Life And Debt: Stories From Inside America’s GoFundMe Health Care System

The Creeping Privatisation of the NHS – Brighton and Hove CCG is Forcing Patients to Buy Medicines Rather than Prescribe Them

  

You may remember that line from Joni Mitchell’s Big Yellow Taxi –

‘You don’t know what you’ve got till it’s gone.’

That applies like nothing else to the NHS.  People take for granted being able to turn up at a hospital if they have a problem or get ill.  We take it for granted being able to obtain a GP’s appointment.  We don’t know what it is like to face the agonising decision of whether we can afford to go to the doctor or afford to buy the medicines he has prescribed.  Yet that is the ‘logic’ of the free market.

With Donald Trump promising that in a US-British trade deal ‘everything is on the table’ including the NHS, then it is worth having a look at what the free market in health is like in the United States.

A comment piece I did for the Brighton and Hove Argus some years ago on Big Pharma

After all the ideology of the market is that everything has its price, everything is a commodity, health included. No one has any social responsibility or duties towards another. If you can afford it then the world is your oyster but if you can’t, then that’s tough. Everyone has the right to starve and sleep under the stars but it just happens that only the poor and homeless take advantage of these ‘freedoms’.

As RH Tawney put it ‘freedom for the pike means death to the minnow.’

In the United States ‘freedom’ includes the right to die without treatment and of course the right to buy virtually any treatment you want and to jump the queue whilst doing so.

Below is a shocking article on how thousands of Americans are having to resort to crowd funding to pay for health care. Billions of dollars have been raised to pay for what we take for granted. Whole communities rally round to raise the funds necessary to pay for someone’s cancer treatment because even when someone is insured, there are ancilliary costs that are not covered.

There is a reason why every newspaper hates Corbyn - and it isn't 'antisemitism'

However those who don’t have a community to rally round them, the homeless and forgotten, are left to die unaided. And the ‘Christian’ politicians who call themselves ‘pro-life’ as they prohibit abortions, because the death of the unborn so distresses them, are unmoved by the death and suffering of those who cannot afford medical care because they cannot afford it.

When I learnt that I had Hepatitis C 7 years ago, I was fortunate in more ways than one. I was unable to cope with what was the then standard treatment of being injected with a toxic drug called Interferon.  Although it was curing the disease it was killing the patient!

I was lucky because at that very moment new experimental non-interferon treatments were coming on stream. A drug called Harvoni was being marketed by an American drug company called Gilead Sciences. I took this drug for 90 days. One pill a day after which I was cured. But without the NHS I couldn’t have afforded it because it cost about $1,000 a pill.  It cost $1 a pill to make.  An obscene level of profit.

I was lucky because I was one of the 500 sickest people with Hep C who were on a government funded programme to pay for this drug on the NHS.  I was the first person my consultant told me in Brighton and Hove.

The drug was developed primarily at Cardiff University but Gilead Sciences got the patent and they charged what they admitted ‘the market would bear’.

There is a brilliant cross-examination by Alexander Orcasio-Cortez, the socialist Congresswoman from New York who Trump particularly hates and who was recently told to ‘go back home’ despite having been born in the USA.  In the same speech Trump accused the Congresswomen of ‘anti-Semitism’.

In the video we see the hapless Gilead representative face the accusations that they are charging $2,000 for Truvada, an HIV drug, in the US whilst it costs $8 in Australia. Big Pharma has no morals.

My complaint to the Brighton & Hove CCG

I mention all this because the Brighton and Hove Clinical Commissioning Group has decided on a policy that any drug that can be purchased over the counter is no longer going to be available on prescription.  It doesn’t matter what it costs, you will not be able to get it. It would appear that it does not depend on what your ailment is either. This is in order that the CCG can ‘save’ approximately £500,000, absolute chicken feed.

The cost of drugs in the US is one of the main ‘extras’ that insurance tends not to cover so it is an important principle that if your doctor believes that you should be prescribed a drug it’s not for the faceless bureaucrats of the CCG to determine whether or not you will be ‘allowed’ it.

I have made a formal complaint and I have threatened that if necessary I will seek to apply for a judicial review of the decision.  However this is not just peculiar to Brighton and Hove but is a national policy. The NHS may be safe with us, as the Tories claim, but one thing is for sure.  Given half the chance they would like to adopt the American system of super profits for private health care companies and an insurance lottery for the rest of us whereby the insurance company will decide whether or not you need the treatment you have been prescribed and how much they will fund.

One statistic has always caught my eye.  Cuba, which has a universal health care system, has a lower child mortality rate than its wealthy neighbour because the United States prefers to spend its money on weapons systems than on the most basic needs of its citizens. And it has a President whose job it is to get the poor to fight amongst themselves, ‘making America great’ in order that the rich can get away with it.

And that is also what the attacks on Corbyn and the ‘anti-Semitism’ moral panic is about. Protecting the wealthy here from those who would like to redistribute their ill-gotten gains.

Tony Greenstein

Outrageous health care costs and a merciless system are forcing Americans to raise money from strangers, revealing the ugly truths about U.S. health care.

The human body is a frail thing, and illness is a pitiless adversary. Every day, an untold number of Americans are diagnosed with a devastating illness or suffer a sudden injury that threatens to upend their lives and tear apart their families.

This misfortune often comes at a staggeringly high financial cost that can be just as cruel.

While health insurance or government programs like Medicaid and Medicare can shield against huge medical bills, massive debt and even bankruptcy, only the truly wealthy can feel secure that sickness won’t lead to financial ruin.

This is why thousands of Americans have turned to crowdfunding website GoFundMe in the last decade to help cover medical bills and related costs. HuffPost is profiling some of those people, and what their stories reveal about the shortcomings of the American health care system.

These are not feel-good stories.

That’s often how the news media cover these fundraisers ― focusing on the generosity of individuals giving rather than the systemic failures that created the need. While it’s hard not to be inspired by successful campaigns and the fortitude of those suffering through terrifying ordeals, such stories portray a chilling reality that Americans ― even those with good jobs and health insurance, can be one bad day away from financial ruin.

A serious disease can put financial strain on people even in countries with universal health care systems and strong safety nets. But the United States, which has neither of those things, leaves its residents uniquely vulnerable. 

More than 50 million donors contributed more than $5 billion to GoFundMe campaigns between 2010 and 2017, according to GoFundMe, which is based in Redwood City, California, near San Francisco.

Two years ago, one-third of all the money raised went to campaigns listed in the Medical category. GoFundMe reports that more than 250,000 medical fundraisers are added a year and raise $650 million annually.

Although the fundraising numbers offer a sense of the need behind the many campaigns, they are imprecise, according to GoFundMe. Users can choose whatever category they like, so not all medical fundraisers are actually for medical bills and related costs, and some users seek help for those things in other categories on the website. Those figures also include money raised in other countries.

Successful fundraisers can generate $100,000 or more, as neighbors and strangers alike rally around families in need, and that money can go a long way to ensuring that treatments can continue, that housing and other daily costs can be covered and that families don’t lose everything while trying to keep loved ones alive and make them healthy.

ISABELLA CARAPELLA/HUFFPOST

Americans pay more for their health care than their counterparts in other developed countries. And even though more than 90% of Americans have some form of health coverage, according to a federal survey from 2017, it’s often inadequate. Some 45% of Americans are “underinsured,” according to a report published last year by The Commonwealth Fund, a New York-based think tank. And 27% of Americans told West Health and Gallup they had skipped medical care because of the cost in the past year in survey findings published this year.

High deductibles requiring thousands of dollars of out-of-pocket expenses before the insurance covers any bills, large copayments at the point of service and costly prescription medicines are among the reasons Americans pay so much. Add to that services or medicines insurance companies won’t cover at all, experimental treatments ineligible for coverage, medical providers that aren’t in insurance networks and other uncovered costs, and medical bills can rise into the millions of dollars. For the uninsured, there is no upper limit to how much they could owe.

According to data from the Federal Reserve Board, 40% of Americans don’t have enough savings to cover an emergency expense exceeding $400. In the past year, Americans borrowed $88 billion to cover medical bills, the West Health/Gallup survey found. Among Americans who declared bankruptcy from 2013 to 2016, 59% cited medical bills as a factor, according to a survey published in the American Journal of Public Health this year.

Illness often means lost income, as the patient and family members miss time at work during treatment. Transportation and lodging costs pile up for people who must travel long distances to receive care, including those in rural areas who live far from the nearest medical facilities and those who seek medical treatment from specialists who practice at prominent institutions like the Mayo Clinic in Minnesota or the Cleveland Clinic in Ohio. These so-called indirect expenses are a reason medical fundraising is the leading category on GoFundMe worldwide.

Browsing the Medical category on GoFundMe offers a brutal reminder that illness doesn’t discriminate. People from all walks of life and at virtually every level of income, both the insured and the uninsured, turn to their communities and to strangers on the internet to solve a financial problem that would be impossible to handle on their own.

There you can find heartbreaking stories about a small boy badly hurt in a car crash, an actor stricken with cancer, a woman injured in a savage sexual assault, twin brothers who both need heart transplants, an infant with a rare disease who needs experimental treatments and practically any terrifying scenario you can imagine.

No amount of charity is enough to compensate for America’s tattered and unforgiving health care system, as GoFundMe founder and CEO Rob Solomon articulated in an interview with Kaiser Health News published in January.

“The system is terrible. It needs to be rethought and retooled. Politicians are failing us. Health care companies are failing us. Those are realities. I don’t want to mince words here. We are facing a huge potential tragedy,” Solomon said. “We provide relief for a lot of people. But there are people who are not getting relief from us or from the institutions that are supposed to be there. We shouldn’t be the solution to a complex set of systemic problems.”

Brighton & Hove’s Monster Demonstration Against Trump

Praise from one racist Israel's Prime Minister to Donald Trump -  it's what I've already done Netanyahu tweeted

Only Israel and Netanyahu Welcome the Mexican Wall and the Ban on Muslims

Completely blocked - the intersection of Bartholomew Square, where Brighton town hall is situated, with Prince Albert Street and The Laines, with Cafe Rouge on the corner

On the steps of Brighton Town Hall - Momentum and Brighton & Hove PSC - no Zionists or Jewish Labour Movement were to be seen - probably because opposition to anti-Muslim racism is anti-Semitic!

I have seen some large demonstrations in my time in Brighton.  Over 5,000  demonstrated in April 2003 at the start of the Iraq War.  Some 4,000 school students demonstrated in 2010 against the massive increase in tuition fees but this was the largest demonstration I can remember in 40 years.  People came from everywhere.  Bartholomew Square in which the town hall was situated was packed solid.  It was impossible to get anywhere near the demonstration as Prince Albert Street was impassable.  So too were the Laines approaches. 

What was so impressive was not only the youthful nature of the demonstrators but the fact that this represented a cross-section of Brighton and Hove.  Parents with their children, old people and of course veteran protestors like me!  The chanting focussed on the racist bigotry of Trump’s measures against Muslims.  ‘Refugees are welcome’ was the cry.  Even a few of our New Labour councillors, such as Emma Daniels, a strong supporter of Israel’s racist anti-Muslim politics, showed her face before scuttling away.  It was also good to see Brighton and Hove’s Green Mayor Pete West.

Photograph taken from Prince Albert Street which was impassable

The hypocrisy of Trump’s measures, which conveniently excluded Saudi Arabia, the country from which the 9/11 bombers had come, made it clear what the purpose of the immigration ban was – to demonise Muslims and Arabs.  It was an attempt to use the race card to divide American society.  What is gratifying, at a time when New Labour politicians are allowing Brexit to divide people in Britain, is the strength and size of the opposition to Trump in America.

We are living in new times.  The election of Trump, who received fewer votes even than the detested Hilary Clinton, has little legitimacy in the eyes of a majority of American voters.  Most American Presidents enjoy a honeymoon when elected.  Trump has started out with negative ratings.

The election of Trump is not only unpopular with the American people but also with the majority of the American capitalist class and its political establishment.  It’s not simply his policies.  There is a lot of truth in the argument that what Trump does aloud Obama did behind closed doors. That Obama too banned Iraqis from visiting America for 6 months.  That Obama also presided over mass deportations of Mexicans.  But Trump makes a virtue out of his racist reaction.  He deliberately plays footsey with the American far-Right who are in ectasy.  He deliberately stirs up racial divisions in order to prop up US corporations.  He uses race in order to satisfy his lumpen working class support.

What is appalling in their eyes is that Trump is stripping the United States of its moral legitimacy as the leader of the democratic world.  To socialists and lefties this has always been a dubious and hypocritical proposition.  Chile, Iraq, El Salvador – the list of countries that the United States has despoiled is endless.  Its support for Israel is well known.

But today people identify the United States with a loud-mouthed bigot, who wears his racism on his sleeve, who is on record of boasting about sexual attacks on women, who has called all Mexicans rapists and who has appointed open racists and anti-Semites like Steve Bannon of Breitbart as his Strategic Advisor.  Tonight his immigration ban has been countermanded by the Acting Attorney General, an almost unprecedented action.

Brighton's Bartholomew Square

I predict that  Trump may serve one of the shortest terms of any American President.  It is almost certain that evidence is going to be provided of his many misdemeanours and crimes – from rape and sexual assault to fraud in the way his charity operated to tax evasion.  New York State already has an investigation into Trump’s charity underway.  I think it is odds on that Trump is going to be impeached.  At the end of the day it will only be America’s far-Right Zionists, White Supremacists and Fundamentalist Christians who will be his supporters.  Although Republicans have lined up in his support for the moment that is unlikely to last.

The fact that  Theresa May went to pay homage to Trump in America without saying a word about his anti-Muslim rhetoric and  racist tirades against Mexicans says everything you need to know about this tawdry woman who goes begging, from one tyrant to another, seeking a way out from her ‘hard Brexit’.  May is demonstrating, despite her fine words on succeeding to Cameron, that she is willing to support anything and anyone who provides her with an economic escape route from her difficulties on Europe and Brexit.  It was toe curlingly embarrassing to see her hand in hand with a man who boasts about grabbing women by the ‘pussy’.  It is or should be a good example to those who believe that having a woman in power is a good thing in itself.

Brighton's Bartholomew Square

There was, not surprisingly, just one voice in the world that welcomed  Trump’s anti-Muslim directives.  That was the State of Israel which has pioneered racial profiling.  Israel has, as Netanyahu boasted, constructed its own wall on the Egyptian border to keep out African refugees.  Israel has refused to accept any Syrian refugees and has called those refugees who did manage to gain entry before the Egyptian wall ‘infiltrators’ (a comparison with Palestinian refugees from 1948 who sought to return to their lands).

Israel has followed a policy of ‘encouraging’ the 60,000 African refugees who did obtain entry in the early years of this decade, to leave.  Methods include indefinite imprisonment in the Holot detention centre in the Negev Desert.  A number of those who were forced out of Israel ended up dead at the hands of ISIS in Libya.  Israel refuses to recognise that Eritrea, where most refugees come from, is a country with a horrific human rights record.  

Ha’aretz described how 'On Saturday, the Israeli prime minister applauded Trump’s decision to set up a wall with Mexico, with the disputable claim, phrased in Trump-style syntax, “I built a wall along Israel's southern border. It stopped all illegal immigration. Great success. Great idea.”  Netanyahu’s arguments in opposing the entry of refugees were explicitly racist.  It wasn’t about terrorism or lowering wages but identity – admitting non-Jewish refugees would dilute the Jewish majority:

"If we don't stop their entry, the problem that currently stands at 60,000 could grow to 600,000, and that threatens our existence as a Jewish and democratic state," Binyamin Netanyahu said at Sunday's cabinet meeting. "This phenomenon is very grave and threatens the social fabric of society, our national security and our national identity." Israel PM: illegal African immigrants threaten identity of Jewish state]

In an interview with the BICOM journal Fathom, Isaac Herzog, Leader of the Israeli Labour Party  put it more elegantly than Netanyahu but he sang from the same hymn sheet:

‘It’s complicated because one doesn’t want to create a precedent which could affect the equilibrium of the nation. There are millions out there who may want to come to Israel.’

In 2012 in an Op Ed ‘The next national target: Eritrea in the Jerusalem Post Herzog urged that Eritrean refugees, who form 2/3 of Israel’s refugees be sent back.  He repeated this on the eve of the 2015 elections. 

Theresa May has also invited Trump to visit Britain later this year.  A petition opposing the visit has already garnered 1.5m signatures.  It is a sign of the opposition that there will be on the streets when or if Trump shows his face.

Netanyahu’s anti-Jewish support for Trump’s anti-Muslim decree

Banning Syrian refugees and Muslim immigrants will help anti-American propaganda more than U.S. national security.

By Chemi Shalev | Jan. 29, 2017 

U.S President Donald Trump is a hero now for Muslim-haters who, in some countries, might even be the majority. He is being lauded by the hard-right in America, extolled as a man’s man in Vladimir Putin’s Russia, glorified as a god among racist parties in Europe and enjoys wall-to-wall support from his groupies in Israel, who are now being led, unabashedly, by Benjamin Netanyahu.

On Saturday, the Israeli prime minister applauded Trump’s decision to set up a wall with Mexico, with the disputable claim, phrased in Trump-style syntax, “I built a wall along Israel's southern border. It stopped all illegal immigration. Great success. Great idea.” Netanyahu’s intervention on a topic that is in sharp political dispute in the U.S. is questionable enough, but the timing of his decision to identify so strongly with Trump, just after the president issued his executive order on Syrian refugees and Muslim immigrants - a move viewed widely as a declaration of hate against Muslims - is a reckless gamble. For no discernible rhyme, reason or political imperative, Netanyahu has placed himself - and Israel, by extension - solidly behind a morally dubious move and a leader who could soon become the world’s most hated.

Trump’s spokespersons claim that the move is aimed at countering threats to U.S. national security, but that’s an obvious ruse. The U.S. already conducts the world’s most stringent screening for refugees. To this day, not one Syrian refugee or immigrant from any of the seven blacklisted countries has engaged in terrorist activities - while those who did attack America, including the terrorists who carried out the September 11 attacks, came from countries that were not included in Trump’s list, either because they’re too vital to U.S. interests or too lucrative for Trump’s business empire.

On the other hand, the damage that Trump’s move may cause, directly or indirectly, in the short term or in the long, is undeniable. The reports of refugees stuck on their way to the U.S. or in American airports, along with the shocking announcement by the Department of Homeland Security that green-card holders who are abroad will be barred from rejoining their families or their jobs, place a disturbing human face on the bureaucratic jargon of Friday's executive order. Much of Muslim public opinion is likely to be outraged by Trump’s actions - and they will be aided and abetted by hostile governments and jihadist groups eager to stoke the flames of hate. Friendly regimes, in places such as Jordan, Egypt and Saudi Arabia, will be under pressure to distance themselves from Washington. Preachers of radical Islam will be able to use the photo of Trump signing the order as proof of their age-old claim that America and the West are on a crusade against Islam. ISIS, which has been on the defensive for the past year and, according to some experts, on the verge of collapse, has been handed a propaganda victory and a new slogan for attracting new recruits.

Trump’s decision is bound to increase polarization between left and right, between liberals and some, but not all, conservatives. What supporters of the move will portray as a defensive imperative, its opponents will view as institutional discrimination and an assault on values. “Tears are running down the cheeks of the Statue of Liberty,” Senator Chuck Schumer said. The famous line of American-Jewish poet Emma Lazarus' The New Colossus “Give me your tired, your poor, Your huddled masses yearning to breathe free,” which is engraved in stone at the footsteps of Lady Liberty, will now need an asterisk that clarifies “  *Unless they happen to be Muslim.”

Trump’s decision is also bound to increase tensions in the American Jewish community, between the right wing that has adopted and compounded their Israeli counterparts’ anti-Muslim narrative and the more centrist and moderate elements - including most of the Jewish establishment - that remains loyal to the community’s traditional liberal values. Most Jews still view themselves as a vulnerable minority, just like Muslims. Most are deeply committed to the values of immigration and sanctuary. Most still carry the traumatized memories of their parents and grandparents of an America that locked its gates for Jewish refugees fleeing the Nazis. Netanyahu’s imprudent encouragement of Trump, along with the overzealous welcome that Trump has received from the Israeli government, further expand the growing divide between the Jewish State and the world’s biggest Jewish diaspora.

One wonders of course about the silence of the GOP chickens, who were quick to blast Trump’s offer to ban Muslims when his prospects to become the party’s presidential candidate looked slim but who are now laying low out of fear and expediency. First and foremost of these is House Speaker Paul Ryan who was rightfully enshrined for a few hours on Saturday on the Wikipedia page for spineless invertebrates. Photos of Likud lawmakers who have been similarly struck dumb when asked about Netanyahu’s corruption charges and other shady shenanigans also deserve a place of honor in the same gallery of cowards. They and their patrons, Trump and Netanyahu, are the proverbial birds of a feather that mock us together.

See also The Death of an Eritrean 'Infiltrator'