The Miniscule Value of Human Life Under Capitalism
Human life is surprisingly cheap in a post-Covid world: to elites, it is not worth even a moment's discomfort or concern for vulnerable individuals and their families.
A recent Guardian article asks “Are Canadians being driven to assisted suicide by poverty or healthcare crisis?”
After pleading unsuccessfully for affordable housing to help ease her chronic health condition, a Canadian woman ended her life in February under the country’s assisted-suicide laws. Another woman, suffering from the same condition and also living on disability payments, has nearly reached final approval to end her life.
The two high-profile cases have prompted disbelief and outrage, and shone a light on Canada’s right-to-die laws, which critics argue are being misused to punish the poor and infirm. In late April, the Spectator ran a story with the provocative headline: Why is Canada euthanising the poor?
But medical and legal experts caution that oversimplified media coverage of the cases fail to capture the realities of the system – and warn that sensationalist coverage of a handful of “extreme” cases ignores a larger crisis in the country’s healthcare systems.
In February, a 51-year-old Ontario woman known as Sophia was granted physician-assisted death after her chronic condition became intolerable and her meagre disability stipend left her little to survive on, according to CTV News.
“The government sees me as expendable trash, a complainer, useless and a pain in the ass,” she said in a video obtained by the network. For two years, she and friends had pleaded without success for better living conditions, she said.
Now a second case has emerged with several parallels: another woman, known as Denise, has also applied to end her life after being unable to find suitable housing and struggling to survive on disability payments.
Denise, as it happens, would be temporarily saved by an increasingly popular fundraising method for the desperate, online donations:
She said the support she has received - including thousands of dollars in donations from well-wishers - has “stabilized” her life.
“It’s ... mind-blowing and inspiring,” she said during a phone interview with CTV News. The outlet noted that “her voice sounded considerably stronger” than during their April conversation.
In April, she said she had tried to find and failed for months to find housing with cleaner air but gave up and was approved by two physicians for an assisted death.
She’s now found a temporary home where she isn’t struggling to breathe and her suffering has decreased. Her MAID application is now on pause, but Denise said she hasn’t cancelled her MAID application because she still suffers from painful chronic health problems that haven’t been properly handled….
One of Denise’s doctors, the medical director at the Environmental Health Clinic at Women’s College Hospital in Toronto, Dr Riina Bray, told CTV News that the “irremediable suffering” that meant Denise was eligible for MAID was solvable.
“These patients can easily return to wellness if they are given the right environment to live. It’s a simple equation,” she said.
A simple equation, but one North America has proven itself incapable of solving as the devaluation of human life, accelerated significantly by the Covid response (which has amounted to “normalcy as we envision it is worth your mass death and disability”), continues unabated:
Alan Nichols had a history of depression and other medical issues, but none were life-threatening. When the 61-year-old Canadian was hospitalized in June 2019 over fears he might be suicidal, he asked his brother to “bust him out” as soon as possible.
Within a month, Nichols submitted a request to be euthanized and he was killed, despite concerns raised by his family and a nurse practitioner.
His application for euthanasia listed only one health condition as the reason for his request to die: hearing loss.
Nichols’ family reported the case to police and health authorities, arguing that he lacked the capacity to understand the process and was not suffering unbearably — among the requirements for euthanasia. They say he was not taking needed medication, wasn’t using the cochlear implant that helped him hear, and that hospital staffers improperly helped him request euthanasia.
“Alan was basically put to death,” his brother Gary Nichols said.
Disability experts say the story is not unique in Canada, which arguably has the world’s most permissive euthanasia rules — allowing people with serious disabilities to choose to be killed in the absence of any other medical issue.
Many Canadians support euthanasia and the advocacy group Dying With Dignity says the procedure is “driven by compassion, an end to suffering and discrimination and desire for personal autonomy.” But human rights advocates say the country’s regulations lack necessary safeguards, devalue the lives of disabled people and are prompting doctors and health workers to suggest the procedure to those who might not otherwise consider it.
The problem is not right to die laws or compassionate euthanasia, but as is the usual case, the corruption of even humanizing, compassionate programs by capitalism. Prurient financial concerns are inevitable in such a system, even one with piecemeal, inadequate regulatory programs such as the Affordable Care Act, little more than a love letter to insurance companies despite its promises to protect patients from exploitation:
In 1993, before the Blues went for-profit, insurers spent 95 cents out of every dollar of premiums on medical care, which is called their “medical loss ratio.” To increase profits, all insurers, regardless of their tax status, have been spending less on care in recent years and more on activities like marketing, lobbying, administration and the paying out of dividends. The average medical loss ratio is now closer to 80 percent. Some of the Blues were spending far less than that a decade into the new century. The medical loss ratio at the Texas Blues, where the whole concept of health insurance started, was just 64.4 percent in 2010.
The framers of the Affordable Care Act tried to curb insurers’ profits and their executives’ salaries, which were some of the highest in the U.S. health care industry, by requiring them to spend 80 to 85 percent of every premium dollar on patient care. Insurers fought bitterly against this provision. Its inclusion in the ACA was hailed as a victory for consumers. But even that apparent “demand” was actually quite a generous gift when you consider that Medicare uses 98 percent of its funding for health care and only 2 percent for administration.
Why did EmblemHealth agree to pay nearly $100,000 for each of Jeffrey Kivi’s infusions, even though they cost only $19,000 at another hospital just down the street? First, it’s less trouble for insurers to pay it than not. NYU is a big client that insurers don’t want to lose, and an insurer can compensate for the high price in various ways — by raising premiums, co-payments, or deductibles. Second, now that they suddenly have to use 80 to 85 percent rather than, say, 75 percent of premiums on patient care, insurers have a new perverse motivation to tolerate such big payouts. In order to make sure their 15 percent take is still sufficient to maintain salaries and investor dividends, insurance executives have to increase the size of the pie. To cover shortfalls, premiums are increased the next year, passing costs on to the consumers. And 15 percent of a big sum is more than 15 percent of a smaller one. No wonder 2017 premiums for the most common type of ACA plan are slated to rise by double digits in many cities, despite economists’ assurances that the growth of health care spending is slowing.
A stark example of the illogical processes guiding for-profit healthcare is the drug insulin, which is uniquely expensive in the US:
The prices of insulin has soared in the US in recent decades and is more than eight times higher in the US than in 32 comparable, high-income nations, according to a Rand Corporation study.
With an average list price of $98.70 per unit in the US, compared with $7.52 in the UK, US insulin sales account for nearly half the pharmaceutical industry’s insulin revenue, though the US makes up only about 15% of the global market.
Many diabetics require several vials of insulin a month, in addition to the costs of medical supplies and monitoring equipment. A 2022 study by CharityRx found 79% of Americans with diabetes or who care for someone with diabetes reported taking on credit card debt to pay for insulin, with an average debt of $9,000. One in four Americans have reported rationing insulin due to the high costs, which can be fatal.
As part of the Inflation Reduction Act passed in the Senate this week, the Biden administration proposed a $35 monthly cap on the cost of insulin in the private market. But the proposal was blocked by Republicans. Connelly, a type 1 diabetic from Illinois who was diagnosed at the age of 33, said she was “devastated”….
But even a cap on private insurance co-pays wouldn’t have affected the real price of insulin in the US. The proposal would merely have limited the co-pay for the price of insulin to $35 for those with private insurance, with insurance expected to cover the difference. It would also probably have resulted in increases for insurance premiums. Those without insurance would still have been expected to pay exorbitant prices for insulin.
Why is insulin not available as a generic? The answer boils down to unthinking greed and patent system exploitation:
A generic version of insulin, the lifesaving diabetes drug used by 6 million people in the United States, has never been available in this country because drug companies have made incremental improvements that kept insulin under patent from 1923 to 2014. As a result, say two Johns Hopkins internist-researchers, many who need insulin to control diabetes can’t afford it, and some end up hospitalized with life-threatening complications, such as kidney failure and diabetic coma.
In a study published March 19, 2015, in the New England Journal of Medicine, authors Jeremy Greene, M.D., Ph.D., and Kevin Riggs, M.D., M.P.H., describe the history of insulin as an example of “evergreening,” in which pharmaceutical companies make a series of improvements to important medications that extend their patents for many decades. This keeps older versions off the generic market, the authors say, because generic manufacturers have less incentive to make a version of insulin that doctors perceived as obsolete. Newer versions are somewhat better for patients who can afford them, say the authors, but those who can’t suffer painful, costly complications.
The dangerous rationing of insulin is a microcosm of Western healthcare, wherein patients are hesitant to seek out routine preventive maintenance out of a fear of incurring exorbitant medical bills. This reticence to seek out care has been transforming into a positive denial of care by the industry for some time, exemplified in the above stories about stressed healthcare systems resorting to suggestions of assisted suicide in place of simply providing adequate care for patients. From the AP story linked above:
In one recording obtained by the AP, the hospital’s director of ethics told Foley that for him to remain in the hospital, it would cost “north of $1,500 a day.” Foley replied that mentioning fees felt like coercion and asked what plan there was for his long-term care.
“Roger, this is not my show,” the ethicist responded. “My piece of this was to talk to you, (to see) if you had an interest in assisted dying.”
Foley said he had never previously mentioned euthanasia. The hospital says there is no prohibition on staff raising the issue.
Catherine Frazee, a professor emerita at Toronto’s Ryerson University, said cases like Foley’s were likely just the tip of the iceberg.
“It’s difficult to quantify it, because there is no easy way to track these cases, but I and other advocates are hearing regularly from disabled people every week who are considering (euthanasia),” she said.
Frazee cited the case of Candice Lewis, a 25-year-old woman who has cerebral palsy and spina bifida. Lewis’ mother, Sheila Elson, took her to an emergency room in Newfoundland five years ago. During her hospital stay, a doctor said Lewis was a candidate for euthanasia and that if her mother chose not to pursue it, that would be “selfish,” Elson told the Canadian Broadcasting Corporation.
The Afghanistan and Iraq Wars proved to the elites, if there was ever any doubt in their minds, that Americans are willing to accept a sharp devaluation in human life—we do not even know how many innocents died in these senseless, illegal wars, but the number is almost certainly in excess of one million in Iraq alone, with many millions more displaced and impoverished in the Middle East; despite the illegality and immorality of the wars, Americans rewarded the their architects with reelection in 2004. Do not think that this nonchalance about the victims of imperialism went unnoticed, nor that they are fully explainable by provincial racism. To devalue others’ lives is to rationalize the devaluation of life in general, to posit excuses for organized murder which could just as easily be applied to American families as they were to Iraqi and Afghan ones. “They were only following orders,” for example, can be said of insurance industry leaders and unscrupulous legislators who are as aware of the deadly ramifications of their shortsighted greed as any American warfighter. Lack of access to medical care and health insurance is already tied to tens of thousands of premature deaths in the US annually, a fact surely known and dismissed by thousands of self-interested mansion owners:
A December 2019 poll conducted by Gallup found 25% of Americans say they or a family member have delayed medical treatment for a serious illness due to the costs of care, and an additional 8% report delaying medical treatment for less serious illnesses. A study conducted by the American Cancer Society in May 2019 found 56% of adults in America report having at least one medical financial hardship, and researchers warned the problem is likely to worsen unless action is taken.
Dr Robin Yabroff, lead author of the American Cancer Society study, said last month’s Gallup poll finding that 25% of Americans were delaying care was “consistent with numerous other studies documenting that many in the United States have trouble paying medical bills”.
Despite millions of Americans delaying medical treatment due to the costs, the US still spends the most on healthcare of any developed nation in the world, while covering fewer people and achieving worse overall health outcomes. A 2017 analysis found the United States ranks 24th globally in achieving health goals set by the United Nations. In 2018, $3.65tn was spent on healthcare in the United States, and these costs are projected to grow at an annual rate of 5.5% over the next decade.
High healthcare costs are causing Americans to get sicker from delaying, avoiding, or stopping medical treatment.
Anamaria Markle, of Port Murray, New Jersey was diagnosed with stage three ovarian cancer in 2017. A clerk for nearly 20 years at the same firm, her family says her employer laid her off after the diagnosis, with one year’s severance and health insurance coverage. When the insurance coverage ended, Markle struggled to pay for coverage through Cobra (a health insurance program for employees who lose their job or have a reduction in work hours), additional expenses, copays (an out-of-pocket, upfront fee for a medical service ), and medical debt not covered by insurance.
Laura Valderrama, Markle’s daughter, said: “It wasn’t financially sustainable to keep paying Cobra out of pocket. On top of the premiums you still have to pay the bills. We kept getting lots of bills for surgeries, chemotherapy, all these treatments, all these bills kept coming in.”
Markle decided to stop receiving medical treatment due to the rising costs and debt, and died in September 2018 at the age of 52.
“My mom was constantly doing the math of treatment costs while she was on the decline,” Valderrama said. “I really miss my mom. She shouldn’t have had to make the decision to stop her treatment based on financial costs.”
A 2009 study conducted by researchers at Harvard Medical School found 45,000 Americans die every year as a direct result of not having any health insurance coverage. In 2018, 27.8 million Americans went without any health insurance for the entire year.
Covid drove the point home: a sufficient number of Americans are prepared to die in the service of maintaining the system of lopsided wealth redistribution to the super rich. Expect the value of human life to decline further as climate change strains resources, overpopulation becomes an undeniable issue, and the program of privatization of essential services and education shred what is left of our sense of self-worth and human rights. As a precedent, Covid will herald the end of of a responsible form of collectivism in which society’s health is everyone’s concern, replaced by a negative collectivism in which we are expected to sacrifice our health for the “greater good” of society, or the comfort and profits of our appointed leaders, who have gone as far as to successfully convince us that being asked to wear a simple mask is intolerable tyranny (and the CDC has now abandoned essentially all of its guidelines, leaving the responsibility to protect ourselves solely on us and throwing the immunocompromised to the wolves).
This abandonment of government responsibility has had dire ramifications for the administrators of medical care as well. The US healthcare industry, despite the supposed efficiency of the free market as a guide, is on the verge of collapse due to nurses and other ground-level workers being overworked, infected repeatedly, and grossly underpaid:
A new analysis from Indiana University, the nonprofit Rand Corp. and the University of Michigan highlights the changes in the U.S. health care workforce during the COVID-19 pandemic and found that the average wages for U.S. health care workers rose less than wages in other industries during 2020 and the first six months of 2021. This is in spite of the health care workforce shouldering the heavy burden of fighting the COVID-19 pandemic.
This is the logical endpoint of any for-profit healthcare system: a mimicry of other industries which do not deal with life and death issues yet similarly expect workers to endure harsh, dangerous conditions with vanishingly little pay (a growing problem given stagnant wages and rising costs of goods, exacerbated by climate change-related scarcity). Much like countless examples of the privatization of other essential goods such as water and electricity, introducing market logic when lives are on the line will transform disastrous inefficiencies into deadly ones.
We condemn an untold number of society’s most vulnerable people to death, both directly and indirectly, every moment we tolerate any system short of universal healthcare. Proponents of market based medicine argue for its efficiency, but a functioning system, let alone an efficient one, would never produce numerous tragedies such as this one:
Substitute teacher Gretchen Hess Miller, 48, of Carlisle, Pennsylvania, was diagnosed with oral cancer in 2009 while pregnant. She has had surgery to remove the cancer, but is supposed to receive annual scans to monitor the cancer, but hasn’t received one in four to five years because her family can’t afford it.
“My doctor told me this is an aggressive form of cancer that will come back someday and I need to stay on top of it, but the deductible and the difficulty with dealing with the insurance keeps me from having it done,” said Hess-Miller.
Her insurance coverage currently requires a $5,000 deductible. She says she has previously had to fight to receive coverage because medical care is constantly denied because insurance classifies oral care as dental rather than medical care.
Do these individuals who are denied life-saving, often infuriatingly cheap medical care not have some self-defense recourse against the administrators (in both the private and public sphere) currently overseeing the senselessly violent system which is killing them as surely and remorselessly as an assassin would? Where does the right to self-defense end? It appears that, as the West moves into a post-Covid world, that line is drawn at precisely the point at which the right to preserve one’s life costs the wrong class of people a dime.
ty for letting me know this stuff is going on in my neck of the woods, will keep an eye out for it from now on and take the step in to help if im able