Plead for charity or die: A blunt message from the American health care system

By Nancy Hanover
28 November 2018

The bourgeoisie … has left no other nexus between man and man than naked self-interest, than callous cash payment, Karl Marx, the founder of scientific socialism, noted famously in the Communist Manifesto.

One recent event testifies that it has never been truer.

Last week, Hedda Martin, a 60-year-old Grand Rapids, Michigan, resident, was informed that despite her immediate life-threatening congestive heart failure, she needed to raise $10,000 before she could be put on a list for a possible heart transplant.

“The decision made by the [multidisciplinary heart transplant] committee is that you are not a candidate at this time for a heart transplant due to needing more secure financial plan for immunosuppressive medication coverage. The Committee is recommending a fundraising effort of $10,000,” the notification from Spectrum Health read, in coldly matter-of-fact language.

Copy of the letter from Spectrum Health

Martin’s son, posting the story on the fundraising site, GoFundMe, implored the public: “Imagine [her] disappointment when she was told she was denied due to finances. Mom work[ed] all her life. She paid taxes into medical care and held up the economy by spending most of her hard earned dollars. Now this.”

Hedda Martin’s story and Spectrum Health’s denial letter have since gone viral on social media. The crisis immediately struck a nerve among workers and young people across the US, many of whom are all too familiar with the burdens of high deductibles and co-pays as well as medical debt, the most common cause of personal bankruptcy.

Spectrum Health told the media that the cause of Martin’s rejection was her insurance’s annual deductible of $4,500 and drug co-pay of 20 percent, stating that if she couldn’t afford the immunosuppressant drugs the donor heart would be “wasted.” Costs are sometimes a “regrettable and unavoidable factor in the decision making process,” they said, justifying their decision.

Sky-high annual deductibles coupled with punitive co-pays in the range of Martin’s were made commonplace by the fraudulently named Affordable Care Act (ACA) otherwise known as Obamacare. Initially sold to the public as a step toward universal health care, the ACA is a cynical plan created by the insurance companies, pharmaceutical industry and hospital chains, which dramatically increased profits to the multitrillion-dollar industry while pricing essential medical services out of range for large portions of the American population.

The response of working-class Americans has been in sharp contrast to the businessmen in charge of hospital cost management. Hedda Martin’s GoFundMe page has been inundated by donations, well-wishers and countless people expressing their outrage at the brutality of Spectrum Health and the prevailing nature of health care. Close to $30,000 has been posted to the site in an outpouring of both personal generosity and social anger.

Hedda Martin and son

“It’s not even as if the doctors are arguing that someone else is more deserving—it’s simply about money. So sad,” said donor Christine Briggs. Michael said, “I hate to hear a story like this! I am a medical doctor and feel that everyone should get transplants FREE (i.e. paid by everyone who pays taxes).” Maya pointed to the class divide, saying, “If this were a VIP, do you think they wouldn’t be on the top of the list already or even have had the surgery and drugs needed?”

Another donor, Debbie, emphasized the obscene profits of the pharmaceutical companies stating, “The medications are very expensive, and quite necessary…those who are poor cannot always afford it. This is a shame in this country.” Another pointed out that Spectrum is a “multimillion dollar organization” and that “treatment like this by our healthcare system is criminal.”

Indeed it is.

It should also be noted that the hospital involved is Spectrum Health’s Richard DeVos Heart & Lung Specialized Care Clinic. The family of recently deceased Richard DeVos, Sr., co-founder of pyramid-scheme Amway Corporation and father-in-law of current Education Secretary Betsy DeVos, is worth an estimated $6 billion. Obviously Hedda Martin’s need for upward of $10,000 in immunosuppressive drugs is a mere drop in the bucket to these oligarchs, but more to the point, their ill-gotten family fortune itself could go a long way to providing health care to tens of thousands of Americans.

The DeVos family epitomizes the class character involved in access to health care. After two strokes and two bypass operations, Richard DeVos travelled to Great Britain to receive specialized care and a heart transplant at the age of 71. Soon thereafter, he was golfing and sailing on his yacht, enthused a report in the Grand Rapids Press. British health officials reacted to the claims that DeVos’s fortune provided the billionaire special care, stating, “He cannot buy a heart; he can only buy his treatment.” DeVos, who lived another 20 years, provided a “substantial gift” to the Grand Rapids facility, getting his name on the door that was later slammed in the face of Hedda Martin.

The DeVos Mansion on Lake Macatawa, Michigan

The DeVos clan is infamous for their promotion of an extreme right-wing agenda including school privatization, homophobia, religious obscurantism and even child labor. Their billions were accrued in the face of various state and federal lawsuits for tax-dodging, while their operations were prettified by numerous awards for philanthropy and Compassionate C apitalism, (the title of one of Richard, Sr.’s books). The DeVos Family may be a particularly malevolent “face” of the attack on Martin, but her story is repeated daily across the US.

“Every transplant center can do what they want,” Dr. Laura Siminoff, a bioethicist, noted in an ABC News article, “Need an Organ? It Helps to Be Rich,” published in 2006. “Centers have different practices. And if you’re a well-to-do patient, you can shop around to centers. But if you don’t have any money, you will go wherever is closest, and their policies are what you are stuck with.” A study, “Health Insurance and Cardiac Transplantation: A Call for Reform,” noted the discrepancy between organ donations and recipients, estimating that as many as 25 percent of the poor or uninsured give their organs, but very few receive them.

Again, such trends have worsened in the aftermath of Obamacare. Research published in JAMA Cardiology (Journal of the American Medical Association) shows that far from bettering conditions for those suffering from congestive heart failure, ACA policy has led to a 5 percent increase in deaths. Obamacare’s Hospital Readmissions Reduction Program financially penalized hospitals for heart failure readmissions, thereby raising the death toll with hospitals opting to send suffering patients home instead of admitting them. According to one of the study’s senior authors, these findings could account for an additional 5,000 to 10,000 deaths annually across the US due directly to the program.

“GoFundMe is our healthcare system now,” observed a young lady in the Public Health Department at Temple University speaking to this reporter. There is truth to her statement. Since the crowdfunding site was created, almost half of its money has gone to health-related campaigns. In 2017, that amounted to $930 million contributed to desperate families seeking medical care.

Martin posted early Sunday that she was “overwhelmed by everyone’s kindness. I will get better and fight to my last breath the injustice and greed in our healthcare and pharmaceutical sectors,” she concluded. Having raised the cash, she said the hospital may now reconsider her case.