This Virus not in the Budget

03-08-2020Fr. John LettersFr. John Bonavitacola

Dear Friends,

As we approach another general election, polls say that one of the top concerns of voters is healthcare. And now with the outbreak of the recent version of the coronavirus, you can bet that healthcare will be even more prominent in this election cycle. It seems like we talk and argue endlessly about our healthcare system and you wonder what exactly happened that makes our healthcare system such a frustrating issue?

If you have ever been scheduled for surgery, you know that your medical provider will submit to your Insurance provider a request for “preauthorization”. Then you get a letter that states, “Your preauthorization is approved but this is not a guarantee of payment.” Then what’s the point, you think. It’s called bureaucratic-eeze. Now if you called your medical insurance provider and ask “under what conditions will you not pay for the surgery” you will not get an answer or at best some gobbledygook response. But you may be stuck with the bill or a large chunk of it if some insurance administrator decides afterwards that the doctor didn't color within the lines.

This is one small example of the result of shifting our healthcare infrastructure from medical professionals to bureaucrats, mostly finance managers. (Boeing did the same replacing Engineers who led the Company with finance managers. Didn't work out so great for them either.) Forty years ago, we were sold on the idea that if we introduced a for-profit model into healthcare, the costs would come down and the system would be more efficient. Hence the advent of the HMO and PPO and the ever-rising costs of insurance. The problem with that is that people are not widgets and healthcare is more of an art than a strict science.

Prior to this our Hospitals and healthcare systems were run by religious organizations, of which the Catholic was the largest, or by community run not-for-profits who were led by medical professionals and not business managers. Sadly, that type of system has mostly disappeared and while you still have a Catholic hospital or Methodist or Episcopal etc., they are pretty much in name only. The days of selfless Catholic sisters running hospitals is long gone. Today, the CEO of Dignity Health, which is the smoldering remnant of Catholic Healthcare West, makes over $10million a year. Worse still is that almost no one in the Administrative structure of Dignity is a medical professional. In the days when the Sisters of Mercy ran their healthcare system, they were not interested in making money or maximizing profits for shareholders but they were concerned about taking care of the sick.

And taking care of the sick is what most physicians and nurses still want to do today. But their hands are so often tied by an ever-increasing bureaucracy that requires them to spend more time on paperwork than patients. Don't be fooled that electronic records are any less time consuming. Too often physicians will tell you that their best medical advice is overruled by an insurance provider. One physician I know has signs posted in his office that he will not deal with a particular national pharmacy chain because they insist on telling him what version of a medication he should prescribe, all because the pharmacy purchases the medication in bulk.

Replacing compassionate care that utilized the resources available with maximizing profit is one of the reasons everyone puts healthcare at the top of their list for the next election. Consumers of healthcare can feel the difference. Sadly, we are not going back to the past but moving into the brave new world of whatever $oats politically this election cycle. The days of Catholic hospitals run by sisters who could cajole some of the best medical professionals to work for them at low pay because their dedication to the sick was infectious are not returning anytime soon. Even more sadly is that Catholic healthcare made too many deals with the devil, namely the government and insurance providers who dangled payment in exchange for surrendering our ethics and moral principles. Patients are now measured by cost/benefit analysis and not the worth of their dignity.

Using free market principles to run healthcare has been pretty disastrous. It makes the system answerable to shareholders and not patients. It’s why Bernie Sanders has gotten such a large hearing on the issue, though it seems to me his Medicare-for-All would just make the bureaucracy even thicker and less accountable. But still I appreciate his pulling the curtain back and exposing the corporate sham we have allowed healthcare to become.

This current pandemic is going to test our healthcare systems but more importantly it is going to test us on how well we can care for each other and how clever and ingenious our physicians and nurses can be to find ways around the maze to treat the sick despite Hospital administrators running around with their heads exploding, screaming about how nobody put this pandemic in the budget.

St. Marianne Cope, one of the newest canonized saints from the US, when she went over to Molokai to help Fr. Damien in the Leper colony and who took over when he succumbed to the disease was asked if she was afraid to go. Her response: “I am a Sister and a nurse; I am not afraid of any germ.” Right on. St. Marianne pray for us and all the wonderful doctors and nurses who care for us.

Love,

Fr. John B.

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