. For every two steps of progress we’ll no doubt regress a step. It will take a long time, and many people will needlessly suffer during that time. I believe we’re in a very long, deep, dark tunnel, but doggone it, I do see a speck of light at the end.

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