Healthcare for People, Not Profit

If you think you’re covered by health insurance, think again. According to a 2007 study in the American Journal of Medicine, illness and medical bills caused 62% of all bankruptcies and most of those people were insured and middle class. Meanwhile, “the five largest health-insurance companies racked up combined profits of $12.2 billion, up 56 percent over 2008”, according to a report by Health Care for American Now based on SEC filings.

In CNN’s analysis of the Fortune 500, “The star of 2009 is undoubtedly health care. The sector's earnings jumped to an all-time high of $92 billion. Health-care earnings rose by $23 billion, or 33%...from two groups, one surprising -- medical insurers -- and the other more predictable, pharmaceuticals. For the drug industry, it's as if the recession never happened. The sector's earnings surged by one-third to $64 billion.”

Three years ago I learned this the hard way. I contracted Lyme disease and coinfections at the peak of my health, right after my employer had closed down, leaving me without health insurance. At the last minute, I was able to get expensive guaranteed health insurance that would cover my new preexisting condition…or so I thought. I fought repeatedly with my insurance company for coverage of my life-saving medicines. They refused to pay for any expensive treatment by denying that it was medically necessary – I could probably survive without it. My health never really improved on the cheaper, less effective drugs they sometimes covered. I was in and out of the hospital, hit with huge co-pays and unable to work due to my disability for years, leading me to declare Chapter 7 medical bankruptcy.

“We waste one-third of every health care dollar on insurance bureaucracy and profits while two million people go bankrupt annually and we leave 45 million uninsured," says Dr. Quentin Young, national coordinator of Physicians for a National Health Program. Even government programs to help the uninsured often leave people stranded, especially the middle class. When I asked Healthy San Francisco, a municipal health plan for the poor about my condition, they said, “We don’t cover chronic Lyme disease.”

In addition, none of the alternative healthcare treatments that helped my body’s own healing process and significantly eased my symptoms were covered by my insurance. Alternative healthcare is often less expensive than conventional medicine and is much better for preventing illness. With its proven treatment value and the comparative rising cost of conventional medicine, one third of all Americans now use alternative medicines and tend to visit alternative healthcare practitioners more often than conventional doctors. Alternative healthcare has been at least half of the recipe to my recovery.

While the government fumbles over legislation to provide this basic safety net that most developed countries guarantee all their citizens, innovative grassroots projects have jumped in to fill the gap. One such project in San Francisco, Adaptogen, that I have volunteered at is a monthly community alternative healthcare clinic providing unlimited visits to professional healers like naturopaths, herbalists, and bodyworkers for a sliding scale admission fee. The event offers tea service, healthy meals, and a talk on alternative healthcare.

Charlotte Maxwell Clinic, where I volunteered for a year, offers free complementary care to low income women with cancer, such as bodywork, acupuncture, herbs and supplements. Many women I massaged there tried to give me tips of money and food in exchange, despite being poor- some were so poor that they were homeless or living out of their cars while receiving chemo and radiation therapies. One terminally ill nun I massaged was so grateful for pain relief, she said she’d put in a good word for me. As a patient, I frequent Circle Community Acupuncture in San Francisco, which provides low cost acupuncture in a communal setting with a social justice mission, linked to similar clinics of the same model across the country.

The Karma Clinic (Oakland, CA), The Gifting Tree (Ashland, OR) and Volunteers for Health Care Today (Mount Shasta, CA) all offer health services through a network of local volunteer providers with the expectation that their communities will support them with gifts to continue providing service and their nonpaying clients will “pay it forward” by volunteering for their community when they are well. The Volunteers for Health Care website explains “we appeal to patients receiving free care to volunteer their skills, knowledge, and energy in your community – to “Pay It Forward”to others in need rather than paying it “back,” in “cash” to those not as needy. My own Lyme specialist doctor continued to see me on the pay it forward model after I ran out of money so I could continue my treatment and keep doing my activist work, as did several bodyworkers and a naturopathic doctor.

Video of a volunteer explaining the philosophy and practice of the Karma Clinic

Taking the “pay it forward” model to another level, some low income clinics have integrated with local Timebanks to provide more access. Four low income health centers in St. Louis (Grace Hill Neighborhood Centers) use their local Timebank (MORE) and two health clinics in Portland, Maine (Turn the Tide Health Collaborative and True North Clinic) use Hour Exchange Portland to allow lower income clients to earn service credits called time dollars by volunteering to help community members and nonprofits. Healthcare is the most used service on Hour Exchange Portland and offers 30 different kinds of health services. One hour of childcare or community gardening can be exchanged on the Timebank for one hour of healthcare consultation. However, clients don’t have to earn first to spend, allowing them to join when they are sick and give back when they are well again.

South Korea has a similar indirect reciprocity system that provides conventional healthcare to thousands of low income patients through Hanabat LETS (Local Employment Trading System). One Hanabat LETS organizer noted that they have no trouble with “freeloading”. In fact, in most of these systems, including the one I coordinate, called Bay Area Community Exchange, people have more trouble receiving gifts than giving. Orion River Exchange in Vermont recently got a three year, one million dollar grant from the federal government to facilitate mutual aid care for the sick and disabled elderly. In Japan, the Fureaui Kippu time exchange is part of the national social security system, where able-bodied people provide care to the sick and elderly in exchange for care for their parents or themselves.

Many of the models mentioned above provide a wide array of outpatient alternative and conventional care, though not usually hospital or emergency care. Ithaca Health Alliance is working to change that through a nonprofit community fund available for minor emergencies, as well as a low cost community provider network. Their health fund was challenged under for profit insurance laws, but maintains they are a nonprofit mutual aid organization. The roots of this program, according to its staff, are in the Amish tradition of community members pitching in for each other’s healthcare costs when in need.The Old Order Amish do not typically carry private commercial health insurance, and about two-thirds of the Amish in Lancaster County participate in Church Aid, an informal self-insurance plan. The Amish have asserted and been approved by the government to opt out of national healthcare.

I wouldn’t have survived without the help of my community and alternative medicine. We need more locally based, community-driven medicine with design, feedback and participation from doctors and patients, not corporate executives that see life value in terms of short-term, quarterly profits. As the national government flounders, communities should pick up the reins, cut out the middlemen, and start implementing these simple and low cost local solutions.

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