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NEWS & LETTERS, March 2002
Column: Workshop Talks by Htun Lin
Truth of John Q. A CEO of a major HMO said in
1996, "If the airline industry were run like the healthcare industry, you
wouldn't want to fly." Although Hollywood may have made the Denzel
Washington film John Q. into an exaggerated melodrama, the situation is based in
reality. The hero, John Q., is an
African-American factory worker on the outskirts of Chicago whose job has been
downsized as production moved to a Third World country. After his son collapses
at a Little League baseball game, John Q. discovers to his surprise that his son
has an enlarged heart and needs a transplant. When he asks how in the world
so many doctors could have failed to diagnose his son’s problem, one nurse in
the ER blurts out that doctors are told to keep costs down, and to postpone
procedures for conditions that are not immediately life-threatening, and they
get a fat bonus check at the end of the year. It is true that our nation’s
doctors have been reduced to the same status as the rest of us workers—namely
ever decreasing control over the quality of one’s work, made hostage to the
demands of capital to cut costs. Unbeknownst to John Q., the
company which downsized his job had automatically downsized his health
insurance, which no longer covered transplants. He goes ballistic after the
hospital administrator advises him to make his son comfortable and prepare him
for his inevitable “last days.” He resorts to desperate measures by taking
hostages at the hospital, including a cardiac surgeon, to get his son a new
heart. Organ donor groups expressed
frustration that the film focuses on lack of insurance rather than organ
availability. Yet a spokesman for one organ transplant center could not
unequivocally deny that people ever fail to get on organ recipient lists because
of lack of funds. What is conveyed accurately is the commodity nature of every
aspect of our health care system. LIVES DEVALUED John Q.’s co-worker
complained, “I think the whole thing just sucks. What we have in this country
is not family values but value, because they put a value on everything." It
is that value which the hospital administrator had in mind when she reminded
John Q., “There are 40 million Americans without health insurance, you’re
not the only one. Later she added, “We can’t
concede to the demands of one hostage taker. That would set a bad example to the
other 40 million." The majority of that 40 million are the working poor,
too poor to afford insurance, yet not poor enough to qualify for governmental
programs like Medicaid. Another worker in the movie pointed out,“This is a
two-tier system. They have modern surgery for the wealthy. And they have sucker
surgery for us." Health care workers
increasingly feel the pressure of being between the HMO patient with legitimate
anger and the dictates of the HMO money managers.
The HMOs know that the employers’ money managers are their real
customers. HMOs made record profits, while tens of thousands of patients and
health workers have been permanently injured by cost-cutting measures. HMOs must
abide by the dictate of capital, if they are to remain players in the market.
They do this by holding hospitals as well as patients and workers hostage to
this despotism on a daily basis. So the story of John Q.
represents a very real hostage situation which workers in the middle feel
everyday, and as a harbinger of more desperate crisis situations to come. In the
hospital where I work, as with many hospitals across the country, the ER (open
24 hours a day) is a place of last resort for many desperate people without
means. LASHING OUT IN DESPeRATION As with John Q., consumed by
their own personal desperation and misery, they may be prone to lashing out.
According to the International Association for Health Care Security and Safety,
285 hospitals surveyed in 1999 reported 213 assaults involving some type of
weapon, and 1,595 other assaults. In my own hospital, many nurses
over the years have reported assaults by their patients, some angered by real or
perceived neglect, some by old patients suffering from dementia. Many nurses and
aides have gone on disability from these attacks. We have had fist fights,
knifings as well as gun incidents in our ER. Management recently decided to
install a metal-detector at the ER front entrance. And an HMO spokesman
complained that Hollywood’s exaggerated portrayal of John Q. may put us in a
bad light and encourage copycat violence. The callousness in those statements
are glaring when you consider that from our own concrete experiences, it is not
John Q.’s violence that we should worry about, but the real and immediate
threats we are already facing daily in the workplace. One spokesman even said there were no 100% guarantees for safety anywhere, so the best you could do was minimize your risks. When capitalists talk about minimizing their risks, they mean financial risks. Many have pointed out the inhuman and immoral nature of runaway greed of HMO money managers. But even without greed, it is the very commodity nature of all aspects of our society that makes us all hostages. |
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