I'm still shaken by the GOP audiences cheering executions or shouting approval to let uninsured people die if they became sick. This type of mob cruelty, like the shameful blood lust of Romans in the Arena or lynch mobs years ago served to remind us of how barbaric humans could be and how little progress our civilization had made. Certainly we're more advanced today, we might think. Sadly, we're not. At least some of us remain heartless jerks.
So I started thinking about how we dealt with this in the past. As a retired RN, I've seen a lot of it. The best example is below the Kos squiggle-o-rama.
Kidney dialysis was developed in the 50s and 60s to treat End Stage Renal Disease (kidney failure). Later, kidney transplants were developed to restore a more normal kidney function and eliminate the need for frequent, lengthy dialysis treatments and the extrememly restrictive fluid and diet needed between dialylsis visits.
ESRD was previously a death sentence. When your kidneys shut down you got very sick and then died. Dialysis allowed people to live. Unfortunately, it was unbelievably expensive with very few able to afford it.
Hospitals basically "ate" the uncompensated cost of dialysis, so they limited the number of patients treated. With a limited number of "beds" available, not everyone who needed dialysis could get it. Hospitals established kidney dialysis panels consisting of doctors, social workers, clergymen, and community leaders to make decisions about who would get a "bed" and who wouldn't. Every potential patient would have to prove their worthiness to live. It was heartbreaking to see and hear. You can't possibly imagine it. They would bring their children and family members, documentation from on how essential they were to their employer or church or community, or anything that they though would move the panel to give them the one spot that had come available from the eventual death of the prior dialysis patient.
These were the real Death Panels. Anyone who didn't get approval died. The public was horrified at the process and results.
That changed in 1972 with Congressional actionto extend Medicare coverage to anyone with ESRD. That simple change, enrolling everyone with kidney failure into Medicare, meant that hospitals would now be paid for every dialysis treatment. The number of dialysis beds exploded, the death panels (no longer needed) dissolved, and every person who needed dialysis got it.
It was simple and effective. Even those newly diagnosed with ESRD got dialysis since hospitals knew they would eventually be paid for the service. Hospital made sure they had plenty of dialysis beds and enough staff to cover them. And it set the stage for coverage for kidney transplants in the future. People lived.
We have failed, as a society, to ensure that everyone who needs care gets it, but this one time and for this one health problem, we saw to it that every patient got the care they needed. Perhaps it was because hospitals limited the number of available dialysis treatments due to their high costs and almost negligible payments, or maybe it was the public horror of the selection committes that made the public demand a remedy. We have done nothing like it since despite the continuing stories of people still dying because they can't afford medical care or expensive treatments.
While I have seen concerns over the profits of Big Pharma, health insurance companies, and the health care industry taking increasing priority over the health and lives of Americans I never thought I'd live to see the day when death would be cheered and encouraged as it was at the GOP debates. In their world, Scrooge was a hero and Tiny Tim deserved to die.
As a Russian comic would put it" "America. What a country."