Several weeks ago, a tragedy occurred in Greenfield that should resonate with us all. A 63-year-old veteran took his own life in a public way. For some time, Daniel Dowd had been seeking treatment at the Franklin County Recovery Center and was not accepted. He finally lost hope and gave up in a way that may sharpen attention upon our health care insurance system and how it drives some to despair.
The Recorder article explains that “(Dowd’s) core complaint focused on the center’s apparent inability or, in his mind, unwillingness to take him into its detoxification program.” The reasons for this may be various but one is certainly the current state and influence of the nation’s health insurance industry — an industry that is mistakenly but intentionally referred to as a health “care” industry by those who support it. But health insurance is not health care.
Many, of course, object to this characterization and the suggestion that our nation’s insurance “system,” systems are usually systematic, not erratic, may have had a central part in the death of Dowd. Some blame the detox center or those employed there, but whether there were mistakes made by the center or not, I think a valid argument can be made that the largest factor by far are the effects of our health insurance laws. The detox center is hamstrung by the limiting factors of the laws it works within.
As a matter of fact, the statistical content of The Recorder article suggests the significant role the insurance system played here. Of its 1,393 words of reportage explaining the basic questions posed by the incident, 48 percent had to do with insurance.
For instance, consider this from the article:
“Just how the center operates and who it can accept has been a prominent point of confusion following the suicide. It isn’t a state-funded facility but relies on private insurance and Medicaid money to keep its doors open.”
With a universal, single payer health care system this would not be at issue.
Or these statements which speak to the hodge-podge nature of what exists now:
“In fact, having zero insurance is better than having the wrong insurance,” Potee said. “But once you have insurance, you can’t pretend to have zero insurance. That’s fraud.”
“We try to contract with every insurance provider out there,” Darcy said. “Some of them just won’t pay for detox services.”
“Most of (the Recovery Center’s) patients arrange admission by telephone, so that when they arrive, insurance issues have already been resolved. But if someone wants help and walked in at night or on the weekend when the center administrative staff isn’t available to check insurance … the person might be admitted temporarily. When the immediate treatment is concluded, if the insurance does not check out, then the center will refer that patient to somewhere that does take his or her insurance to continue the care.”
Again, these problems would be gone with single payer.
And finally, there’s the contradictory demands and circumstances our present system places upon hospitals:
“Hospital ERs are obligated to provide that care with or without insurance, often losing thousands of dollars in uncompensated care (and driving up health insurance costs for others).”
But there is one more statement in the article that is central to the recent tragedy. Sheriff Christopher Donelan, another opioid task force co-founder, said he hopes to work with the task force to push state officials in Boston to consider changing rules.
“Let’s focus on the crisis first and the insurance second,” he said
This, certainly, is exactly right. But immediately following that particular focus should be a national non-ideological, non-insurance industry driven commitment to create a health care system in line with the established and successful systems of most developed countries.
In this light, what the ACA tried to do was to insure as many Americans as possible despite the political morass created by (largely) Republican obeisance to the insurance industry. It put in place what it could under the political circumstances it faced and went a long way in doing that successfully. Whatever its flaws, they are significantly the effects of obstructions put up by lobbyists of insurance corporations made effective by Republican intentions to make the ACA as flawed as possible. The consequent insurance cob-job we’re stuck with, this profit-driven system, is about life and death for millions and, arguably, has more to do with Dowd’s frustration and loss of hope than the consequent actions of the detox center.
Jim Culleny lives in Shelburne
Falls, works in construction, is a singer/songwriter, and has done commentary for National Public
Radio. His email address is
jimculleny@comcast.net.