John and Donna McShane, citizens of Alberta, Canada, spend part of each year on vacation in Arizona in their mobile home. In 2012, while vacationing in Arizona, Donna developed a bad cough; she was advised to go to the Western Arizona Regional Medical Center, in Bullhead City, for an examination. Since she had health insurance from AMA, which is owned by Manulife Financial, both of Canada, there was no hesitation in recommending that she enter this regional hospital for tests.
During her five days’ stay at the Western Arizona Regional Medical Center, she underwent different tests, none of which proved conclusive; and even spent 2 days in isolation on the fear that she might have tuberculosis. (She didn’t.) After a five day uneventful stay in the hospital, she was released, with only a prescription for steroids for her troubles. Her total bill: $105,000!
That’s not the worst of it. Her insurance company, AMA, obviously not wanting to pay the hospital bill, said that, on closer examination, they had “found an error” on the McShane’s insurance application form regarding prescription medication, and as a consequence nullified their policy, making the McShanes, who live on $30,000/year, liable for the entire amount! This is an all-too-common subterfuge employed by insurance companies to keep from honoring a policy where large outlays are to be paid. And, unfortunately, they usually get away with it.
What are the notable points here? First, a simple mistake on an application, found only after a large outlay was to be paid to the hospital, is used as a pretence for cancelling their policy–although no such problem had been detected so long as the McShanes were paying into AMA! But as soon as AMA was faced with honoring their contract, suddenly the McShanes’ application came under the closest scrutiny and—surprise—was decreed wanting.
Secondly, it is nothing short of obscene that after only five days in a hospital—however, not in the ER or ICU, and not involving multiple surgeries, limb replacements, organ transplants, or other expensive, labor intensive procedures—the hospital could charge her $105,000. Given what Donna McShane underwent while in the hospital—or perhaps one should say what she didn’t undergo—such a huge bill is simply incomprehensible.
Years ago I worked in a hospital in the Northwest and became good friends with one of the ER doctors. He was in charge of organizing lectures, at the hospital, for the physicians. For that year’s lectureship, he invited a well-known physician/professor from an Ivy-League medical school who was an expert on hospital pricing. What he said was unbelievable. Costs—the expert used as one example open- heart surgeries—astoundingly, were arbitrarily set—literally “picked out of the air;” in this case a “cost” of $5,000 per valve. Not because it really cost that much—it didn’t. None of the costs he mentioned were grounded in reality. They were simply—incredibly—arbitrarily decided upon.
Let’s examine this $20,000 per day expense more closely. A bed at a nice motel might cost $70/night. That’s a far cry from a hospital’s $20,000 per night, even granted the obvious differences between the two! (Indeed, is there even a super-luxury hotel that charges this much?) Clearly someone—or many people—are making lots of money with these super-inflated costs. As for me, there’s no possible argument that can make me believe that resting your head on a hospital pillow, plus a few tests, could cost $20,000 per diem! By way of contrast, I see my doctors in Korea for about $4 per visit. I had an endoscopy in the hospital for around $100 dollars. I see both my orthopedist and his in-house physical therapist(s) for about $12 combined. These prices put into stark relief the absolute unreality of the hospital’s $20,000 per diem price tag.
When health care is left up to doctors, for-profit hospitals and clinics, and insurance companies, cases like the McShanes are rife; for their sole concern is how much profit can be made, while the health of the patient is always of secondary importance.
This is why health care is one of many aspects of our modern life that the federal government must take complete charge of–contra the Republican party’s no-government-at-all platform—in order to serve the greater interests of the nation and its denizens. Infrastructure, including the development of mass transportation systems and the repair of bridges, gas and electricity for homes and businesses, the funding of new forms of energy, well-maintained streets and highways, conservation, worker health and safety, the establishment of a livable minimum wage, affordable medications, etc—these are some of the areas in which, for the sake of our nation’s health, safety, and welfare, the federal government MUST take control. Corporations, with their eye exclusively fastened on profit, are unfit to control these vital sectors of our common life. The CEO of Exxon/Mobil put it memorably when he stated, “I don’t care about America, I only care about Exxon/Mobil.” In a nutshell, that’s what makes corporations so dangerous.
Aristotle, in his Nicomachean Ethics, Book 1, Chapter 13, states: “The true statesman…wants to make his fellow-citizens good ….” That is, or ought to be, the true aim of every politician. Today, however, the only thing politicians care about is how to make their corporate clients richer, how to extend the corporation’s (and its lobbyist’s ) power into every crack and crevice of our modern life—but clearly not how to make America’s citizens “good.” Yet until and unless we elect to public office men and women who do fully subscribe to Aristotle’s view, such manifest injustice as has struck the McShanes must continue to wreck and ruin the lives of countless others—all the while making the 1% even richer, more powerful, more callous—and more evil!
Goodness or Profit: Democracy or oligarchy: that’s our modern era’s strict either/or. We are in a fight-to-the-death. Either we win and reclaim democracy for America or we lose and become mere slaves of the oligarchic Corporate State. The choice is ours to make.
Len Sive Jr.