I love my socialist kidney

[babylonsister]

I love my socialist kidney

We already have a public option. How it saved my life -- and my dad's life -- and how it may one day save yours

By Jennifer Nix
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Sept. 28, 2009 | The day after this country elected Barack Obama its 44th president, a doctor told me I'd inherited from my father a rare form of cystic kidney disease and that I was already in renal failure. Beyond the devastation I felt on hearing this news, and despite having health insurance, my greatest fear in those first, foggy days was one that haunts millions of Americans. I was more terrified of being dropped or denied treatment by my insurer over some minuscule technicality than I was of facing the disease. After four years of progressive activism, delivery of Obama's campaign promise of universal healthcare suddenly became very personal and urgent rather than simply a political goal for me.

A few weeks into my ordeal, however, I learned that my diagnosis qualified me for a little-known existing "public option," or government health insurance plan. The same program had saved my father's life, but I was frankly surprised to learn it still existed despite numerous legislative changes through the decades. Today, almost a year after my diagnosis and amid the disheartening acrimony and willful misinformation pervading our healthcare debate, I can bear witness to what constitutes "socialized medicine" in the United States.

My family's 36-year journey with end-stage renal disease -- the only long-term, chronic disease classification for which the U.S. government provides insurance coverage, regardless of age or income -- offers a telling case study into what once met Congress' standard of an unequivocal, moral imperative to provide public-financed health insurance. My family history mirrors exactly the period from 1973 to 2009, during which this entitlement program has allowed access to life-saving dialysis and kidney transplants, treatments previously denied to all but a very privileged few.

The story of the Medicare End-Stage Renal Disease (ESRD) Program is illustrative of a government plan compelling private insurers to cover more Americans than they ever did when induced solely by market forces or their own good intentions. In today's political parlance, as the president put it in his Sept. 9 address to a joint session of Congress, this translates to a public option that will "keep {private} insurance companies honest." This history also presents a cautionary tale of how profit-driven forces chipped away at Medicare ESRD's effectiveness, resulting in higher treatment costs and worse patient outcomes (compared with those of other industrial nations) for the 506,000 ESRD patients in the U.S. today.

snip//

By the 1960s, dialysis and transplantation were established as effective treatments for kidney failure, which could allow ESRD patients to live full and productive lives. With no funding for long-term, chronic dialysis, however, hospital committees decided who would live and die. These committees looked at age, complicating health concerns, psychological well-being and a patient's "social worth," but because the wealthy could afford to pay for their treatments outright, they were the most often treated, resulting in a class-driven mortality rate. The government "death panels" decried in the hyperbolic rhetoric of today's right-wing anti-healthcare reform fanatics may be imaginary, but in the 1960s and early '70s there really were death panels for ESRD patients.

It was the federal government that put an end to this practice.

"At that time, simply put, there were no private insurers willing to cover ESRD patients," according to Richard Rettig, an adjunct social scientist with the Rand Corporation and a leading authority on the history of the Medicare ESRD Program. "I have a letter from Belding Scribner to Met Life, imploring that company to initiate coverage for life-saving medical treatments for chronic kidney failure patients. Scribner and others went to all the big insurers at the time, and not one answered the call to cover chronic ESRD treatments.

"We had established treatments for chronic kidney failure available, but they were beyond the means of Joe Citizen, and our society had a very real dilemma concerning how to balance proven care against scarce resources," Rettig told me by phone.

But even if he didn't know it back in that summer of '72, my father had reason to be hopeful. By then, after years of activism carried out by advocacy groups, pioneering dialysis and transplant physicians, a growing community of nephrologists, patients, elected officials and congressional staffers, the stars were aligning for the inclusion of ESRD in the Medicare insurance program. The passage of Medicare and Medicaid in 1965 had opened a legislative door, and in the fall of 1971, Congress held hearings on the idea of national health insurance for all. Advocates for ESRD's inclusion in any proposed legislation were well represented, particularly by dramatic testimony from Shep Glazer, then the vice president of the National Association of Patients on Hemodialysis (today the American Association of Kidney Patients), who shared his story while dialyzing right there on the chamber floor.

more...

http://www.salon.com/news/feature/2009/09/28/kidney_disease/

[Justitia]

1. Great article. My son rec'd his "socialist kidney" a month ago. Medicare saved his life too. -eom

[babylonsister]

2. Wow. I'm glad you knew about this program. I hope he is doing well. nt

[LeftishBrit]

3. k&r

All the best to all who need and use this programme - and hoping that there will soon be a similar system for those with ALL illnesses, as in most other developed countries.