Sunday, August 21, 2016

Saturday Morning at the Movies: Political Reality and its Discontents

Inforgraphic from
Fix-It: Healthcare at the Tipping Point
   There is an eminently practical solution to a terrible problem that is not an issue in this election campaign, simply because it's considered to be political impossible.  Saturday morning, about fifty dreamers who want to make it an issue, gathered at the Rialto Theater in El Cerrito to watch the movie Fix It: Health Care at the Tipping Point.

The Rialto Theater in El Cerrito,
supported by the generosity of many donors
    Our health care sysem is a slow-motion train wreck.  The U.S. spends 17% of it's GNP on health care, and even with the ACA, that figure has been on the rise — and 1/3 of all health care premiums are eaten up in administrative costs.  Most bankruptcies in the U.S. are due to medical expenses; many of those bankrupt had insurance, but it didn't cover enough.  Health care costs are only around 10% of GNP for the EU, where health care insurance is not tied to employment. They also have a higher life expectancy,

    Single-payer is a practical solution to the health care mess because when a single entity buys insurance for everybody, costs are lower and health outcomes improve.

    And alas, single payer is politically impossible when we're only hanging on to the Affordable Care Act by the skin of our teeth.  The Republican congress voted to repeal the Affordable Care Act (ACA), but last February the House failed to override President Obama's veto.  Hillary says she wants to extend the ACA by offering a "public option," which would compete with private insurance plans.  But unless there's a dramatic change of fortunes in congress, she would need to play defense too.  Donald J. Trump says he would ask congress to repeal the ACA on the very first day of his administration.

    Fix It emphasizes that single-payer saves both lives and money.  The movie was funded by Richard Master, owner of MCS Industries, which makes picture frames and decorative mirrors. The company was struggling to meet annual increases in health care insurance, and Richard decided to try and find out why. He discovered the system was broken, and that in the words of the movie's title, there's a fix.  The movie also features a Republican legislator from Pennsylvania, explaining that single-payer would be good for the economy because it would lower the cost of doing business.  Well, duh.  There's also an interview with a Canadian conservative, amazed that his fellow conservatives in the U.S. cannot grasp this logic.

    As for saving lives, many of us already know sad stories about people who could not afford treatment. One I'll never forget came courtesy of Jean's sister Anne, a retired radiation oncologist and a brain tumor survivor herself.

    Anne was invited to give a second opinion on a man who had been treated by another radiation oncologist for a nasopharyngeal tumor that had invaded his skull. Following that treatment, that doctor found necrosis spots in the man's brain and decided that the tumor had progressed even further. The man was told he had not long to live.

    However, when Anne examined the scans from the first treatment, she saw that his tumor was actually stable. The spots in his brain, all within the radiation fields of his treatment, were not evidence that the tumor had spread. Instead, they were areas of damage caused by the treatment itself, and the way it was given.

    Anne expected the man to be overjoyed when she called to tell him he would live. But she found that from the patient's point of view, her news had a serious drawback. Expected to die, his hospice care was paid for. Expected to live, he had to resume paying for his medications out of pocket. And how in the world could he afford to do that?

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