It’s a Chronic Condition
Our current health-care debate is rooted in the 1930s.
By Mary Carmichael

April 16, 2007 issue – Jonathan Cohn has studied health care for more than a decade, and in that time he’s heard hundreds of grim tales­people who skimp on doctors’ visits and skip medications so they can make the rent; patients who died because, as he writes in his new book, they “literally could not afford” to fall ill. That book, “Sick: The Untold Story of America’s Health Care Crisis­And the People Who Pay the Price,” focuses in heart-rending detail on nine of those stories, the kind of which may well find their way into stump speeches in 2008. But it also brings a fresher perspective to the health-care debate, thanks to a second, more surprising source: Depression-era documents that tell nearly identical stories. Then, too, ailing people went without care as politicians and physicians sparred over its spiraling costs. “It’s frightening how parallel the situations are,” Cohn says in an interview. But America isn’t necessarily doomed to repeat its history, as long as there’s still time to learn from it.

Cohn begins his saga around 1910, a time, at least in the medical world, of hope. Doctors had pioneered anesthesia and antiseptics, transforming hospitals “from places where people were lucky to survive to places where people expected to be cured,…”

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“HMOs are all about middlemen raking off dollars from both sides. They have no function except to enrich themselves. Their only role in the health care system is to prevent both health and care.”


From Life and Times:

Toni Guinyard went to Chinatown to meet Dr. Ma.

Dr. Ma is an internist, Chinese-born, California educated and, at times, frustrated with the very health care system he cares so much about. High health insurance rates and low Medicare reimbursements are taking a toll.

Dr. George Ma: I have patients with no insurance or lack of adequate insurance. We want to prescribe a drug. They can’t afford it. We want to do a blood test. They can’t afford it because someone denied it or somewhere along the way, there are roadblocks.

Toni Guinyard: His practice gives us a glimpse inside the world of health care for the uninsured and under-insured. It’s a world forcing physicians to become creative to make sure patients get the care they need.

Dr. George Ma: I do my own billing. My wife chases the bills because most insurance just doesn’t pay.

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