Here Comes Trouble: Stories from My Life

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Donna Smith

Donna Smith, American SiCKO, is executive director of the Health Care for All Colorado Foundation

March 16th, 2010 11:42 AM

It’s Really Quite Simple: Do We Value Each Life in America?

The question is straightforward and simple. Do we value each life? Yes or no.

No matter what Congress passes or doesn’t pass, no matter what the President signs, no matter who buys insurance or has a subsidy to buy it, no matter which person is on Medicaid or Medicare or in the VA system or the Indian Health Service system, we need to answer that question for ourselves and future generations.

Do we value each life? If not, then what are the criteria by which we make our determinations? Clean and clear. How do we decide? Is there some sort of unspoken master race or master class we value more highly? By birth? By religious affiliation? By social strata?

De we value each life? If our answer is no, then we will keep reading reports like the one in the New York Times yesterday about Carol Y. Vliet in Flint, MI. We do not value her life. The brutality of what we are doing to one another is mind-numbing.

FLINT, Mich. — Carol Y. Vliet’s cancer returned with a fury last summer, the tumors metastasizing to her brain, liver, kidneys and throat. ..

Dr. Sahouri informed her a few months later that he could no longer see her because, like a growing number of doctors, he had stopped taking patients with Medicaid. .. ‘My office manager was telling me to do this for a long time, and I resisted,’ Dr. Sahouri said. ‘But after a while you realize that we’re really losing money on seeing those patients, not even breaking even. We were starting to lose more and more money, month after month.’

It has not taken long for communities like Flint to feel the downstream effects of a nationwide torrent of state cuts to Medicaid, the government insurance program for the poor and disabled. ..

Mrs. Vliet, 53, who lives just outside Flint, has yet to find a replacement for Dr. Sahouri. “

I get it. The gist of the story is about the financial woes of the Medicaid program, as administered by the states, and how doctors and other health providers cannot afford to care for people like Carol. I get it.

The clear message in Carol’s story is that we have already answered the straightforward question about the value of life. We’ve answered it thousands and thousands of times every year in the country when our doctors and health providers turn away from treating all the Carol’s in the nation.

This is the part I do not get – and hope I never do. How does a healthcare provider walk away from people who need care knowing the care is available? How exactly does that office manager continue to run the numbers and find Carol’s life too expensive? From a human perspective, how do the healthcare providers’ workers do it? Do they ever check back in with Carol to see if she’s still alive, or do they just find a way to wall off the brutality in which they participate? Nurses tell me they cry, they cry a lot.

I do not understand the mental and emotional gymnastics many people must go through to be able to tell another human being from their own community, their own neighborhood, their own family, that they are sorry but the drug or the treatment we have right here available to some to relieve suffering or even cure a disease is not available to all. Do the people who deliver these death sentences have any sort of training about how to tell others that their lives have been deemed somehow less valuable to us all? Often the job of comforting that patient is left to a nurse. Those who make the final (how apropos) decisions have often washed their hands of the human consequences by that time.

So, let’s start asking not only those in elected office but also our health providers and others in our own spheres of influence, “Do you value each human life equally?” And if the answer is yes then we have to confront the inconsistency in our actions while we are still able to do so. The for-profit insurance giants, the large pharmaceutical companies and the for-profit hospital corporations have already weighed in. All of them find it quite easy to quantify the quality of each life. Since we as taxpayers will be supporting those life and death panelists so heavily with subsidies and the forced purchase of private insurance products, I think we have a right to see the criteria they use in the valuation of life process. Maybe we would find Carol’s life worth sparing.

I do not believe all the good doctors and other health professionals are so callous about life and human suffering that they enjoy that pain resulting from the current healthcare mess. But I do believe that until more of them stand up and loudly say they will no longer sit across from patients like Carol and dismiss them from treatment, they will keep being complicit in the loss of life.

Medicaid patients matter; patients with sub-standard insurance coverage matter too.. Their lives are no less valuable than the office managers’ who calculate the upside-down financial outcomes for their medical practices of treating these human beings. The lives of Medicaid patients are as valuable as the doctors’ lives who hire the office managers who run the numbers. The lives of the Medicaid patients are even as valuable as the lives of the powerful in our society who make the far-removed policy decisions that eventually play out at the patients’ bedsides.

And will our elected officials ever make it to the point where they value each human life enough to extend the right to healthcare to all? Clearly right now we are living in times where a life like Carol’s isn’t even as valuable as the re-election of her Congressional member. That’s how we currently value life.

When we extend the basic human right of healthcare to all in America, we will finally have answered the question in the affirmative. Do we value each life? Under a progressively financed system with a single standard of high quality care for all patients, yes we do. Life matters. Carol’s life matters.

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