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“The Market” Does Not Work for Health Care


Opinion Contributed by Brad Cotton

There is a reason Republicans failed to pass a free-market based health care plan that works. There never has been, nor will there ever be a free-market solution that provides humane care. The rest of the civilized world knows this. All other advanced nations guarantee equitable care for all—and at less cost.. Perhaps it was the fable of the Old West, perhaps the Marlboro Man, perhaps Ayn Rand that destroyed our sense of community, of Jesus-preached responsibility to our neighbors. We naively believe that the corporate boardroom has a caring heart.

For the sake of my patients I see in the emergency department (ED), for your sake, I launch a continuing set of columns about health care reform. As all questions of public policy are in fact moral and faith value concerns we shall explore nothing but the intersection of  health care reform, religion and politics. In addition to being an emergency physician, I am a Quaker, a faith that has long been centered on matters of conscience, ethics and social justice.

My professional association, the American College of Emergency Physicians, opposed the recent Republican health care reform bills. Fully 90% of my peers report seeing patients who suffered medical harm, became sicker or died from financial barriers to care, unable to afford treatments or medications. The American Journal of Public Health in September 2009 published a Harvard College of Medicine study that conservatively estimates that, prior to the Affordable Care Act (ACA) , nearly 50,000 of our beloved neighbors died yearly as they had no health insurance. The ACA likely halves this carnage. 50,000  died from lack of care, the non-fatal suffering, the families ruined and bankrupted by medical costs are in the millions upon millions. All to protect a failed theology, the conservative theology of the market and limited government. In the ED, we man the lifeboats, we try to rescue freezing swimmers after the “Titanic” has gone down, an apt analogy for our health care system, as on the “Titanic” the rich survived while the poor were locked below decks to drown.

Anthropologist Margaret Mead was once asked what evidence can be found at an archeologic site that the proto-humans being excavated had become civilized. Mead answered that finding a healed femur fracture proved that the primates were human by having demonstrated a sense of community, of compassion, of “neighborliness”. Others cared for, shared their food with and generally looked after this injured fellow for the 8-10 weeks it would have taken for this thigh bone break to heal. I think of Tim, my patient no longer able to speak, no longer able to work as an auto mechanic and care for his wife and daughters. Tim had a stroke because he couldn’t afford his meds. I think of Linda who couldn’t get follow-up care for her gallbladder as her hard work as an office cleaner didn’t provide insurance. By the time she came to my ER she is life-threateningly ill with a septic gallbladder and fever of 104. I think of Mary, the server who suffers all day long every day on her feet as she can’t get her arthritic knees replaced. Soon Mary will be incapacitated. Mary’s crime: her hard work as a restaurant server provides no insurance.

Mead’s tribal society was more civilized than health care in America. In America, if you are not a successful “market player”, you suffer and die. One’s value as a human being has absolutely no correlation with one’s economic “success”. Tim, Linda, Mary were our hard-working good American neighbors. They deserved better.

I am enraged at the injustice of our profits-first US health care non-system. Anger at injustice is not a sin, to not be angry in the face of evil is wrong. St. Thomas Aquinas wrote:  “He who is not angry when there is just cause for anger is immoral. Why? Because anger looks to the good of justice. And if you can live amid injustice without anger, you are immoral as well as unjust.”

We shall continue to explore health care reform, faith, values,  religion and politics in upcoming columns. We shall explore the facts and the science. We will debunk “alternative facts”. I am available to speak to church, community, civic groups on health care reform. I will address in a respectful, factual discourse on these pages all queries in as timely a manner as full-time work and raising grandchildren allows. I shall not insult or call names and shall not respond to “lib-tard”, “snowflake” or other such thought-preventing epithets. My e-mail is [email protected]. I invite you to visit Physicians for a National Health Program at www.pnhp.org, the Ohio Single Payer Action Network at www.spanohio.org and to join us in our Circleville Quaker Meeting, for date, time go to www.circlevillefriendsworshipgroup.org.

Peace to you and yours.