Archive | January 3, 2012

My Dying Uncle vs. Ron Paul: A Public Health Disaster in the Works

I’m going to tell a story. My uncle is 52 years old; that’s ten more years than I. When I was a kid he would introduce me to all kinds of amazing 70’s rock and psyche records. My uncle, like much of my family, is mentally ill.

Specifically, he fights severe depression; though through medication, he has been able to maintain a minimal standard of living and assisted my grandfather through his arduously long passing. Like many caregivers, his efforts are little appreciated nor recognized.

After my grandfather passed, my uncle had a job but lost his health benefits. Unable to obtain a new prescription for his depression meds, he started self-medicating through alcohol. Most people in his family are addicts. Little understood is the role that depression plays in addiction. Without anti-depressants, my uncle will drink almost constantly.

Recently, I went to see him. He looked nearly 20 years older than his actual age, was incontinent and hadn’t eaten in nearly two weeks. He subsists off calories from beer. I left heartbroken.

Six weeks ago, I received a call that my uncle had been admitted to the ICU. He had a stroke while buying beer at a local convenience store, fell and fractured his skull. Somehow, he managed to walk home and locked himself in his house. Someone found him and brought him to the hospital, where he was operated on for a brain hemorrhage. He then later had second stroke, fell again, and had to have the surgery once more.

My uncle has since relearned to walk, but has no use of his hands. I must stress again that he has no health insurance. The hospital discharged him since he could not pay. Now, he lives alone in his house, with no power, heat, nor food, he is barely mobile and will never be able to work again.

I tell this story because it fills me with rage. The Republican Party would happily let my uncle die. That we live in a country where basic health care is available only for the rich, and requirements that everyone enter into some kind of health plan are viewed as “Hitleresque” fills me with an indescribable rage. It’s almost cliché to point out that we live in the wealthiest country on the planet (by GDP), yet still can’t seem to figure out how to provide for the health of all of our citizens.

By far, out of all of the Republican candidates, , Ron Paul has the worst suggestions for what to do about the uninsured, let alone what to do about health care in the United States. He believes that insurance companies should be allowed to insure whomever they wish. That no one should be forced to pay for the health care of another individual. That hospitals should be allowed to decide whom to exclude treatment to.

Paradoxically, he believes that the solution to the problem of health care in America is to shift the burden of cost to doctors themselves. He believes that doctors should volunteer their time and resources to assist the poor so that they will stop troubling the rest of us.

Presumably, he’s never asked doctors whether they like working without being paid. Or that most of the cost of health care is for materials and services that do not involve the practitioner. Nurses, for example, are they to work without getting paid as well? Are doctors merely to absorb all the costs of care from their own incomes? If they pass these costs on (as they are now) to other patients, does that not also violate Paul’s ideas of forced remuneration from those who have? Paul, though, waxes nostalgic on health care pre-1965, ignoring the fact that health care was less complicated, less costly, less effective and less accessible in the good old days. But then we should expect no less from bull-headed Ron Paul.

Even worse yet, Paul believes that one of the solutions to health care in the United States is to support “alternative therapies,” such as as vitamin therapy, a movement that believes that massive doses of vitamins can cure cancer. Maybe he also supports aromatherapy?

He even fans the flames of a vast government conspiracy to control the supply of vitamins. What a great idea! It’s cheaper than surgery, and even cheaper than chemo! In Paul’s massively unrealistic world, if the vitamins don’t work, then there will always be a kindly doctor willing to step up and provide multi-million dollar cancer treatments for free to anyone who wants it.

Paul hates the FDA,, who ensure the safety of pharmaceuticals marketed in the US. He hates any hindrance to quackery and the protection of public safety , assuming the free market will weed out dangerous pharmaceuticals. It seems he never considered all of the people that have to die first, or the desperation of the poor who have to balance safety, cost, and the potential for relief.

Paul rightly recognizes that health care is costly, but wrongly believes that the free market will contain costs, assuming that health care is subject to standard models of supply and demand, an assumption that has been repeatedly proven wrong. Have you ever tried to bargain with your emergency room doctor for a better price?

He hates Medicaid, SCHIP, and Medicare. I would venture to assume that he even hates employer-provided health plans, which do not allow individuals to opt-out. In fact, the only insurance plan he seems to support is that of health savings accounts (HSAs).

The math might work out for Paul, but not for my uncle, who skated by on less than $20,000 a year. HSAs are hardly realistic. Even if he were to hypothetically save 2.5% of his income for thirty years (which is nearly impossible, the poor spend everything they earn) and receive a 5% annual interest rate, he would still only end up saving approximately $30,000. He hospital bill well exceeded $30,000 the first night he spent under surgery.

Worse yet, Paul believes that all foreign aid should be rescinded.

This includes successful programs such as the President’s Emergency Plan For AIDS Relief (PEPFAR), which has provided HIV medications for more than 1.2 million people in Africa. Paul believes the private sector should provide these funds and made all kinds of grand predictions about PEPFAR that didn’t come true. Here’s Paul on PEPFAR, spouting the same condescending and borderline racist nonsense that he disavowed from his newsletters:

“I concede it’s very well intended,” Rep. Ron Paul said, “[but] I think if we’re going to be doing any social engineering or social suggestions it ought to be here, and we ought not be naive enough to believe we can change habits that occur in Africa.

In discussion of foreign aid, he ignores that fact that the Global Fund to Fight HIV, TB, and Malaria is overwhelmingly funded by public sources. The private sector provides a little chump change to improve their sales figures (e.g. the (RED) Campaign) but in reality, nothing substantive in comparison to public funding. Please note that Bill Gates is the exception, not the rule.

A Paul presidency would mean that scores of people around the world would die, simply for the crime of having been born poor and not having a little blue passport. It pains me to laud the health successes of the Bush Presidency, however, the Obama Administration has been embarrassingly lackluster compared to Bush, barely mentioning world health issues in his four years in office. I fear that the rise of extreme right-wingers like Paul signals a general indifference of America—and not only to world health issues—and that the day will come when programs such as PEPFAR are lost to history.

Paul’s attitude toward health care is akin to Jehovah’s witnesses who refuse to provide blood transfusions to dying children. He would let the world suffer and die for the sake of a pig-headed adherence to a limited ideology but what else should we expect form the guy who supports nuclear proliferation?

Václav Havel, the former dissident-turned-President of Czechoslovakia who just passed away this past December, argued in his seminal essay, The Power of the Powerless: Citizens Against the State in Central-Eastern Europe, that, “Ideology, in creating a bridge of excuses between the system and the individual, spans the abyss between the aims of the system and the aims of life. It pretends that the requirements of the system derive from the requirements of life.” Unfortunately for my uncle and millions like him, ideology is a prescription destined to fail each and every time. For Paul, it’s a talking point engineered to sell more newsletters and pad his pockets.

Domestically, the health concerns of the poor are not to be heard on the campaign trail. Republican voters simply don’t want to hear about it. Worse yet, conversations about Paul’s health care policy are absent amongst his youngest supporters, who seem to be more concerned about legalizing weed and the waning wars in Afghanistan and Iraq. The young and healthy, it seems, think little about the sick.

Fortunately, Paul will not become President. His ascendency, however, signals that a large sector of America is comfortable letting people like my uncle die.

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