Stay disappointed with Ryancare

Published in the Wisconsin State Journal on Tuesday, July 26, 2011.

Here’s a fool-proof, two-part plan guaranteed to effectively improve health care in the United States. First, require all hospital administrators to work from desks that share space currently occupied by their emergency room admissions staff. In that space there would be no cubicles, no partitions of any kind. Everything that the admissions staff hears the administrators would hear.

Second, Representative Paul Ryan and his fellow members of Congress, regardless of age, should be stripped of the health care benefits they now enjoy and be forced to rely solely on Medicare. Instead of seeing the attending physician in the Capitol as often as they want for a referral to Bethesda Medical Center they’d have to take their chances in the nearest ER waiting room.

This two-part plan would be in effect for five years. By then, my guess is that there wouldn’t be a health care issue for any of us to worry about.

What Representative Ryan is proposing isn’t an overhaul of Medicare, it’s insurance allowing the present, private health care providers to go on with business as usual. In Madison, that allows Meriter and UW Health to play loose and fast with the welfare of the citizens they purport to serve by building duplicate facilities to chiefly enhance their respective bottom lines.

Here’s an example of what the business-as-usual health care monster sounds like, taken from a June 23, CBS News feature on the closing of Huron Hospital in impoverished East Cleveland. Residents of East Cleveland had relied on Huron for 75 years and CBS’s Cynthia Bowers asked Huron president, Dr. Gus Kious, about local apprehension over the impending closure.

“Well, Kious replied. “the people we serve are used to being disappointed.”

It’s taken me a while to decide whether that statement is more insensitive than offensive. Truth is, it is both and is indicative of how our pre-Obama health care system has been allowed to roll over us for a very long time.

In the early 70s I was the purchasing director for Divine Savior Hospital and Nursing Home in Portage. I arrived after the board of directors had approved renovations to the existing facility, some necessary, some not. Chief among them were improved lab facilities and better emergency room access. Also on the list were a new meeting room for the board of directors and a greatly expanded office for the hospital administrator. That board room would be enhanced by a custom built table that turned out to be so long that it had to be cut in half to be moved into the room. The administrator’s office would be graced by original works of art. As the renovations got underway the third floor of the hospital was closed due to a drop in occupancy. Staff from that floor was either laid off or transferred to the newer, adjacent nursing home. But life went on as usual for the board of directors and the administrator. The table went into the board room, the art was hung on the administrator’s office walls and, to relieve the staff doctors of the arduous duty of covering the emergency room on weekends, a group of doctors was hired to drive up from Madison.

In the almost 40 years since, health care has either gotten better or worse depending upon which side of the looking glass you’re on. If you’re on the pampered side you’re living with state of the art equipment that duplicates identical equipment across the street at your competitor’s facility, original art on your walls, dedicated parking and the rest. If you’re on the other side, well, you are used to being disappointed.

Representative Paul Ryan wants you to remain disappointed. When he’s in the Capitol in D.C. he doesn’t have to leave the building to find the best of medical care. Chances are he doesn’t have to wait for that care. Best of all, he’s covered under the Federal Employee Health Benefits Program. Sitting on that kind of cushion it’s easy for him ask the rest of us to make sacrifices he’ll never have to experience.

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