Health Care Reform: No Public Option = Passive Eugenics, an Open Letter to Tom Daschle

It is with some despair that I watch the goings-on in the health care reform debate. I truly believe that this historical period is not only our best shot at real reform, but most likely our only shot, and it is enraging to watch the influence of the health insurance lobby, physician’s lobby (AMA) and other powerful special interest groups frame the debate. Our current system of care amounts to passive eugenics, purposely weeding out the sick and allowing them to suffer and face untimely death because they are a ‘drain’ on society–or more accurately, a drain on health insurers bottom line. Isn’t that exactly the same rationale eugenicists have used for decades to support their vile policies?  Tom Daschle narrowly avoided nomination as Secretary of Health and Human Services and I think we should count our blessings. His recent comments support opponents of a public option for health care reform expose his true motivation and a health industry lobbyist and demonstrate the conflict of interest that is poisoning the opportunity for real reform.

Open Letter to Tom Daschle:

This morning I took a call from a patient who is a member of the organization I work for. She has a 7-year-old son who is rapidly losing lung function and is heading for transplant if this disease progression can not be managed. Her physician ordered an inhaled drug, Pulmozyme, to help him get rid of excess secretions in his lungs and hopefully cut down on the nasty infections that are scarring his airways. Pulmozyme is a patent-protected drug with FDA approval to market. However, the bulk of the testing done on Pulmozyme was done in cystic fibrosis and the market approval was for that condition only. Because the evidence for efficacy of Pulmozyme only exists in cystic fibrosis, insurance companies often deny this drug to individuals with similar need, but a different diagnosis. The prescribed dose of Pulmozyme for this child costs $2,100 each month. Even with insurance coverage, the co-pay for Pulmozyme for this family would run $300 to $500 per month. Pulmozyme is one of seven medications this child takes and some of them are even more expensive. He does not qualify for Medicaid because he is not yet “sick enough.” What exactly do you propose as a non-public option for people in this situation? They simply can’t afford the medication, so their ‘option’ is to watch their son get sicker and finally succumb to symptoms that are treatable.

This is the reality on the ground. Over-priced drugs and therapies, niggling rules imposed by the insurance company to avoid having to pay for over-priced drugs and therapies and a dismissive attitude by society that assumes having insurance actually means you can afford health care. If this is the nightmare faced by those with insurance, imagine what is happening to those of us without.

So, congratulations. By your comments endorsing the position of the Republicans opposed to a public option, you have just endorsed the continued misery of millions of vulnerable Americans who don’t nicely fit the actuarial models of the insurance industry.  As someone who currently can’t get insured at any price because of a well-managed chronic illness, it disgusts me that–once again–the very people who created the problem are going to benefit most from the solution. I am tired of patiently waiting while people with no stake in the game–elected officials and others who are both wealthy and well-insured–debate whether I am deserving of health care at all and watch families fall into financial ruin as they try to secure care for their children. To allow the same industries that feel no remorse about decisions to deny necessary health care to certain people based on actuarial models–literally life and death decisions distilled to a simple calculus about impact on the bottom line– more of a voice in this debate than American citizens is an outrage. As far as I’m concerned, you and others who oppose a public option are guilty of passive eugenics, sitting by while private industries decide which American citizen is entitled to care, knowing full well the current private insurance model leads to preventable illness and untimely death.  To assume these industries will suddenly become good actors, more concerned about American health and prosperity than their own greedy bottom line, is ridiculous.  To expect them to do so after watching the government cower under pressure from their lobbyists is obscene

It is clear that many people involved in this debate have no actual idea what is going on at the grassroots level. I have heard talking heads, including elected officials who should know better, suggest that the uninsured and underinsured ‘choose’ not to have coverage. That may be the case in a very small minority, but the vast majority of us either can’t get insurance due to a pre-existing condition or can’t afford the outrageous premiums. Under the current system, not only are you penalized for medical conditions over which you have no control, but you are doubly penalized for attempting to responsibly manage your health with your medical records serving as the basis for increased premiums or outright denials of coverage. It is legalized discrimination. To suggest that the average American, who these days is having trouble just holding on to his/her home, should find a spare $1,200 – $1,500 per month lying around for premiums, plus be able to foot the bill for co-pays, is just plain ignorant. The ‘option’ to pay for insurance (if you are lucky enough to be deemed insurable at all) that costs 1/3 to 1/2 or more of your total monthly income is no option; it’s a recipe for financial disaster.  Haven’t we had enough of that already?

Your suggested alternative, shifting the burden off the federal government and instead onto state and local governments that are already broke and have far fewer resources, only ensures that the goal of covering all American’s will fail. You must surely know this, so this plan is exposed for what it really is, a way to sustain the status quo with private industry actually calling the shots, while appearing to make an effort at reform. This is an insult to those of desperate for real reform.

Our elected leaders managed to overcome their differences and find a ‘public option’ for banks and other industries. It is about time they find their collective will to do the same for the American people.

Mickey Musing

Phoenix, Arizona

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