Author: R J Adams

Since I came to America ten years ago the cost of healthcare has appalled me. Every doctor visit, every hospital outpatient appointment, not to leave out the horrendous bills for in-patient procedures, results in insurance co-pays amounting to thousands of dollars a year, even for those “well insured”.

You wait with dread for the insurance company’s form to arrive stating the total cost of the medical bill, the amount the company will pay, and the amount outstanding (the co-pay) that is your responsibility. Inevitably, this is closely followed by the hospital/doctor bill demanding payment forthwith.

It’s always been my habit to check the medical bill with the insurance form to ensure the figures coincide, before stapling both together and instructing our bank to pay the outstanding amount.

The Marquette General Health Service, our local provider, has always given good service. Then it sold out. Duke Lifepoint was a relatively small operator when it bought MGHS in September 2012 for $132.7 million. Not a bad bargain for a 276 bed hospital with a host of ancillary departments, including a number of doctor’s offices and a pristine medical center.^[1]

At that time the Tennessee-based Duke Lifepoint, financed by hedge funds, had purchased three other hospitals: the 102-bed Maria Parham Medical Center in Henderson, N.C., an even smaller 50-bed Person Memorial Hospital in Roxboro, N.C., and the 86-bed Twin County Regional Healthcare in Galax, Va..

But it was, according to ‘Modern Healthcare’:

…the July deal for 276-bed Marquette General that was a turning point for the joint venture—signaling its intention to be not only a regional health network, but also a national one, where potentially every region of the country is ripe with targets.

Leif Murphy, executive vice president and chief development officer at LifePoint, said the joint venture has a list of 50 “perfect candidates” to pursue, which he described as having a reputation for quality but in need of additional capital to meet the demands for technology and clinical upgrades. Duke LifePoint, he said, is focusing on hospitals in the southeast region stretching as far as eastern Tennessee and South Carolina, but also major acute-care hospitals that could be located anywhere…”^[2]

That was twelve months ago. Shortly after the takeover my wife developed a serious condition in her right eye. It was the weekend. We rushed to the emergency room. Eventually, she was seen by a doctor, given treatment, and we went to leave. Our passage was blocked by a woman behind a desk in the foyer.

“You have a co-pay of $250,” she rasped, somewhat abruptly.

Rather taken aback, I responded, “We’ll pay it when the bill arrives.”

“You have to pay it now!” she snapped, “It’s expected that you pay before you leave.”

To be brief, I told the good lady we wouldn’t be paying ‘now’, and that we’d await confirmation of the co-pay from the insurance company before handing over a penny. With that, we left.

When the insurance documents eventually arrived, the co-pay was $175, not $250 as she’d stipulated.

Some months later I made a routine visit to our doctor’s office. As I was about to leave, the receptionist informed me I was expected to pay a $20 co-pay. On querying this, she told me “they” wanted co-pays to be paid before the patient left the office.

“Then ‘THEY’ need to learn a hard lesson,” I said, “that ‘THEY’ don’t always get what they want in life.” I left, keeping my credit card in my pocket.

Since this incident I’ve spoken to some of the staff at the Marquette General Hospital. While Duke Lifepoint’s website is smothered in images of ecstatically happy doctors and nurses, on balance, I found those at Marquette were somewhat unhappy. It seems Duke Lifepoint is cutting lots of corners to save money. Equipment is being replaced with inferior quality products; staff morale is sinking fast.

Perhaps the most disturbing comment I heard was that credit card readers were being taken around the wards and sick patients coerced into paying co-pays even before they were discharged.

Of course, its only hearsay. But I doubt nurses and medical professionals would have any reason to state this if it were not true. Duke Lifepoint, it seems, despite the sickly sweet rhetoric of its website, has only one thing on its mind: money. Not that Lifepoint’s CEO has to worry too much on that score. His annual income last year was just under $9,000,000.^[3]

Patients; caring quality healthcare; basic humanity, are all way down Duke Lifepoint’s list, if they’re on it at all.

‘Modern Healthcare’, again:

Durham, N.C.-based Duke [University Medical Center] launched its joint venture with publicly traded LifePoint Hospitals, Brentwood, Tenn., in January 2011 with the acquisition of 102-bed Maria Parham Medical Center, Henderson, N.C…Duke LifePoint marked the start of an aggressive, nationwide expansion strategy for the two-year-old joint venture when it clinched a deal to acquire a hospital on Michigan’s Upper Peninsula.

The addition of Marquette (Mich.) General Health System, 1,100 miles from Duke University Medical Center— which holds a small stake and brings its name and clinical expertise to the venture — also will test whether a university health system could play on the same turf as its investor-owned peers.

Partnerships among for-profit and not-for-profit systems are nothing new — nor is it unusual for an academic medical center to forge clinical affiliations with hospitals hundreds of miles away. But groups such as the Mayo Clinic Care Network, which was launched in 2011 and now has 12 members, are about extending expertise on clinical matters, not ownership…

…LifePoint CEO Bill Carpenter declined to quantify how many deals he expects to pursue this year, but noted that LifePoint has acquired $500 million in new revenue from the joint venture’s four buys with the potential to continue on that scale…”

Is this the bleak future for US healthcare? How long before the doctor’s office receptionist is replaced by a card reader and computer screen on the waiting room wall? Insert your credit card, pay your money, or, sorry, the doctor won’t be available to you this morning.

My last post dealt with the corporate takeover of government. What we, in Marquette, are seeing is the early result of that takeover.

Believe me, it will get worse.

^{[1] “Duke Lifepoint” (For more of the sickly sweet rhetoric)}

^{[2] “Modern Healthcare” January 12th 2013}

^{[3] “Salary.Com” Mister William F Carpenter the Third’s tidy little stash for 2012.}

In the councils of government we must guard against the acquisition of unwarranted influence, whether sought or unsought, by the military-industrial complex. The potential for the disastrous rise of misplaced power exists and will persist. We must never let the weight of this combination endanger our liberties or democratic processes. We should take nothing for granted.” ~ US President Dwight D Eisenhower, January 17th 1961.

The internet is abuzz with comment on the closure of the US government. Much of the feedback relates to the immaturity of those responsible: “Stop playing childish games”; “Grow up and get back to work”; “Wise up and sort out your differences”, are just a few of the public reactions encapsulated by the US media, for once not too removed from public opinion.

Unfortunately, the public are wrong. The events leading up to this week’s government closure have nothing to do with childish bickering between parties. Put simply, the issue is a war between government and corporate America.

Those members of what is colloquially known as the Tea Party, are basically corporate infiltrators into government, working (often unwittingly) to bring down the system on behalf of their corporate masters. It’s common knowledge that the Koch brothers gave birth to the Tea Party and that funding comes primarily from health professionals, the real estate industry, and oil and gas.

Obamacare, while not of itself a major threat to corporate America, is a step in the wrong direction for those who would see corporate government control as the future for this country – if not the world.

In its present form, the ‘Patient Protection and Affordable Care Act’ will probably benefit the health industry, but the fear for corporate capitalists is that it will prove a mere rung on the ladder towards a more social welfare form of health service, and that’s definitely not the way Messrs Koch and associates view the future. After all, they’re working hard behind the scenes to cripple social healthcare services in other countries – particularly Britain, where the right-wing Minister of Health, Jeremy Hunt, has stated publicly that he favors “…the American system of healthcare.”

Already, the British Health Service is in disarray; deliberately starved of funding by the government, reduced to skeleton staffing levels, publicly maligned by the right-wing press in an effort to poison public opinion, while a sudden influx of advertising extols the benefits of private healthcare on British TV screens in a manner never before seen on UK television.

It’s hardly surprising that most of the private health companies now available in Britain are American infiltrators.

This quote, from Pinnacle Care, LLC, a Baltimore company that calls itself a ‘patient advocate service’, with a foothold not only in the US, but also Canada and Britain:

..a growing demand by patients for quality management of health care, more information and personalized attention, and a true partnership with health care providers has sparked explosive growth in the field of patient advocate services not just in the United States, but in Canada and the U.K. as well.”^[1]

It comes as no surprise then that Jeremy Hunt has recently released the UK’s ‘Care Quality Commission’ from parliamentary control. The CQC was a government body responsible for vetting all aspects of health service care, and Hunt’s announcement is surely a first step towards privatizing the commission.

Accompanying Hunt’s announcement, Leader Cameron dropped a bombshell on GPs (family doctors) by informing his party conference this week that doctor’s surgeries will soon open seven days a week, from 8am to 8pm. Dr Chaand Nagpaul of the British Medical Association responded that:

“These additional hours amount to around a 58% increase on current levels and we really don’t have the GPs to meet current demands, let alone an additional 58% increase in hours.”^[2]

No doubt Mr Cameron will be happy to call in the US private sector to assist.

Most Tea Party politicians are likely blissfully unaware of their enslavement to corporate America – as, indeed, are their supporters, happily brainwashed twenty-four hours a day by media advertising, perverted news programs, dip-stick radio-jocks, and the well-paid boot-lickers of Rupert Murdoch on his Fox News TV cable channel.

It begs the question as to why the less depraved members of the US Republican party, otherwise known as the majority – don’t simply vote the Tea Party out of the picture?

The only obvious answer is that they, too, find it advantageous to bow the knee to their corporate masters. After all, they’re not fools, and they’re certainly not children. Their power, as well as that of the Tea Party, is dependent on those who financially support them.

And that most certainly is not the voting public.

^{[1] Pinnacle Care Website}

^{[2] “PM wants longer GP hours” ITV, October 1st 2013}

Rafael Edward Cruz is, undoubtedly, an idiot. But, as idiots go, he’s not particularly outstanding among members of the US Congress. Like many of his colleagues, he’s more enamored of the sound of his own voice, than the quality of his words.

He may well hold his nose. Much of the guff he spouted during his recent Congressional marathon stank to high heaven and beyond.

Frankly, I don’t give a damn what Cruz, or any other American politician, says in criticism of their fellows. They can call each other the most horrendous names, accuse their opponents of a preponderance of foul crimes, or even, as happens frequently, expose themselves sexually on the internet. It all does no more than prove the shallowness of their thinking, and a lack of concern for those poor suckers who voted them into office.

What sticks in my craw is a habit common to many American politicians, that of blackening the names of those they know absolutely nothing about, to gain effect for their otherwise pathetic, childish, and frankly, stultifying speeches.

Senator Rafael Edward Cruz isn’t fit to mention the name of the late British Prime Minister, Neville Chamberlain. His reference to that gentleman as an ‘appeaser’ of the Nazis is insulting to the British and shows a total lack of any knowledge of the period.

Chanberlain’s ‘appeasement’ stigma resulted from political propaganda propagated by a gutter press, both in Britain and America, following his attempts to prevent a European war he knew would prove disastrous for the continent. Chamberlain was feted for his efforts when he returned from Munich on September 29th 1938. King George VI wrote:

“After the magnificent efforts of the Prime Minister in the cause of peace, it is my fervent hope that a new era of friendship and prosperity may be dawning among the peoples of the world.”

It was only in later years, when scapegoats were being sought, that the label, ‘appeaser’ was laid at Chamberlain’s door.

Senator Rafael Edward Cruz has likely never bothered to consider reasons why Chamberlain would seek a peaceful solution to the problems afflicting Europe in 1938. After all, it’s a nice story spun to Americans as cowardice – not something that could happen in America, where the military alternative is the only alternative on the table. You know, like the bully in the school playground who’s as thick as a farmyard full of pig-shit and only knows how to use his fists to win an argument?

Consider why Chamberlain attempted peace by diplomacy before going to war (and it was Chamberlain who declared war on Germany in 1939). The country wasn’t ready for war. Its munitions were in a sorry state. France, the only real ally of the British, was weak, and America – that great land of the free and the brave – like Pontius Pilate, was washing its hands of the whole affair and wasn’t going to get itself embroiled in someone else’s war.

When it came to the crunch, Britain took on Germany, Hitler and the Nazis, alone. According to Senator Rafael Edward Cruz’s history books, WWII began in 1942. Actually, Senator, it didn’t. It began in 1939. Where was America in the intervening years? Surprise, surprise! America was busy appeasing the Nazis by financing their war effort via highfalutin US families whose members would go on to become US Presidents.^[1]

…The debate over Prescott Bush’s behaviour has been bubbling under the surface for some time. There has been a steady internet chatter about the “Bush/Nazi” connection, much of it inaccurate and unfair. But the new documents, many of which were only declassified last year, show that even after America had entered the war and when there was already significant information about the Nazis’ plans and policies, he worked for and profited from companies closely involved with the very German businesses that financed Hitler’s rise to power. It has also been suggested that the money he made from these dealings helped to establish the Bush family fortune and set up its political dynasty…^[1]

Which begs the question: who were the true appeasers?

While we’re on the subject, like most Brits I’m heartily sick of hearing Americans tell us how they won the Second World War for us. By 1942, when Japan made fools of the US by bombing Pearl Harbor, the war in the air over Britain had been won by the RAF. Hitler’s attempt to invade that island by sea had been thwarted. ‘Unternehmen Seelöwe’, (that’s ‘Operation Sealion’ in case Senator Rafael Edward Cruz’s German grammar is a little rusty) was cancelled and the German chancellor instead instigated ‘Fall Barbarossa’ – the invasion of Russia on his Eastern Front. We all know what happened there. Well, maybe Senator Rafael Edward Cruz didn’t make it that far into history while at Princeton, and unfortunately the US history books used in educational establishments are not known for their accuracy.

So, Senator Rafael Edward Cruz, if your fellow Americans are prepared to tolerate listening to the shite emanating from your vocal chords for twenty-one hours and nineteen minutes, that’s their prerogative. No doubt there are some who might even agree with you. After all, it appears the ‘standard’ for US political pundits is to announce the most outrageous lies in the certain knowledge that someone, somewhere, will nod sagely in agreement simply because their grand-daddy belonged to the same political party.

We British – even those of us who live in this country – would be most obliged if you would leave our history out of your rhetoric, unless of course you can provide a truly accurate assessment.

But, then, even if you could you probably wouldn’t dare. It might just cause a rent in the fabric of that American, arrogant, exceptionalism that makes you believe you can stand up and spout the most obscene nonsense and the rest of the world will simply nod slavishly in agreement.

^{[1] “How Bush’s grandfather helped Hitler’s rise to power” Guardian, September 25th 2004}