Commentary––

I’ll Have Some Health Care Please

By William A. Collins

Food or meds,

Please take your pick;

Life can work,

If you’re not sick.

Perhaps it’s a sign of the times. Discount Drugs of Canada has just opened an outlet in Darien, corporate heartland of America. If even those captains of industry want to avoid inflated drug prices, a sea change may be underway.

And when it comes to health care, we could use a few sea changes. The United States has long been swimming against the civilized tide. Germany started the trend toward universal care back in 1883, providing treatment for all its citizens. Most Western nations eventually followed suit, including the United Kingdom in 1946, Canada in 1966, and, of all places, South Africa in 1986. Now in 2003 our president is magnanimously proposing health care for all Iraqis, though not for all Americans.

That’s because in this country health care is looked upon not as a public service, but as a profit center. HMOs and drug companies are the prime beneficiaries, reflected in their enormous expenditures to influence Congress and the state legislatures not to rock the boat.

The result is a health cataclysm. Medicines here often cost several times their price abroad, meaning that many poorer citizens simply can’t take them. Their price has also deterred Congress from including them as a Medicare benefit. Plus finagling with the patent laws has allowed the pharmaceutical companies to fend off many generic substitutes. Self-defense against this profiteering has led to a boom in bus tours to Canadian and Mexican pharmacies. And now we have that outlet in Darien.

But private health insurance is an even bigger curse than private drugs. Bureaucracy now consumes nearly half our treatment dollar, and since the companies exist to produce profits, not health, they devise many ruses to ditch expensive customers. As a result, a study released this month showed that 59 million Americans lacked coverage for at least part of last year. This shame is unheard of elsewhere.

But here in America’s Money Belt, the penalty for this outlandish cost of care takes many forms. Just now the state is dropping coverage for 30,000 poor parents whose kids are covered by the HUSKY program. And even the kids themselves lack dental and mental health care. Hospitals, in turn, are being accused of keeping quiet about their mandate to give stopgap care to patients who have no place else to turn. You can hardly blame them for their silence, since they’d go broke if everyone showed up.

Employers too, are acting in self-defense. Many offer no insurance at all, while others are cutting back on coverage, passing through more of their premiums to workers, or raising co-pays. And of course you may not get hired at all if your health history fails to pass muster. Unions have naturally been fighting this erosion of care, but most folks aren’t represented by unions.

Some states are also fighting back. They’ve set up their own pharmaceutical purchase plans and proposed their own statewide universal health care. But storms from Hades fall on their heads. Lobbyists and lawyers pour in to fight them, as do millions of advertising dollars to oppose their referendums. No plan has yet been completely implemented, though Maine’s has just survived its first Supreme Court challenge.

Needless to say, Connecticut has not been one of those courageous leaders. Neither courage nor leadership is the hallmark of our capital. Our pols prefer to simply accept their corporate donations and not rock that boat. Only the heroic protest of private citizens is fending off dreadful cuts to Medicaid, so relished by our governor. It may be that true reform will have to sprout instead in the poorest states. We’re just too fat and happy here to bother.

(Columnist William A. Collins is a former state representative and a former mayor of Norwalk.)