America’s Pay-or-Die Health Care System

Original article by Ralph Nader, subheaded The Story of Lisa Kelly, via

This is a tale of pay or die that recurs again and again all over our country and only in our country in the entire western world.

I wonder how many of these tales it will take for America to come to its senses.  My guess is that we’re getting to the point of ‘bad health care’ burn out.  Of course, it’s an argument for Single Payer.  Of course, none of the major candidates are running on a pro-Single Payer platform.

Advised by her physician to go to M.D. Anderson for urgent treatment of her leukemia, Mrs. Lisa Kelly was told she had to pay $105,000 up front before being admitted. The hospital declared her limited insurance unacceptable.

Keep this in mind as you navigate our current health care system.  Your insurance may be deemed ‘limited’ and keep you out of the hospital.  You would think we deserve better.

Time out from her torment for a moment. M.D. Anderson started this upfront payment demand in 2005 because of a spike in its bad debt load.

I wonder if the same would happen under Single-Payer.  If the chance to keep people from receiving needed health care is possible, it’ll happen.  It’s likely that some for-profit hospitals won’t go for Single-Payer even if it’s avaialble.  Single-Payer will almost certainly have an opt-out provision to placate the insurance industry.

It isn’t as if non-profit hospitals like M.D. Anderson are hurting. Look at this finding in an Ohio State University study: net income per bed at non-profit hospitals tripled to $146,273 in 2005 from $50,669 in 2000. And you also may have noticed the huge pay packages awarded hospital executives.

Market forces at work, even for non-profits.  Why should we be surprised?

Back to the 52 year old, Lisa Kelly. She and her husband returned with a check for $45,000. After a blood test and biopsy, the hospital oncologist urged admittance quickly. Then the hospital demanded an additional $60,000-$45,000 just for the lab tests and $15,000 for part of the cost of the treatment.

This for a person who had some insurance.  Think your way through this.

Imagine anything like Mrs. Kelly’s predicament and pressures occurring in Canada, Belgium, Germany, Italy, France, Switzerland, Holland, England or any other western country. It would never happen.

Bingo!  Only in the good ol’ USA.  But we have the best health care in the world, don’t we?

None of these countries spend more than 11% of their GDP on healthcare. The U.S. spends over 16% of its GDP on health care and does not cover 47 million people and tens of millions are under covered.

You’ll look forward to being required to carry insurance.  Aren’t we past this?  Of course not, and on the path we’re on we never will be.

When a friend showed the Journal’s article to a Dutch visitor, the latter blurted in anger – “you are a nation of sheep.” Not a very flattering description of “the land of the free, home of the brave.”


Someday, soon maybe, Americans will finally band together and say “enough already,” we’re going for full Medicare for all- without loopholes for corporate profiteers and purveyors of waste and fraud.

Needless to say, it’s where we should be headed (hell, we should already be there).  Don’t expect it with the current crop of leaders in the major parties.

Last month after being in remission, Lisa Kelly’s leukemia has come back.

I wonder how ‘hope’ and ‘change’ will help Lisa Kelly.

Originally posted here:…

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  1. It’s you must pay

    And you will die

  2. That in one of the wealthiest countries in the world, tens of millions of us have no coverage, and millions of others are inadequately covered, even with insurance. Our health care insurance system is merely a pork barrel for middle men whose job it is to deny benefits.

    How insane is that? I guess about as insane as the war for oil or believing in honest elections.

    You would think it would be a no-brainer, since everyone has to go to a doctor sometime.

    But even the loyal opposition can’t work up the nerve to fight for something that would save lives and win the political support of millions of ordinary people.

    We are well and truly screwed, and it pisses me off.  

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