ACO’s are the price of life

A big THANKYOU to Evie AKA punkfoodbandita,  who has kindly given her permission for us to include this account of the recent Public Lecture by Professor Allyson Pollock, with guests Professors Steffi Woolhandler and David Himmelstein.

More of Evie’s writing is found at https://punkfoodbandita.wordpress.com/

punkfoodbandita

A couple of weeks ago I attended a public lecture at Newcastle University titled ‘Is US style healthcare the future for England? It was held by Allyson Pollock a doctor who is a consultant in public health medicine and director of the institute of health and society at Newcastle University.

She was joined by Professors Steffi Woolhandler and David Himmelstein, two doctors who were advisors to Bernie Sanders and have been long involved in the fight in advocating non profit national health insurance in the US and have travelled to give us a real life dystopian glimpse of what we can expect if we allow this system to be implemented here.

The message all of them gave was clear. The move towards US health care provision is not hypothetical. It is already happening. It’s been a gradual move and one which the government is trying to sneak in without us noticing. They’ve adopted a similar stance that I did, when, aged 14, I wanted to dye my hair blue. I was forbidden outright by my dad, but when I discovered he is so severely colourblind that he could barely differentiate between different colours, I went ahead and did it anyway. He had no idea until one of the neighbours grassed me up, by which time the damage was done. He demanded an explanation and I just flat out denied I had blue hair, despite the evidence of my ears looking like a smurfs and there was a ruined towel stuffed at the back of the airing cupboard that I was praying wouldn’t be discovered.

But this isn’t a bottle of blue hair dye they are trying to sneak into the house. it is accountable care organisations, without it being discussed in parliament and without any consultation whatsoever. And the funny thing about accountable care organisations is that they are anything but accountable.

In fact ACO’s are only accountable to the health insurance company that holds the treatment budget for the population it covers. They dictate what treatments are available and who can get them, which is usually determined by who is cheaper to treat and more likely to recover enough to keep earning money to pay insurance to them. If they come in under that set budget, they get to keep it. What better incentive do they have then to cherry pick their patients and deny treatment to those in need who they deem unprofitable?

There are other signs, too. The NHS act 1946 placed special duty on the secretary of health to provide health care for all. No one could be left out. This duty is no longer in place. We are seeing care services dismantled and hospitals closing, or ‘merging’ as they like to call it as they honestly believe we are that fucking stupid. Here in the north east there is a fight to save South Tyneside hospital A&E, maternity and acute stroke services.

And yet the government tells us that these things are nothing to worry about. That we will still be receiving our healthcare. That this will make the ‘failing’ NHS better (plot twist: it is failing deliberately so we will welcome any odious changes they try to make).That we are over reacting.

Nothing to worry about.

At the moment, 30 million Americans do not have health insurance. This has been reduced from 50 million since the introduction of the Affordable Care Act (or Obamacare as it was nicknamed). In 2016 36,530 Americans died from preventable deaths due to no insurance.

American patients delay seeking help for suspected heart attacks and skip care more often. Patients insured through Medicaid- a state and federally funded insurance scheme for low income individuals and families- are denied or delayed care significantly more than those with private insurance.

And even if you do have private insurance, you’re rarely in a better position unless you happen to be really wealthy. You still have to pay deductibles when you have private health insurance and many of those who have it say deductibles are making their health insurance useless when they are having to pay sometimes thousands of dollars upfront before the insurance kicks in. 60% of those who are medically bankrupt became so despite having private health insurance. Medical debts account for 52.1% of items sent for debt collection.

Americans are now dying younger, life expectancy is falling, the gap between the life expectancy of the rich and the poor is becoming larger, and the US has seen an unprecedented increase in maternity mortality.

But the profits are huge. Health insurance salaries are between 17 and 47 million pounds a year- that’s over $100,000 a day which comes out of their patients pockets. People are dying because they can’t afford medicine while drug company profits hit $67.7 billion a year. David Himmelstein joked that as a doctor he was here to stop the spread of disease. The disease being the greed of private healthcare systems. And he knows a lot about this. In 1996 David was fired by US Healthcare, Inc for speaking out about how doctors are paid more for providing less care and can find themselves unemployed if they don’t. Health insurance companies write gagging orders and the right to fire without any reason into their doctors contracts.

He told us about the Tenet healthcare corporation (formerly National Medical Enterprises) who have found themselves in court for fraud and their horrifying treatment of patients, including unnecessary open heart surgery and electro-shock treatment and for literally kidnapping psychiatric patients, holding them without due reason until the day their insurance expired and then kicking them out on the street.

65% of US hospices are for profit businesses. And we are going the same way, rapidly. Listening to what was being said was nothing short of terrifying. Have a think about the people you love- how many of them have or have had health needs which, if not treated, would lead to an early death? And what would happen if you were told you had to pay thousands of pounds in order to save their life, even if you had insurance?

The NHS is something many of us take for granted. We aren’t angry enough or defending it enough because most of us don’t truly believe that the move towards the US model is something that could ever happen. But it is, it has started. The accountable care organisations are the evidence of it. Civil liberties have never been given to us, they have been fought for and protected by us. The government has already begun its cull of the poor with welfare reforms and sanctions. Now is the time to get involved. It’s not enough that it is left to the usual few activists. It doesn’t matter if you don’t see yourself as being ‘political’. Most people don’t until something happens that makes them realise it is really down to us to look after each other.

https://keepournhspublic.com/ is a good place to start to find out where your local MP’s stand and what events are happening in your area, but don’t be afraid to start your own campaigns. “Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed it’s the only thing that ever has” (Margaret Mead). We still have time to protect the NHS. It is not free health care. It is funded and paid for by us and it is not theirs to sell to the highest fucking bidder or to the company they hold shares with. Do you think our taxes will go down if it is removed altogether? Of course not. It will be spent on MP pay rises. On sprinkler systems for parliament while the rest of us burn to ash.

The government attacks on our NHS is a disease. But we are the medicine.

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