(Even more) things we need for real HCR

1. A ban on pharmaceutical advertising to consumers.

It's not impossible. Despite huge pressure from big pharma, every industrialized nation except the US and New Zealand has this ban in place. They also have publicly funded single payer health insurance for all. Coincidence? No.

One thing single payer advocates underestimated is the extent to which the status quo in health insurance/care benefits so many special interests. When Meet the Fricking Press cuts to commercial, three to one it's for some pill. As I've pointed out before, GE sells credit card services to doctors. There is a huge unseen revenue stream from health care in the United States that stacks up against real reform. Until we expose those who benefit from people NOT having access to care due to expense, we will not change the system that allows them this profit.

2. An understanding that the US cannot be the sole source of profit for health care companies, and that this is an international issue.

I really don't know why Lou Dobbs and his minions of anti-foreigner bigots don't get on this band-wagon. One of the main reasons patented pills in the US are so expensive is because they are not ALLOWED to be this expensive in other industrialized nations, whose governments have the common sense to set prices on medicines at the national level. So Americans are not only paying the profit margins for our own consumption, but for those damn Canadians and Scandinavians, too. Don't get me started about the French.

But seriously, companies that manufacture these pills need enough profit to stay in business (and they do employ a lot of people so this is economic, I get that). But the profit needs to be reasonable not outrageous and it needs to be spread out to all nations who make those drugs available. Drug prices need to be negotiated internationally, and the US needs to tell other nations as well as big pharma to get a grip on their greed. Good luck with that.

3. An understanding that insurance does not equal health CARE.

We're coming to this understanding right quick now that health CARE reform is being watered down to INSURANCE reform. I know it's a call-to-arms for the pro-reformers, but I have to mention a caveat on the "so many people die without health insurance" argument, simply because so many people die WITH health insurance, too. And insurance is a terrible, terrible healthcare "provider."

There is something very screwed up when a doctor tells a middle class American woman that one course of treatment is not available to her (as happened to someone I know) because "your insurance won't pay for it."

"How much is it?" the way-too-educated-and-assertive (ha) woman asked the nurse.

"Seventy-five dollars."

She picked up her purse. "I'll take it."

Many, many people don't have this luxury, and that is the pathetic state of healthcare in America. But what if the woman, who COULD afford it, hadn't asked? This situation wasn't life-threatening, but still. The health care system is not only broken because some people don't have insurance. It's broken by a system where insurance or lack thereof makes the medical decisions.

4. A calmer, more rational approach in our own psyches to aging, death, and dying.

This is personal, and we all have to do this work at some point. I'm so tired of hearing the death panel argument, and the "grandma couldn't get a hip replacement because Medicare wouldn't pay for it" (see above on insurance making health CARE decisions). No one who loves an elderly parent wants to Google "surgical risk for morbidity after age 80" but there's lots of hits there, folks. And whether Sarah Palin can use it for her propaganda or not, there are lots of doctors having 'the conversation' with mournful adult kids about how the better part of love is not forcing Grandma into the operating theater.

Of course, as all of US middle-aged types continue to age, it becomes even more personal. I wish fundamentalist Christians would actually take the lead on this, since so much of their effing international policy is based on Jesus coming back to earth, the rapture, etc. Why not come to more of an acceptance of "passing on"?

Too much to hope for?

image from here updated by me.