Synopsis

Dr. Rudy Mueller, a respected general practitioner and geriatrician of Jamestown, NY, and a graduate of Case Western Reserve University and The Ohio State University Medical School, took a unique step in 1999. He kept notes on his patients, and on those whom he met when called to the emergency room or elsewhere to consult, who had difficulty accessing or getting complete healthcare. In his book As Sick As It Gets, he tells stories of those who were uninsured, under-insured and who were supposedly insured. The stories describe the specifics of the effects of the American multi-payer healthcare system, especially for those in the lower income quintiles.

Among the uninsured was “George the Carpenter.” He never had a primary care doctor or healthcare insurance as he could not afford the premiums. Being self-employed, he was “too rich” for Medicaid. He delayed seeking care for serious symptoms including blood in his urine and diabetes. He needed surgery for cancer and medications. After much delayed surgeries and hospitalizations, he never recovered and died in a nursing home five months before qualifying for Medicare. The public cost of his failed care was hugely more than the cost of his insurance or the primary care treatments he needed. Had he, and several million men and women and children like him, had universal healthcare, much would have been saved in costs and in their suffering from illness.

Dr. Mueller also reviews the pharmaceutical companies, their marketing practices, the multiples of duplicate drugs, the financial assistance programs and other rituals. He describes the effects on people, duplicated in millions of instances. The stories he relates of the antics of insurers and HMOs and their policies are sometimes funny but more often tragic. Dr. Mueller also writes about doctors. What do physicians think? What pressures do they feel? What are the multi-level barriers to good healthcare? There were 700,000 of them at the time.

When appraising other healthcare systems, Dr. Mueller reports high levels of popular satisfaction where they provide universal healthcare and where they are well designed and well managed. He cites OECD surveys showing two-thirds of the populations as fully or mostly satisfied during the year 1997 in France, Germany, The Netherlands, Sweden, Denmark, Finland and Luxemburg.

Analyzing the costs in America, he cites eight segments of expenditure where the US is higher and then adds one that he considers a key reason for the American costs being nearly double the average of other rich nations. This is that we have too many sick people. There are several million people every year with stories similar to George the Carpenter. Dr. Mueller offers a trove of data from the time with a well-referenced book. His treatment plan is to establish universal healthcare in the United States.

The new book forthcoming from Olin Frederick Publishing, America’s Healthcare Realities, adds considerably to the data and more thoroughly connects the dots among the many different aspects of the American healthcare system. It describes the history of “The Illness Lobby” that promotes the “market driven” healthcare system and it provides a total structure for implementing and financing single-payer universal healthcare for the United States.