http://www.boston.com/news/globe/editorial_opinion/oped/articles/2007/08/05/a_strike_for_better_healthcare/A strike for better healthcare
By Stephen J. Bergman | August 5, 2007
SOON AFTER HMO/managed care came to Massachusetts in the late '80s, I got a call from a patient I had admitted to the 28-day alcohol unit at the hospital. He said that he was being discharged after three days because that was all that the HMO would now pay for alcoholism. He said the HMO representative told him to go out and get drunk again and they would readmit him.
How did this happen? Managed care let it be known through massive advertising that either doctors join up, or be left out -- we would lose patients to HMO doctors. This seemed strange: Doctors did the work; without us, there was no "care" to manage. If we stuck together, we could get what we wanted from the insurance industry. Instead, doctors elbowed each other out of the way to make sure they would "get in." We lost our clout in setting standards for good care for patients, and a work environment that would allow it.
Now, healthcare in America is a national disgrace. Forty-five million are uninsured, most are underinsured -- one illness away from bankruptcy, poverty, or homelessness. Our private healthcare system is worse for patients and doctors and better for the insurance industry. Even the insured are suffering. Their doctors are rushed, mistakes are made, good care is hard to find. Private health insurance spends about 30 percent on administrative costs; government-run Medicare spends 3 percent. The single-payer national model seems inevitable.
Yet it has not happened. The health insurance industry is profitable, and a well-funded lobby. Only one of the presidential candidates (Dennis Kucinich) is sponsoring a single-payer system -- the others are just whistling past the grave of medical care. However, elements of change are arising -- scholars, politicians, media, pundits, and the public, and now Michael Moore, in his new documentary "Sicko," pointing out the relative inadequacies of our system. But one piece, a vital piece, has been missing.
Change will not originate from the top. In any hierarchical system, the only threat to the dominant group is the quality of connection among the subordinate group. This is true of race, gender, class, ethnicity, and sexual preference. In three great movements of my lifetime -- women's rights, civil rights, and the ending of the Vietnam War -- change came from my generation seeing an injustice and believing that by organizing together at the grass-roots level we could right an obvious wrong. And now?
I propose a doctors strike (or a healthcare workers strike, but I can only speak as a doctor). First, doctors would recruit enough colleagues to pledge that if, in two years (say, by July 4, 2009), there is not a federal law for a single-payer, universal coverage health system, we will go on strike.
FULL article at link.
Cross posted in the labor forum.