Who Runs America? 

Published Circleville Herald 15 September 2010

Nick came to our emergency department when his co-workers became concerned about his left foot weakness making it difficult for him to walk. Nick is my age, just a few years short of the safe harbor of Medicare. We also are both grandfathers  with full custody of  young grandchildren. Nick’s scarred up, oil stained hands testify to his hard, honest work as a diesel mechanic. Nick got up at 5:00 a.m., playing down his left foot numbness and weakness as “must of slept on it wrong.”  Nick and I confide in each other how our health is not just about us, what with so many family responsibilities, young children.

The tragic difference between Nick and I is that my job provides my family with health insurance. Nick is one of those abandoned by our profits-before-people US health care system. His wife vigorously agrees with me that our nation needs Canadian style healthcare , wherein no one is tossed overboard. I share with Nick that I write, speak, plead publicly with my elected representatives constantly for all the worthy folks, just like Nick, that I see in the emergency department  daily.

Nick wasn’t expecting my advice that he be admitted to the hospital for a transient ischemic attack (TIA). I explain that since his foot symptoms have gotten better, he may have had a stroke that started, then got better as a temporary blockage in his big neck arteries cleared up, like when a floating log temporarily dams up a stream, then breaks loose. I explain I don’t know enough about diesel mechanics to put it in those terms, but I am glad we have folks that like him that do know the ins and outs of these engines. The nation’s truck and trains would be in trouble if I was to be in charge of fixing them. I tell Nick I do a little better with people than diesel. Nick laughs.

I explain to Nick that he is at significant risk for a stroke within the next few days.  There was some research in the last several years suggesting that TIAs could be treated in a cost-saving outpatient manner. More recent work, especially since we can now aggressively stop strokes in progress if they are caught in time, clearly indicates hospital admission is the way to go.

Nick signs out against medical advice (AMA). He can’t afford admission to the hospital. The $1,000 to $3,000 bill for the emergency department care will come out of the budget for food, clothing, care for  his family. I tell him he can throw the bills away as far as I’m concerned. Nick and his wife shake my hand firmly, thank me for his care. I can see his wife’s concern for Nick’s health. Nick looks me in the eye. I feel Nick’s embarrassment and anger that his hard knuckle-busting work just isn’t enough in today’s America to guarantee the safety of his family.

I don’t know what became of Nick. I don’t know if he has had a stroke yet. Perhaps luck will be on his side. I pray for his grandchildren. I do know that he is a finer man than all those health insurance company, pharmaceutical company executives and lobbyists, Republican politicians so full of free market theory stupidity, that they can’t or won’t see the human suffering they are directly responsible for.

Who can you trust to tell you the truth about healthcare reform?  Not the insurance or pharmaceutical companies or the attack ads or politicians they buy. There are big profits in the system as it stands, even bigger profits when the Patient Protection and Affordable Care Act (still better than no reform) starts pumping your tax dollars faster than the Gulf oil spill directly into corporate coffers. Money protects itself. Money talks loud. Money lies while cloaking itself in Tea Party values.

Believe the 17,000 members of Physicians for a National Health Program at www.pnhp.org. Believe Washington Post correspondent and author of The Healing of America: A Global Quest for Better, Cheaper and Fairer Health Care T.R. Reid: “The design of any country’s health care system involves political, medical and economic decisions. But the primary issue for any health care system is, as president Obama made clear last week, a moral question: should a rich society provide health care to everyone who needs it? If a nation answers yes to that moral question, it will build a health care system like the ones in Britain, Germany, Canada, France and Japan, where everyone is covered. If a nation doesn’t decide to provide universal coverage, then you’re likely to end up with a system where some people get the finest care on earth in the finest hospitals, and tens of thousands of others are left to die for lack of care. Without the moral commitment, in other words, you end up with a system like America’s.”  (“No Country for Sick Men” Newsweek 21 Sept. 2009)

Who runs America? Is it we, the people, or corporate interests?

--- Brad Cotton

Dr. Cotton is available to talk on health care reform. Contact : roundtownquaker@hotmail.com