The View From Here? Pass the empathy, please!

by Marianne Richmond on June 30, 2009

toesThe word “empathy” became a topic for discussion last month when President Obama used it in the context of choosing a Supreme Court Justice to replace Justice Souter.  Specifically, the President said he wanted a Justice who “understands that justice isn’t about some abstract legal theory or footnote in a casebook; it is also about how our laws affect the daily realities of people’s lives, whether they can make a living and care for their families, whether they feel safe in their homes and welcome in their own nation. I view that quality of empathy, of understanding and identifying with people’s hopes and struggles, as an essential ingredient for arriving at just decisions and outcomes.”

He then went on to discuss dedication to the Constitution and the law as further requirements for his choice of a Justice but it seems as if “empathy” got all the attention, and most of it seemed critical of the trait; as if our laws were somehow black and white, clear as written and beyond interpretation. Why then would we even need the myriad of courts that we have and the thousands of judges that preside over them? Let’s be honest here, every judge on every bench in every court by virtue of being human, just like the rest of us mere mortals, see others through the lens of their own experiences.

Empathy is relative. The quality of empathy as defined by President Obama as understanding people’s hopes and struggles and applying that understanding to legal decisions could just as easily be applied to the government’s dealing with banks in the financial crisis.

For instance, Bill Moyers stated in a PBS interview  of Simon Johnson that “Geithner has hired as his chief-of-staff, the lobbyist from Goldman Sachs. The new deputy secretary of state was, until last year, a CEO of Citigroup. Another CFO from Citigroup is now assistant to the president, and deputy national security advisor for International Economic Affairs. And one of his deputies also came from Citigroup. One new member of the president’s Economic Recovery Advisory Board comes from UBS, which is being investigated for helping rich clients evade taxes.”

Do these appointments indicate that Geithner’s empathizes with the banks’ “hopes and struggles”? Moyers asks “how do they make a dispassionate judgment about how to deal with Goldman Sachs when they’re so intertwined with Goldman Sachs’ mindset?” I don’t have an answer for those questions about Mr. Geithner. His charge is to lead the economic recovery which I hope includes a visit outside of his apparent comfort zone.

According to the latest economic data unemployment is continuing its rise, the mortgage delinquency rate is getting worse, and credit card defaults are climbing; the debate on health care is ongoing.

In the last few months my family and I have personally experienced the insane cost of health care and allowed me the opportunity to gain a very healthy dose of empathy. In April my son had an appendectomy: Emergency room, operating room, one overnight and the hospital bill was $17, 867.00. At the beginning of May, I began a month long journey that took me to the ER, to several doctors and several out-patient tests and finally to an ulcer diagnosis. For the 3 hour stay in the ER including a CT scan the hospital bill was $6028.00. I also missed a lot of days in the office and I am self employed.

OK, so we have health insurance. The $17.8 hospital charge magically becomes a $2000.00 out of pocket charge; the $6028.00 hospital charge becomes through the wonders of insurance company calculations a $971.00 bill for me with a note from my insurance provider that I have saved $5036.37 by using one of their providers. What is the REAL cost of the healthcare that is delivered? To me, this is one of the basic issues of the health insurance quagmire. I read somewhere recently that every medical treatment that is delivered is revenue for someone.

But, what if we didn’t have health insurance? An un-budgeted, unexpected $24k surprise.  And another scarier what if….what if the hospital stay had been a week? A $100k surprise in the middle of the worse economic environment in a lifetime where all the usual safety nets, credit cards, home equity loans, home sale are not available? And what if my ulcer had been something worse, less manageable and longer lasting?

The “View From Here”? it was a little too close for comfort. I could visualize pretty clearly how people were finding themselves upside down. I could feel it. Empathy is a good thing for a Supreme Court Justice, and for everyone who is setting policies, passing laws and passing judgment on others. Health Care needs to be fixed….the thought of the federal government administering it does not instill confidence.

A recent article in the New Yorker, aptly named The Cost Conundrum analyzes health care costs vs quality in McAllen Texas. McAllen has the lowest household per capita income in the country, $12,000; it also is one of thre most expensive health care markets in the country, spending $15,000 per Medicare enrollee, twice the naational average and $3000 more than the average person living in McAllen earns.

I highly recommend that you read the entire article, but in a nutshell, the author, Atul Gawande contrasts the McAllen model which is driven by a lucrative incentivized physician revenue model versus the Mayo Clinic model, an empathy model where the tenet is “the needs of the patient comes first.” At Mayo there is a team approach, revenues are pooled and doctors and staff are paid a salary, and a goal is to eliminate the financial barriers of access to quality care.

Pass the empathy and maybe the mess can be fixed.

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{ 2 comments… read them below or add one }

MotherOfBun July 7, 2009 at 1:07 pm

I can so relate to the healthcare costs! We have some of that “why do we even bother?” health insurance. We’ve paid out $1,800 in med bills in the past two months. (This doesn’t even take into account the costs of a miscarriage, the resulting surgery and follow-up appts and my son’s trip to urgent care earlier this year.) I’ve got more bills on the horizon for allergy shots, blood tests, (2 @ $500 a test), my son’s annual check up and a specialist I have to see.

I finally broke down last night. Hubby’s company suspended bonuses many months ago. A big chunk of his salary comes from bonuses since he’s performanced based. So even though he’s meeting goals and making good on his committments, we aren’t getting that money because sister companies are struggling to stay afloat. They don’t want to lay anyone off. But we’ve needed that money more this year than ever. (Ironic. He gets a big promotion but now makes less than many of the people he oversees. And my job hunt has been going crappy.) Less money this year + more expenses? Health care is draining our savings. And what’s scarey is not knowing how long this is going to go on.

Marianne Richmond July 7, 2009 at 1:48 pm

Thanks for adding your similar experiences….this is reality for so many people and there really won’t be an economic recovery any time soon as long as the unexpected medical bills keep landing in mailboxes.

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