I took a train down to Manhattan about a week ago to see the Occupy Wall Street protests. At that time, many of the protesters had marched into Washington Square Park from Lower Manhattan. Just beyond most of the commotion, closer to the Washington Square Park arch, stood a comparatively reserved group of five or six people wearing white coats and holding cardboard signs that read “Doctors for the 99%.”
The next day, in Zuccotti Park, I found my way to the medic area and met Dr. Deanne Lembitz. She and the other volunteer clinicians were there to treat the minor ailments and injuries that result during a day’s protest, such as blistered feet, nausea, headaches, scrapes, and bumps. Dr. Lembitz told me why she, a family doctor, had come all the way from Colorado to Occupy Wall Street.
Over the last several years, she explained, “I began noticing that my middle-income patients were beginning to look more and more like my indigent patients.” Dr. Lembitz was troubled by this trend. She decided to do some digging and found that a growing number of her patients were having difficulty affording their co-pays and insurance premiums. They were avoiding care altogether.
Dr. Lembitz thinks the culprits for these growing health disparities are the for-profit interests in medicine. She argues that for-profit organizations such as health insurance companies generate revenue in the only way they can, by “restricting access to care.” Her solution: ending what she sees as “profiteering” in medicine – companies making huge profits at the expense of patient suffering – and, ideally, a shift toward a single-payer system.
Along with Dr. Lembitz, there was another physician, as well as a psychologist, an herbalist, a home health nurse, and an EMT. While I was there, an anesthesiologist stopped by and inquired about volunteering his time. Of course, no one was waving around diplomas or state licenses. I can only assume, from a mixture of good faith and my own judgment, that these titles were in fact accurate.
The nurse, Janet (who did not give her last name), explained that she was “marginally” employed. With her time off, she decided to support the effort of the protestors by volunteering at the clinic. As a former medical social worker, she explained that she witnessed the cracks in our medical system, sometimes seeing patients discharged from the hospital even when it appeared obvious they needed additional care that they could not afford.
After leaving the clinic I met a psychiatrist, Dr. Robert Redondo, on the perimeter of Zuccotti Park. Dr. Redondo described gradual and potentially harmful changes in his profession. He spoke of an increasing amount of pressure for cost control and efficiency: a growing proportion of his professional decisions had to be pre-approved by insurance providers.
While cost control and efficiency can be beneficial in reducing the growth of health care expenditures, the concern for doctors like Redondo and Lembitz is that they are reducing the quality of patient care. The worry is that such changes are implemented not out of concern for patients or a functional health care system generally, but are merely motivated by the financial interests of insurance companies, managed care organizations, and health care industry’s corporate executives.
It’s not hard to understand these doctors’ frustrations, especially when you come across reports on the extremely high pay scales of health care’s leaders. According to a Wall Street Journal survey of all industry CEOs, health care CEOs beat the lot with top salaries – a whopping $10 million median salary in 2010. Increased profits are supposed to signal a healthy industry. However, the health care workers occupying Wall Street seem to think that industry is increasingly failing patients.
The protesting clinicians are, at the very least, raising important concerns. If profits in the health care industry continue to grow at the expense of the sick and suffering, then we have a fundamental moral problem on our hands. Health and healing are the things that ought to be incentivized; if the propagation of suffering is compatible with a thriving industry – the very industry that is meant to protect the suffering – then our system has failed us.
Injuries can be mended and illnesses can be prevented and sometimes cured, but when patients suffer because the health care system is broken, helping them is beyond the power of individual clinicians. It is this sense of powerlessness that, I imagine, draws these health professionals to Wall Street. The protests offer a glimmer of hope for these women and men looking to remedy larger, structural problems that extend beyond the clinic.
The concerns they raise aren’t novel; health inequity, increasing bureaucracy, and “profiteering” in medicine have long been part of the public discussion of our troubled health care system. These are enormous and complex problems. It remains to be seen if the Affordable Care Act will bring about some of the change that is needed, or whether this reform will survive the political process at all. So far, we have had the most success in ignoring the failings of our health care system. But when our doctors are hitting the streets in frustration, it is a strong indication that these matters are becoming far too severe to ignore any longer.
Cameron Waldman is a research assistant at The Hastings Center.