is the most shocking and inhumane.”
Introduction/Zoom Orientation with Kem Tetlow
Ringing the Bell
Welcome with Tim Parker
Opening Words with Kem Telow
Chalice Lighting with Melody
Covenant with Kem Tetlow & Tim Parker
Opening Hymn: #146 Soon the Day Will Arrive; Oshana, Shira Oshana by the Chancel Choir, First Unitarian Church of Oakland (See video below)
Of Our Hearts with Tim Parker
Pastoral Reflection with Kem Tetlow
Pastoral Hymn: Singing In These Hard Times by Director's Cut (See video below)
Offering and Invitations with Tim Parker – The offering this month is being shared with the Minister’s Discretionary Fund (link)
Story for All Ages: I HAVE A DREAM Read Aloud from Reading in a Virtual World (See video below)
Wandering the Morass of Health Care: The Rest of the Mess
with Kem Tetlow
Love Our Neighbor: Break the Mental Health Stigma
with Tim Parker
with Kem Tetlow
messes we face -- the state of American health care? Much of my information came from the 2013 Time magazine cover story’ Bitter Pill, the High Cost of American Health Care, which I highly recommend to you.
1. There is health inequality connected with economic class. Instead of the CEO’s of modern industry suffering with higher rates from heart disease, the opposite is true. As was published in 1981, when men in the lowest employment grade were compared to the top administrative grades, the lower grades had 53 percent higher likelihood for angina, 75% higher for EKG abnormalities and in the 7.5 year follow up the mortality rate for the lower economic class was 3.6 times higher than the top rate.
a.) The story with cancer is similar. People in deprived economic areas have later diagnoses, delays in treatments and poorer access to optimal care and overall poorer general health which affects survivability. So economic and social justice intersects here with health care.
b.) And racial Inequities continue. There is a special week in Black History month, called Black Maternal Health Week. Here is the summary from a recent survey of the issue reported this month. “The COVID-19 pandemic along with the growing racial justice movement have highlighted longstanding disparities in health and health care for people of color, including stark disparities in maternal and infant health. (Black women are 3-4x more likely to suffer a pregnancy-related death than Caucasians.) Despite continued advancements in medical care, rates of maternal mortality and morbidity and pre-term birth have been rising in the U.S. Maternal and infant mortality rates in the U.S. are far higher than those in similarly large and wealthy countries, and people of color are at increased risk for poor maternal and infant health outcomes.” (Maternal and Child Health Journal 24, 1093-1098(2020)
2. Health Care costs have been rising steadily since 1960, when it cost 5% of the national income to the Cost of 18% of our national income in 2017. That means it went from 1/20th of national income to 1/6th of the national income in fifty plus years. Or an increase of 3 and half times as much.
a.) In 2017, our health care system spent $10, 739 per person, which was 5 times what the country spent on defense and almost three times what it spent on education. Now I might accept that health care costs three times of what we spend on education after all, schooling only takes 20 years of our lives, but defense—the military industrial complex is being outspent by health care to the tune of 5 times as much. (Personally, I'm not sure that they know this) But what is more significant—is that those ratios are changing as health care costs keep climbing. So whatever we accept as fair today, will be worse tomorrow. And it isn‘t all being spent on care. our administrative costs are complicated by the fact that nationally there are 1,300 insurers and hospitals have to contend with increasing administrative burdens. Medicare’s administrative costs are 2%, while private insurers are at 12%. In January 2020, Time magazine reported that the US spends $2,500 per person on health care administrative costs, while Canada spends $550. The authors estimated that the US could save $600 billion dollars if they matched Canada’s costs. And we are warned by the experts that any system change that preserves all of these private insurance companies without a single payer approach will be doomed to higher administrative costs.
3. Americans are overpaying for their health care, as shown by the “profits” that non-profit medical corporations make. Profits in this sense mean the amounts over the cash expenses. Since they have no share holders, and also owe no taxes, these non-profits spend their excess on new technology and equipment, expanded facilities, higher salaries and bonuses for their executives, etc. And of course the
more equipment you buy, then the more you need to use it. McKinsey found that the more CT and MRI scanners are out there, the more doctors use them. In 1997 there were fewer than 3,000 machines available, and they completed an average of 3,800 scans per year. By 2006 there were more than 10,000 in use, and they completed an average of 6,100 per year (Time article Bitter Pill.)
4. Another way to look at the overpayment issue, is looking at a hospital bill. I'm going to tell you about a bill for 13 days of care for my husband near the end of his life. The total billed to Medicare was $282,751.51. However, Medicare payment was just $16,019.42. And the hospital accepted this $16K as payment in full. Under the law, Medicare is supposed to reimburse hospitals for any given service, factoring in not only direct costs but also allocated expenses such as overhead, capital expenses, executive salaries, insurance, differences in regional costs of living and even the education of medical students. And Medicare takes this seriously and mines the data provided. So where did the $282 thousand bill come from? It’s a system called charge master and it routinely overcharges for everything. If you are uninsured, you could be charged that level of bill. The article Bitter Pill that I mentioned has numerous examples of these high charges.
So far, my quick look at the heath care system has revealed 1.costs are rising more than inflation and taking a larger share of our national income ,2, the poor have poorer health and subject to systemic racism, and 3, we are overpaying for the services we get and 4. administrative costs are excessive. Further study shows that government isn’t helping us. Here are just two laws that affect our costs.
Administrative studies of Doctors practices has shown that doing extra procedures to protect from malpractice suits is widespread. Tort reform of medical malpractice has been studied and widely advocated, such as allowing a doctor to have a reasonable level of care defense but it has gotten nowhere. The last attempt was when Obamacare was passed. The Trial Lawyers Association
pushed back hard and it was defeated from the final bill. And there have been studies and ongoing complaints about the section of the Medicare law, which restricts Medicare’s ability to negotiate lower bulk drug costs with the pharmaceutical companies. Congress says that this helps with the R&D costs that the drug companies have. We need an investigation into that. Other countries negotiate discounts of course.
And it is important to note that the health care industry, including doctors, nursing homes, hospitals and insurers account for the largest share of lobbyists in the US Capital. In fact, the count in 2013 was 5 lobbyists for every congressperson. I doubt its less today. And those extra profits that the hospitals make can go into hiring doctors as consultants and hosting free educational seminars for medical personnel in exotic places, along with paying for those lobbyists. This is where the health care issue intersects with campaign finance reform. Im sure you’ve heard of the comparison studies which show that other
industrialized nations have better health care outcomes than we do, in terms of maternal health, infant deaths, longevity, and of course significantly lower costs.
Frankly, it’s a depressing picture and one that appears incredibly hard to tackle. Now its time to consider the spiritual aspects of our health care system. It is clear that fear dominates it; fear of losing big profits and huge salaries and fear of loss of control for those in the health care industry. For all of us putting up with this system, it is fear of not getting good health care, of being disabled or death itself.
The Acronym for FEAR is Fantasized Expectations Appearing Real (F-E-A-R) There are many ways to combat those expectations such as Developing information, setting up safeguards for those impacted by salary losses when the system changes. .Developing and finding positive benefits from the changes we are needing and developing a community awareness, instead of selfish individualism. As Winston Churchill said, “the only thing we have to fear is fear itself.” It's time to be brave and confront our health care quagmire.
with Tim Parker
Closing Song: Rise Up by Andra Day (See video below)
Benediction with Kem Tetlow
Extinguish the Chalice with Tim Parker
Let's Talk About It
Prelude: “Wake Up Everybody” by John Legend & The Roots
Opening Hymn: STLT #146” Soon The Day will Arrive Shira Oshana
Singing in These Hard Times by Director's Cut
I HAVE A DREAM Read Aloud from Reading in a Virtual World
Closing Song: “Rise Up” by Andra Day