We took a family vacation up toward the Cabinet Mountains in western Montana. This meant we got to go through the beautiful town of Libby on the Kootenai River.

Libby is famous for asbestos. And asbestos gives you more than 15 minutes of fame.

There was a vermiculite mine there, operated at a wonderful profit for the mine owners for some 70 years. The vermiculite contained asbestos. They declared bankruptcy when the cancer claims started rolling in. See, profit isn’t forever, but dead is.

The US government did what they could, I guess. In 2009 EPA declared a public health emergency. Haven’t such declarations always fixed things?

Max Baucus, a Democratic Senator from Montana thought he had a solution. He was in a pivotal position as ObamaCare got debated back in 2011. He had anyone testifying before his Senate committee who brought up the suggestion of “Medicare for All”, universal coverage, arrested. Though he found voicing such a solution to our health care problems criminal in testimony, he was not above slipping such a solution into some of those thousands of pages of the Affordable Care Act for Libby and Franklin County, Montana citizens.

His amendment offered free, never had to pay a dime into FICA, don’t have to be over 65, Medicare coverage to anybody living in Franklin County Montana exposed to asbestos. This might explain why Medicare has a payment code for “vaginal delivery”. Not everybody on Medicare is over 65.

This coverage follows qualifiers after they leave Franklin County. I’ll admit, I delivered a baby of a resident who moved to Moscow, Idaho from Libby. So, I am guilty of dipping my finger into this cookie jar.

I guess for Max Baucus an environmental/ public health emergency warrants universal health coverage, but public discussion of such a solution is criminal? Welcome to the American Healthcare Follies.

We like piecemeal, not universal solutions in this cowboy country.

Another such bite at the apple occurred back when the invention of kidney dialysis put the “God Committee” in charge of who lives or who dies. Swedish Hospital in Seattle had 17 machines, and there were thousands dying from kidney failure, so a committee chose the folks who got the treatment. In response to the uproar when Life Magazine did a cover story, our government offered universal Medicare coverage to anybody with the diagnosis of “end stage renal disease”. Not only would someone with this diagnosis get their dialysis covered by Medicare, but their erectile dysfunction is paid for too.

So, we offer universal government coverage based on county of residence, your exposure to a bad chemical, or if you have a qualifying diagnosis. We sure love piecemeal solutions, don’t we?

Some argue we should expand this piecemeal approach to medications. Say you need insulin. Then it should only cost you $XX a month. The Big Pharma CEOs and stockholders will expect their whittled down returns to be made up on the cost of blood pressure medications.

It’s a lot like me fixing the dripping faucet on a rundown house with a falling in roof and a settling foundation. Sometimes it’s just best to scrape the failing structure and start over.

Have we come to that point with American Healthcare? Max Baucus, no longer in the Senate, now says maybe we should be considering universal coverage and single payer.

Just how should healthcare be paid for and apportioned? Oops, will I get arrested for bringing this up? I’m not in front of a Senate Committee, so I’m probably OK. But I sure won’t get elected to public office anytime soon. No, to please the public you have to propose piecemeal solutions for poor, innocent victims.

If we keep this up, we’re all guilty.

About ddxdx

A Family physician, former county coroner and former Idaho State Senator
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