I think that putting my thoughts into a small church blog has a number of advantages that I didn’t consider when I asked to do this. Although one has to avoid adopting a political stance, and I might be a bit more on my guard about salty language, it occurs to me that the UUCCV has no commercial sponsors. There is no doubt in my mind that any reporter in the mass media thinks twice before they criticize the health care industry, as I see their advertisements paraded across the screen between news briefs. And although these companies spend a great deal of money on feel-good commercials touting the care and dedication of their services, I for one doubt their sincerity. The media does report on some of the more ludicrous cases of gouging, such as Martin Shkreli, and sometimes politicians follow suit, such as the recent criticism of Valeant Pharmaceuticals. Nevertheless, due to the incredible sums of money both politicians and the media receive from big pharma, you will forgive me if I feel these are few sensational examples meant to appease an ever more weary populace. So I pray that you’ll give me the benefit of a doubt, rather than picture me in a tin foil hat, if I feel that there are some glaring gaps in the national dialog on health services.
The media as of late seems to fancy the catch-phase “Elephant in the room.” So I would like to make use of it myself, and say that the elephant in the room, in every single conversation in the media and from Washington, is that health care is a for profit industry that is completely and totally a seller’s market. You the reader, would pay anything to keep your child from dying of leukemia or cancer. You would sell your house or spend every penny you’ve saved for your retirement to do so. You would sell the family home to see your elderly parents get the care and comfort that you could not provide to them yourself in their final days. The people selling medical services are quite aware of this, and they price said services accordingly.
It’s been about 13 years now that my maternal grandmother passed away. We all stood in a circle around her bed in her final moments. It had been almost a year earlier that she had signed a no resuscitation order. She had been in and out of the hospital a number of times with congestive heart failure before signing the waiver. The family consensus to this day is that she never fully understood what she was signing. I wasn’t there much through the long months that followed, as my relatives supplemented what care they could actually afford, but I was there as much as I could be. During the time that I was there, there was one thing I was certain of, Ruby Galliher wasn’t ready to let go of life.
It was then that I was struck by the stark fact that an eighty something woman on social security who repeatedly visits a hospital with heart problems, is a drain on the resources of the hospital. Once she signed the order, they immediately put her into hospice care. This meant that the only medications she got were painkillers and the like. My aunts and uncles and cousins were there daily. One had power of attorney and they used up her savings, then they borrowed against the house until that was almost gone. Even though one person had the authority, it was a family decision. We probably wouldn’t have felt so bad about spending what little inheritance we had coming, if the care we were able to afford had been better. What we got were some very part time, not even nursing assistants sometimes.
I spent the week after Christmas with grandma that year. Most of the rest of the family had been caring for her for months, some with full time jobs, so they were ready for a break. I got a taste of what they were going through. Because they didn’t send someone physically strong enough to do it, I was obliged to help set my grandma on a potty chair. Ruby Galliher was a Primitive Baptist and believed that the Bible was printed in King James English, so the experience was far more traumatic for her than it was for me. A few days later I was there with a maybe a nursing assistant, who was doing paperwork on the kitchen table where we used to play Scrabble with grandma. Grandma was on oxygen at that point, and had rolled over and gotten tangled up in her tube. She was not a small woman, and I’m not a strong man, so I asked the assistant to help me, pointing out that the tube had gotten wrapped around her neck, and was in fact choking her. The girl actually ignored me and continued doing her paper work. I ended up having to shout at her to break her attention, and practically pulled her out of the chair. She obviously wasn’t equipped to deal with the situation, but managed to provide just enough help for me to untangle grandma. My grandmother’s fingers and lips turned blue. If you’ve never seen it, an oxygen deprived human being can have parts of their body turn just about the same shade as a cloudless spring sky. It is quite shocking. That is the level of care that a modest, single bedroom home and the life’s savings of someone raised during the depression can afford you.
In spite of it all, and the fact that there was no ambulance to call that night, grandma lived another four months. She got to see pictures of her latest great-granddaughter, born in Australia. For the better part of that time she was awake and lucid. We all got down there as much as we could. The final few weeks weren’t so lucid, but we were there for her anyway. We all stood in circle around her bed when she passed.
I’ve often thought about that girl doing her paperwork. I complained so vehemently and my family was so shocked that the service actually let her go. At first I thought this was justice, and I was very wrong. All that did was leave her without a job, and at that time, without health insurance herself. That is not to say that somehow her actions were justified, or that she shouldn’t have been let go, just that it really didn’t solve anything. I also demonized her boss, who let this and a host of other things happen on her watch. Perhaps that would be satisfaction enough for some, but fortunately I was able to move on past it. The fact of the matter is that, that young girl, who probably couldn’t deal with the fact that there were dying people around her, buried herself in her paperwork in order to deal with the daily horror of her low wage job. She shouldn’t have been there, and likely had taken the job because there wasn’t anything else available.
The fact of the matter was the girl who ignored my grandma on the verge of death was cost effective. As long as she went into la-la land doing her paperwork, well there were fewer resources being paid for, and less labor cost. No doubt her boss did not think in those terms. Rather she was given a shoestring budget and was hiring who she could, and was just trying to hold things together. Even the doctor that cajoled grandma into signing a no resuscitation order isn’t the villain I’d like him to be. No doubt there is considerable pressure to do these things, and perhaps he consoles himself by saying it’s somehow for the best. That is not to say that the behavior of any of these people is laudable, or even excusable.
The fact of the matter is that we have created a system that favors the behavior of the people mentioned above. The fact of the matter is that laissez-faire capitalism does not work for everything and everywhere all the time. With any force, market forces or other, there is an appropriate controlled use, and others that are foolhardy and dangerous. The only force, man made or otherwise, that anyone argues should be allowed to go uncontrolled are market forces. And these arguments are put forth by the bullies of the leisure class, who in fact do control those markets, and their pets in the media. Even through viewing nothing but mass media driven by commercial advertising, anyone of critical thought realizes that laissez-faire is for the disenfranchised, and bailouts and golden parachutes are for the wealthy.
You can have one of two goals; either you put profits first, or you put human care first. You can only have one master, for if you serve one, you will disdain the other. I certainly do have friends who work in health care, who went into the profession to care for people, and they hate what big pharma, lay administrators and insurance companies do. And I certainly have encountered health care professionals who will prescribe you something no matter what, because they get perfectly legal payola and perks from big pharma.
Perhaps the Barely Affordable Health Care Act has improved things since my grandmother’s demise, but for me, it’s no more than triage for a deeply diseased system. What we need to do is assume our individual share of the collective responsibility in allowing this system to exist. We need to look into the mirror, and say, “I am better than this,” and say it with conviction. We need to look around us and say that our friends and neighbors are better than this. We must come to realize that humanity can do better than this. We are better than this.
I do not believe that one grandiose essay will bring about the end of an inherently unfair system, but I do believe that it can plant the seeds of its destruction. Some things were not meant to be profit industries, and medicine is an act of mercy that should be paid out of the public trust for the public good. It should be considered immoral and illegal to make a profit from inventions meant to cure illness, and they should only be priced to cover development costs, and to pay a fair wage to those who labor in their making.
We should work for the day when people who knowingly make a profit from others’ suffering, no matter how removed they are from the scene of the tragedy, are treated in mental institutions, where that mode of thinking belongs. We should work for a day, when making any more profit from medicine, other than a fair salary for people who dedicate their lives to care giving, is thought to be as immoral and as archaic as medieval indulgences. The world can’t be changed in a day, but we can foster an attitude, a morality, that is stronger than the one that currently exists. We can have faith that doing what we believe is right will ultimately triumph, because what we name as wrong is a dead-end path, and cannot prevail. This is a church. Believe. Have faith.
Your Friend and Fellow Member,
Martin S. Stephens
UUCCV: Opinions from Members 
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