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NEWS & LETTERS,
AUGUST-SEPTEMBER 2003
Workshop Talks
‘For a few dollars more’
by Htun Lin At the HMO where I work, new machines are being introduced
that can identify someone based on their fingerprints, voiceprint, and eye
patterns. These will not be used to track terrorists and criminals, but to track
us workers, to make sure we comply with their new cash-handling procedures. The company official instructing us made us sign an
agreement that said “failure to comply...may lead to loss of employment.”
One young Latina who works as a receptionist said, “Why do I have to give up
my fingerprints just to keep my job? It feels like I’m being treated like a
common criminal.” The instructor assured us that this agreement was drafted
with the approval of our union officials--the union’s name is right on the
letterhead of the company form. What’s new for us is that the union has
now become a full partner in carrying out management’s disciplinary apparatus.
DEGRADING WORKERS AND PATIENTS What both management and the union want to pound into us is
that these new “security” measures they are imposing are absolutely
necessary in a world where everything, even healthcare, has become mere
commodities. Capitalists need to track their commodities. And we workers have
become mere appendages to their machines, which track those commodities. One of those commodities tracked now is the number of times
a patient uses a hospital bed. Sometimes it feels like our job is to
punish the frequent user (the sicker and older patients) with a higher “sick
tax,” because they owe another huge co-payment for each admission. We are told
daily that our increased performance in “revenue recovery enhancement” will
determine the size of our annual bonus. One of the biggest lies is their assertion that reducing
costs is for the benefit of healthcare consumers. This is how HMO executives
justify increasing co-payments imposed on patients, while at the same time
reducing services. They insist they have to cut services and impose new costs on
patients, in order to reduce costs. In other words, they have to harm the
patient in order to help him. Even George Orwell couldn’t have been more
ironic. TARGETING THE SICK While I hear a lot of economic clichés about “supply and
demand” to rationalize price increases, in practice, healthcare organizations
are manipulatng both supply and demand to milk all sides of the system for their
gain. With bean counters in charge, the sickest are targeted for the
greatest financial pressure. I’ve heard patients say things like “It doesn’t pay
to be sick,” or “I never should have let that doctor examine me in the first
place,” or “Next time, I’ll just keep him at home, it’s cheaper.”
People in effect weed themselves out of healthcare, based on their inability to
pay. Patients are beginning to catch on to the words of one bumper sticker:
“Our National Health Plan: Don’t Get Sick.” Senior citizens on Medicare are the HMOs’ favorite target
for price-gouging through increasing co-payments. The goal is to reduce
their healthcare demand. Seniors are now in the crosshairs especially
because the Bush administration deliberately underfunded healthcare these
retired workers have already paid for. Every time I see an old patient on
Medicare being punished by huge co-payments, I see their money going towards
Bush’s war, and his tax cut for the rich. HARVESTING PATIENTS The huge Tenet Hospital chain shows another deadly side to
healthcare run primarily for the bottom line. It is the most egregious
example of how unparalleled revenues are brought into a multi-billion dollar
company. In Redding, Cal., Tenet and its Chief of Cardiology were engaging
in criminal activity by performing unnecessary angiograms and heart-bypass
surgeries on patients who didn’t even need them. When there’s a pool of
money available to dip into, health care managers find a way to artificially
boost “demand.” Nurses and doctors appealed to Tenet’s management to
conduct an administrative review of the practices. Management rebuffed their
appeal, and instead promoted the cardiologist and put his face on Tenet’s ads
because, to them, he was their star performer in enhancing their bottom line. He
marketed a lucrative commodity even if it had no use and in fact did enormous
damage. We have entered a brave new world where patients are
treated either as financial liabilities or opportunities for revenue
enhancement. Health workers are treated as either mere labor cost to be cut, or
as enforcers of revenue enhancement. There’s no other way out of this dehumanized world of all against all dictated by capital’s perverted form of social “cooperation” unless we begin to consciously strip away the commodity form out of not only healthcare but also other areas of life and labor in society in general. |
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