Guest commentary: Obamacare — Greed and Health Care gap

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By Rodolfo F. Acuña / Guest contributor

In the John Grisham’s 1995 novel The Rainmaker, Rudy Baylor, a graduate from Memphis State Law School, is about to take the bar. While waiting for the bar results, he becomes an ambulance chaser. One of his clients is a poor family, Dot and Buddy Black. They have an insurance claim that could be worth millions.  Their son, Donny Ray, is terminally ill with leukemia that a bone marrow transplant could cure — his identical twin brother is a perfect match. Great Benefit Life Insurance routinely denies claims, and is backed by cadre of ruthless lawyers headed by Leo F. Drummond. The motive is profit; Great Benefit plays the odds.

In a David and Goliath story, Rudy beats Drummond and gets a judgment of $50.2 million. However, Great Benefit goes bankrupt. Rudy becomes disillusioned with the law and quits the legal profession. The Rainmaker was later made into a movie starring Matt Damon and Claire Danes.

The tendency among Americans is to read or watch stories such as Great Benefit Life Insurance and conclude that they are aberrations. The Rainmaker after all is fiction – it is a book, a movie, and Americans to read about injustice and procrastinate.

Euphemisms and satires have always been a popular method to attack power and corruption. It disguises the views of the author. For example, William Shakespeare often used it in his plays to attack the powerful. During the 17^th and 18^th centuries Luis de Góngora, a Spanish Baroque lyric poet, employed a style called culteranismo. Las carpas mexicanas, traveling troupes, used farces to mock the government and corruption. Luis Váldez took it to a new height in the founding of the Teatro Campesino.

However, American society is so full double speak that it is difficult to separate the tale from reality. Americans laugh at the absurdities or as in the case of The Rainmaker, bite their nails and later admit to similar experiences with insurance companies or the medical establishment, but when pressed they say you can’t do anything about it.

They even resent comparisons of the American medical care to Wall Street, an industry based on Gordon Gekko’s principle that “Greed is good”. Liberals get insulted when you say that Obamacare has done very little to correct this inequity. Like Wall Street insurance corporations are too big to regulate.

The quality of health care depends on how much money a patient has. Witness the absurdity that 26 million residents of this country will not be covered by Obamacare. But still many liberals insist on comparing it to Medicare.

I have been accused of playing the race card for saying that my opposition is based on the fact that a large number of Latinos will be excluded. The truth be told, Latinos are the least likely to be covered by health insurance in every state of the union. Some 11 million undocumented Latino immigrants in the United States will go without health coverage even after the implementation of Obamacare.

The insidious part is that it divides the Latino community much the same as green card have, creating two Latino communities. In California where undocumented people can get a form of Obamacare, immigrants are weary of applying. They don’t trust the government. Support for the act is among those with green cards or citizenship.

Obamacare favors the large insurance and pharmaceutical providers at the expense of doctors. It is logical that if we want to save money, cut the middle man. Instead the government pays $8,233 per year per recipient, more than two-and-a-half times as much France, Sweden and the United Kingdom.

The logic is idiotic. Americans who say the cost may be unfortunate but the U.S. has “the best health care in the world.” But do we?  I learned that I had diabetes in Cuba where I went into a semi-coma. I was treated free of charge and received excellent care. I have received near free medical care in Mexico ($5), Spain (no charge) and Germany ($2). But if citizens of those countries come here, they pay through their noses. In the case of the undocumented, most pay taxes that are never redeemed.

The principle beneficiaries are Health Maintenance Organizations (HMOs) that did not exist before the 1970s. The result is that they have lessened the control medical doctors and put medicine in the hands of hospitals and the insurance industry – following the American principle that “Greed is Good!”

Like Emilio Barzini, a head of the Five Families in The Godfather (1972) argued at a meeting of the capos “If Don Corleone had all the judges, and the politicians in New York, then he must share them, or let us others use them. He must let us draw the water from the well. Certainly he can present a bill for such services; after all… we are not Communists.”

Just as the capos blamed African-Americans, Americans blame the poor and the immigrants for the rising cost of health care. Instead of expanding Medicare, and creating a single-payer health care system it has cut the capos of the health industry in.

“We are not Communists” so in 2010 the U.S. spent $8,233 on health per person. Norway, the Netherlands and Switzerland spent at least $3,000 less per person. The average member members of the other 33 developed OECD countries spent $3,268 per person for health care. The U.S. lagged behind other nations in hospital beds per 1,000 patients; it had less practicing physicians 2.4 physicians per 1,000 people compared to 3.1 for the other OECD member states.

But “We are not Communists” so we share with the other capos and spend nearly $900 per person annually on administrative costs. France spends $300 per person.

Who profits? Corporations don’t pay for medical research, the taxpayers do. Corporations profit from the grants and once the product is developed sell it at a profit. You would think that they owed the taxpayer. No that would be communist.

If you have ever been to an emergency room, the first thing they ask you is if you have insurance. Just as in the case of education and government itself, the medical industry has been privatized and more and more hospitals are for-profit, and as one critic put it “the opportunities for patient manipulation and exploitation are endless” as the physician-patient relationship is eroded.

Does Obamacare address these problems? Who will be affected? Well, we are not communists so the rules are twisted. Like urine it will not trickle down to the base. In California you can get Medicaid and receive a subsidy, but that does not insure you the same quality as a person with money. Your choices diminish considerably when enter the Medicaid ghetto.

Lastly, have you ever filed a grievance against even a high end insurance group such as Kaiser Permanente? You will encounter the same bureaucracy as Donny Black did with Great Benefit Life Insurance. All grievance procedures are handled internally, the reviewers are staff members. From personal experience I know that it takes a hundred hours of phone calls, grievances and complaints all handled internally without you seeing a physician. You will eventually appeal to the state which is capo friendly. Can you imagine what a person with limited English will go through, that is if they get coverage?

Mexican and Poor People Need Not Apply! My refrain is answered by, “Rudy, the glass is half full!” Is it?

A Gift

Every time I come out with a new edition of Occupied America, I feel guilty. The cost of books has gone through the roof. For this edition I wanted to say thank you so I am posting online a 194 page Student/Teacher Manual—or, as I call it, the “Mini-book”—that is over 194 pages. It is designed to accompany Occupied America, it is also meant to guide the students through Chicana/o history as well as periodically refresh their knowledge of the field. The manual also makes Occupied America and the field of Chicana/o history more online friendly for teachers and students. It makes heavy use of the internet. If the hyperlink is down, please email me to Rudy.Acuna@csun.edu. It is available free of charge at http://forchicanachicanostudies.wikispaces.com/Acu%C3%B1a%2C+Occupied+America+Student+Teacher+Guide  It is also available on the link for Center for the Study of the Peoples of the Americas (CESPA; http://www.csun.edu/cespa/Acuna%20Manual%20Binder.pdf It is not much but perhaps it will facilitate more Chicana/o History courses and your learning.

For those who have an extra $5 a month for scholarship