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I can't help it, if I'm still in love with you.
Nashville, Tennessee, is the country music capital of the world, where you can hear
songs of hard luck and heartache any night of the week. Nashville is the center of another
industry that turns peoples' misery into gold ... for-profit health care.
There are 873 investor-owned hospitals in the U.S. More than half are headquartered here.
So is Caremark, the nation's biggest mail-order prescription retailer. Nashville is home to more
than 300 other outpatient clinics, imagining centers, disease management services and
other specialties -- all start-up medical companies, and they make a ton of money.
Total revenues for the U.S. health industry last year were about U.S.$1 trillion.
"Power to the people, not the government!"
Health-care reform is the principal goal of President Barack Obama's domestic agenda.
These protestors don't want to be forced to buy health insurance. And you can hardly blame them.
Premiums have more than doubled since 1999. Under the health-care bill being debated in
Washington right now, they would have to buy insurance or pay a fine.
And we do not need ... just everybody gets blanket healthcare. We do not need that.
We need our freedom to choose. We don't need the government in our bank accounts, in our
health-care accounts. We don't need any of that.
Actually, it's this company -- HCA, Hospital Corporation of America -- that wound up with much
of the U.S.$2.5 trillion Americans spent on health care last year.
HCA has 163 hospitals and 112 outpatient clinics. For years, the company filed false Medicare claims
with the government. It paid U.S.$1.7 billion to settle the case in 2003. And it's still the largest and
richest hospital chain in America. In the second quarter of 2009, it posted profits of U.S.$282 million.
Those profits are squeezing Americans dry. Since 1980, average incomes in the U.S. have risen
slightly, about U.S.$3,000, but health-care costs have risen three times faster, and now account for nearly
half of the average income of 90 percent of the population.
Health care in America is a commodity for some, an entitlement for others. Two out of three
Americans buy private health insurance through their employer.
But the elderly and the poor are covered by two federal programs -- Medicare and Medicaid.
Forty-six million Americans have no insurance at all, and can't afford any.
A recent study from Harvard Medical School estimates 45,000 Americans die each year
because they have no health insurance and can't get medical care.
What do we want? Single payer! When do we want it? Now!
These people want to take health insurance premiums that go to hundreds of private
insurance companies now and put them in a single fund that insures everyone.
They point to other countries, where public hospitals and government health insurance
is the norm and produces better outcomes at lower cost.
A woman in Canada under the Canadian Health Service has half the risk of dying in pregnancy
as an American woman in pregnancy does. That's intolerable.
But single payer isn't even on the table in Washington because the big players in
health care -- insurance and drug companies, hospitals and health professionals -- have
spent U.S.$3 billion since 2000 convincing Congress to ignore it.
Senator Max Baucus, who chairs the committee examining the issue, is the fourth-largest recipient
of funds from the health lobby. Since 2005, he has received U.S.$3 million in campaign contributions
and Political Action Committee donations from the industry. When this physician tried to talk
to the Senate Finance Committee about single payer, Baucus had her arrested.
I am mad as hell. I've had enough of this. I want to go back and take care of patients.
And the health insurance industry, the way it is now, is getting between me and my
patients in a way that Medicare never does. Give me Medicare for all. I'll be happy as can be.
In 2006, private insurance companies took in U.S.$186 billion. If that money went to
to actual patient care, it would cover more than half of America's 46 million uninsured.
Last month, a group of doctors drove from Oregon to Washington, stopping along the way
to tell people how a single-payer system would work.
Is it going to be harder to go to the doctor when you need to go to the doctor?
It should be 10 times easier. If we had a single payer, everybody in the country
would have all their payments made by the same organization -- a public agency --
and all the doctors and hospitals would all be private. You could choose among any of them.
You would have a universal identification card, just like a credit card or a bank card would be.
That card identifies you. You go to the pharmacy. You give them that card.
They give you your prescription. No charge.
Our fellow Americans are suffering and dying needlessly. That's why I am mad as hell.
The "Mad as Hell Doctors," as they call themselves, spoke to a crowd in front of HCA
headquarters last month. When they talked about money, even the counter-demonstrators
who came to disrupt the doctors' rally grew quiet.
Americans have the dubious distinction of being the only country in the developed world
where people are going bankrupt from their medical bills. It doesn't happen in Canada,
England, Germany, Switzerland, Scandinavia, Israel, Japan, Taiwan. I could go on and on.
All those countries deliver quality health care for much less than we pay for ... and everybody,
nobody goes bankrupt, and they do it for less money.
Losing your job for most Americans means losing your health insurance.
According to the nonpartisan National Coalition on Health Care, unpaid medical bills were the
were the primary cause for 62 percent of personal bankruptcies in 2007.
Having bad health insurance in America that doesn't pay for prescriptions you need
can mean losing your health, and then losing your job.
I can remember calling United on a daily basis saying, "Don't you understand? If this medication
doesn't happen, I'm going to be really sick. I'm going to be out of work.
Everything's gonna go down the tubes." So sure enough, in May of this year, I had radical surgery --
surgery that put me in the hospital for over two weeks, and out of work for two months.
Have you had any trouble sleeping?
If you're poor and sick in the United States, and can't pay for medical care, you can go to a public hospital,
like Nashville General, if you can find one. General treats about 70,000 charity cases a year.
In 2008, that bill was U.S.$65 million. The cost for all charity care in Tennessee last year was U.S.$1.2 billion.
Publicly owned hospitals in the U.S. make up about 20 percent of the total,
but their numbers are declining. Always in the red, fewer remain open to treat the poor.
No single dose of medicine can cure what ails health care in America. Single-payer advocates
say only radical surgery will work. That if you cut out the waste, the fraud and the profit,
there would be more than enough money to pay for a publicly funded health system for everyone.
If Congress can figure out how to do that -- pass a health-care bill that covers everyone and
bankrupts no one -- then people in Nashville and the rest of the country
will really have something to sing about.