The problem--and the solution--remain.

Got a letter from my dentist last week. What did she want? I'm all paid up, haven't missed any appointments, so why send postal mail? Here's what she wanted to tell me: Use you remaining benefits before the end of the year or lose them! Just one more example of how convoluted, how constipated, our current system is. The principles remain simple: UNIVERSAL. CRADLE-TO-GRAVE. SINGLE-PAYER. Of course, you'll hear the opponents say, "It'll never fly. It's socialism! No one wants the government to control their healthcare. We've got to cut expenses, not increase revenues or taxes! It's too hard!" Sure, it's hard! If it were easy, we would have done it already! Confront the problem and solve it! No guts, no glory! Or--and I like this variation better--"No pressure. No diamond." It's a weird situation: Everyone, in their heart of hearts, knows that the principles above are the answer. It's been the same for the past 20+ years. For the same span of time, though, since many legislators are in the pockets of big pharma and the medical establishment, politics--and, of course, lack of courage--stops them from acting in the best interests of the people who elected them. Time for a change, no?

As I've written before, when healthcare availability and delivery are controlled by people who know the price of everything but the value of nothing, stories like the one below occur. We'll be hearing about similar situations all too often in the near future and beyond: Clinic Rejects Immigrants After Impasse With Hospital By KEVIN SACK ATLANTA — After the collapse of negotiations between Atlanta’s public hospital and the world’s largest dialysis provider, a dozen immigrants suffering from renal failure were refused treatment at an Atlanta clinic on Thursday and advised to wait until their conditions deteriorated enough to justify life-saving care in an emergency room. Unless the deadlock is broken, 22 patients, most of them illegal immigrants, face a debilitating cycle. Rather than receiving dialysis three times a week, as is standard protocol for cleansing their blood of toxins, they must wait until they are in sufficiently serious jeopardy to trigger the federal law that requires hospital care. Dialysis patients said that typically means placing themselves at risk of serious impairment or death. “Trust me, it is just like dying,” said Bineet Kaur, 28, an illegal immigrant from India who was turned away on Thursday morning from the clinic, operated by Fresenius Medical Care. “You are almost unconscious, you know. Even if you are talking, your brain is not working. Sometimes you have to be hospitalized for days or weeks.” As was said in a different context in the 1950s, "Have you no sense of decency, sir?" My mother was on dialysis for several years, and, while she would occasionally skip one of the three required weekly treatments, she knew, as we all did, that to stop dialysis meant death. These illegal immigrants know it, too. Yes, they should have become citizens, but, for whatever reasons, they didn't or couldn't. And, because they have a medical condition that requires three-times-a-week treatment for life, they get an additional penalty imposed. Not only do some folks want to deport them (which, if they were healthy, might be an option), these same people want to withhold the dialysis keeping the immigrants alive. This act would cause cruel and unusual punishment for a somewhat victimless crime: Self poisoning followed by death. You know that old saying: Every 4th house in America will be burgled. So, look out your front door and count down three houses. In other words, withholding medical treatment for cost reasons could happen to anyone in this country. Here's a specific example--from 20 years ago! A doctor told me about a patient of his who went for a routine mammogram. As sometimes happened, the film's resolution was marred, so the facility asked her to return the following week to repeat the scan. The second scan showed no disease. However, when the patient applied for life insurance, the potential insurer saw that she'd had two mammograms in two weeks, and, "reasoning" that she all but had breast cancer, refused to insure her! The doctor went to bat for his patient, and, eventually, the insurance company relented, making a Solomon-like decision. It insured the woman, BUT NOT HER BREASTS!!! And so, the pattern goes in America. We are the only industrialized country that apportions health insurance and healthcare delivery on the basis of whether an applicant can afford it, rather than as a basic right of citizenship. Oddly enough, this rationing drives healthcare costs up much more than insuring the entire population by virtue of citizenship would. Let me know your thoughts.