RATIONING

I have spoken, on these pages, about the delivery of  Healthcare only to those who can afford it. In a land of such abundance as ours, this rationing is unconscionable. For a stark example, we need look no further than a heart clinic's recent letter to a woman seeking a heart transplant:

"Your medical situation was presented to our multidisciplinary heart transplant committee on Tuesday, October 20, 2018. The decision made by this committee is that you are not a candidate at this time for a heart transplant due to needing a more secure financial plan for immunosuppressive medication coverage. The committee is recommending a fundraising effort of  $10,000....We thank you for the opportunity to participate in your care." 

WTF?! 

This woman has been told to beg for $10K from GoFundMe, a crowd source where, I'm told,  one of three appeals is based on healthcare needs. and this in the United States where the plutocrats have more money than they know what to do with, and yet the leading cause of bankruptcy is healthcare bills.  Alexandria Ocasio-Cortez is dead-on to decry GoFundMe as official policy: "Customers can die if they can't raise the goal in time - but sure, single-payer healthcare is unreasonable." 

Her sarcasm stems from her knowledge that Single payer is in fact the only reasonable healthcare proposal out there. It's based on the premise that there can be plenty of healthcare resources for all -- plenty of medicines, plenty of healthcare providers, and plenty of  money to pay them. Plenty, I say, with one big seemingly intractable exception:  organs for transplant. There are far more patients needing them than there are organs available, and that situation is not likely to change any time soon.

I have a personal interest in this, having inherited a kidney disorder which can lead to renal failure and dialysis, which could shorten my life substantially. By the grace of God, so far I am holding my own in this. Yet should I ultimately need dialysis, I'm sure I'd be better off in many other medical systems than the one under which we currently suffer.  

Eight years ago, there appeared in THE ATLANTIC MONTHLY  an article which shook me up. It was called God Help You. You're on Dialysis. It began as follows:

Every year, more than 100,000 Americans start dialysis. One in four of them will die within 12 months—a fatality rate that is one of the worst in the industrialized world. Oh, and dialysis arguably costs more here than anywhere else. Although taxpayers cover most of the bill, the government has kept confidential clinic data that could help patients make better decisions. How did our first foray into near-universal coverage, begun four decades ago with such great hope, turn out this way? And what lessons does it hold for the future of health-care reform?

It goes on to detail how our dialysis programs are set up for corporate profit, at the expense of patient health, and contrasts it unfavorably with what it calls The Italian Solution, and singles out a town called Reggio Calabria,  dusty and poor, and whose hospital "has the tired grubbiness of a bus station," but whose unit for kidney patients is "world-beating," and concludes:

Other countries provide universal access to dialysis care, much like the United States. But some, notably Italy, have better patient survival and cost control. Italy has one of the lowest mortality rates for dialysis care—about one in nine patients dies each year, compared with one in five here. Yet Italy spends about one-third less than we do per patient.

It's really a terrific article -- though 8 years old, it's more timely than ever!
I recommend it heartily. Here's the link: God Help You. You're on Dialysis   After I read it I figured that if worst came to worst, I'd learn Italian!

But if we should get Single payer health care by that time, I wouldn't have to move abroad.  I might have to reconcile myself to the fact that a younger man with his life ahead of him would more likely to be allotted  a scarce kidney than would an 82-year-old like me. But I wouldn't have to shudder -- as I do now -- that the corporate blood-sucking ghoul of greed  would be stalking our hospital halls,  lurking in corners of our clinics, and standing drooling over the surgeon's shoulder as he cuts open a patient's chest to replace his heart.

Dio

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