After this past weekend of horrific storms and tornadoes, it was clearly appropriate for our elected officials to declare a federal disaster in some areas. With the designation comes some federal money and help for the storm-ravaged areas and residents. Few would quarrel with our government stepping up and stepping in when so many lives and so many livelihoods have been damaged and lost. It is the right thing to do, and some suffering will be mitigated.

Over the past four years since the making of SiCKO, Michael Moore’s 2007 documentary, an estimated 45,000 people each and every year have died simply because they lacked access to healthcare. The US healthcare dead are dead not because the care wasn’t available – it just wasn’t available to them. They did not have the financial means (either the cash, credit or correct insurance coverage) to demonstrate to a healthcare provider or doctor that they should be treated and that their lives should be saved.

That’s tipping toward the quarter-million dead mark soon enough. The US healthcare dead could fill Trenton, NJ, or the Palm Springs area of California, or Daytona Beach, FL, or Canton, OH, or Boise City, ID, Rockford, IL, or Ann Arbor, MI – to name just a few of the cities with populations roughly equivalent to those killed by greed not disease or injury just since 2006 and 2007 when SiCKO was being produced and when it was released.

And the bankrupt due to healthcare crisis? That’s a tsunami of devastation raging through working families and communities where no one steps in to help. Homes and dreams are lost. Future plans are altered forever. In 2010, nearly 1.6 million people filed for bankruptcy in the US. Estimates that more than 60 percent of those who filed did so because of medical crisis would make the number of US financial casualties due to healthcare crisis a million or so every year gone broke.

Is that not a disaster with enough dead and enough suffering and enough long-term human and economic consequence in these United States to warrant a column-inch or two above the fold or radio or television coverage once in a while or a leading news position somewhere? Mainstream media? Liberal media? Anyone? Who does the daily death count? 123 dead every day. Who reports the financial death? 2,739 gone bankrupt every day. Who reports?

How much death and how much suffering will be enough to warrant our collective attention in appropriate proportion to the damage being done? Talk about a war on your own people? As far as I am concerned, we have nothing to say to other countries about human rights when we so blatantly participate in the death and pain for so many of our own.

When the nation launched into the healthcare reform debate following the 2008 elections, it seemed that patients and their families provided some good background color for the political arguments – much like the military troops and their families are sometimes used to color our discussions of military actions or patriotic devotion.

But in the direct war on working Americans that is being waged within the broken healthcare system, we now seem to have forgotten the healthcare dead and the healthcare broken. The patients and their families apparently served their intended purpose as political props, and now it’s back to business as usual. The dead keep dying and the broke keep going broke, and the money keeps flowing to the top of the healthcare food chain.

At least if we’re not going to declare this an emergency, I wish we’d at least report it as significant. 123 dead for lack of healthcare access a day in the United States in 2011. 2,739 bankrupt due to medical crisis every day in the United States in 2011. The numbers don’t lie. We do. We lie to each other when we ignore the shared reality of the torture and pain behind those numbers.

And to hear assaults on Medicare and Medicaid and any other programs that might reduce even a bit the rising tide of pain is an affront to any sense of common decency any of us might have imagined was present in our society.

If you don’t tell at least one other person today who doesn’t already know it that 123 people died today in this country not from a hole in a jet’s fuselage or an air traffic controller asleep in the tower or even due to a war or a conflict, but because we were too selfish and too greedy to change what could be changed in our healthcare system, then you don’t actually believe it’s a crisis. If we don’t count them, who will?

123 dead today. 2,739 broke today. Your fellow Americans. My fellow Americans. Every day until the day when we actually implement something different, like a progressively financed, single standard of high quality care for all without financial barriers. We know how to do it. We just haven’t demanded that a disaster be declared and that action be taken to mitigate the suffering.

Donna Smith is a community organizer for National Nurses United (the new national arm of the California Nurses Association) and National Co-Chair for the Progressive Democrats of America Healthcare Not Warfare campaign. She is also on Healthcare-NOW!’s Steering Committee.

“Sooner or later people are going to realize that decisions about whether one lives or dies should not be predicated on ‘How much money can I make off this?’” says Michael Moore, looking back at his film Sicko with Donna Smith of National Nurses United. They both note that it’s the health care workers who are leading the fight for a better system for all, even as those workers are under attack themselves.

To kick off our new series, The Nurses’ Station, Michael and Donna joined Laura in studio for a look back at Sicko and a conversation about what has changed since the film was made, and why it’s not enough.

It’s a club I will never be in. Michael Moore told us about them this week. The Forbes 400. The richest 400 people in America. They own more stuff and have more cash and assets than half of the rest of us (roughly 150,000,000+ people) combined.

But I had to dig deeper. It wasn’t offensive enough to me that just 400 people own so much that was as the result of the hard work and suffering of so many of the rest of us. I was willing to bet it was a deeper profile of power in 2011 America than that repugnant statistic alone indicated.

I was right. In the Forbes 400, most of the people are white guys. In fact, 365 are guys. Very few non-white people, and only 35 women are in the club. And Oprah is the only black woman. 365 plus 34 and Oprah.

That just about says what we need to know about our society. It’s a good ol’ mostly white boys and a few mostly white girls plus Oprah club. Their money controls our industries; their industries control our access to the good life or lack thereof. And they are still mostly male, mostly white and drenched in wealth – even 235 years after a bunch of mostly white, all male folks declared that all men had rights unalienable. They weren’t lying about the men part. I’ll give them that.

Sometimes when I am thinking we’ve advanced so far since the Founding Fathers set forth upon this continent a new nation that I forget reality slapping me in the face. I am not on the Forbes 400 or the Forbes 4,000 or the Forbes 4,000,000. And I never will be. I’m a working class white girl.

I guess I will have to content myself with the notion that I’m in a more exclusive club than they are. I am a cancer survivor who weathered financial collapse that followed being an American with inadequate access to healthcare and then had my story told in Michael Moore’s 2007 film, SiCKO. About a dozen of us were featured in that film, and we’re not in the Forbes cohort.

Just yesterday, the report came out that bankruptcies due to medical crisis had not been significantly reduced by the Massachusetts healthcare bill known as RomneyCare, or Chapter 58, the mandated purchase of private insurance, passed in 2006. More than half of all personal bankruptcies still flow from medical crisis and of those going broke, 89 percent had health insurance.

I think that my club, though small, is pretty diverse and full of good-hearted people (men, women and kids of all races, colors, sizes and shapes) who would trade the chance for all the influence and power on earth and a slot on the Forbes 400 list – and our moments of fame in SiCKO — for a transformed healthcare system that provided a single standard of high quality care for all without financial barriers. I like my club better.

Donna Smith is a community organizer for National Nurses United (the new national arm of the California Nurses Association), National Co-Chair for the Progressive Democrats of America Healthcare Not Warfare campaign, and Healthcare-NOW! Steering Committee member.

I’d love to see a Super Bowl commercial Sunday that stated the facts about how many Americans will die on Super Bowl Sunday this year because they didn’t have access to the healthcare they needed. 123 will die on Sunday, and perhaps a photo of one of the dead every 12 minutes or so during a commercial break would be instructive. That’s how often someone dies in the country because he or she couldn’t get care.

The Dead Patient’s Society grows larger by 123 every single day in America. There is no time off for major sporting events.

Every 12 minutes while we jam in nachos and giggle about the most creative Super Bowl ads, someone will die who could have – should have – been saved. That dead person didn’t have the cash or the credit or the insurance approval to get the care he or she might have accessed in order to survive to see the Packers and the Steelers play.

The patients die while doctors and hospitals hold at arm’s length the treatments that could have saved lives. I don’t understand how they do it. I have never understood how the people or provider organizations that take oaths to care for the sick and relieve suffering can get a phone call from an insurance company and then turn their backs when payment is denied. Or how they see a shivering, hurting person and turn them away when care is so easily available. Too bad we cannot run the sick to the field on Super Bowl Sunday and have teams of medical experts rush to treat them. But then they are not star football players, are they?

Oh, I understand the evil empire of the for-profit insurance giants and that providers cannot give away healthcare lest they go broke. I do get that. But, still, I do not know how neighbors turn their backs on neighbors and doctors turn their backs on patients. I couldn’t do it. Maybe I am weak in that regard. I always wonder why we don’t see and hear more about the dear doctors and providers who defy the financial death warrants and treat people in spite of the financial risk. I know there are some. We just don’t hear about them too much. Some doctors say they have to be careful lest their hospitals and other doctors punish them for speaking or acting outside the profit-making fold.

The death every 12 minutes of a sick or injured American won’t make the news on Super Bowl Sunday. It didn’t make the news today, and it won’t make the news tomorrow. We care an awful lot more about the big game than the end game for patients in America.

The membership ranks grow daily from all walks of life, all ages and from all across the nation. While a people’s revolution unfolds in Egypt – and perhaps beyond – American patients are staging their own silent and deadly revolt. Slow, wasting, preventable deaths don’t make the evening news in America or elsewhere.

The 123 Americans who died today without access to life-saving treatment are part of the acceptable cost of doing business for the American healthcare industry – and they are part of the acceptable political casualties for those elected to govern for the common good who just don’t quite do that.

Even our loved ones and neighbors are sometimes immune to the ravages of patients’ realities. Obedient up until the very brutal end, patients and families often don’t know how to fight back against the hospitals and providers who won’t supply the care – or they are mislead into thinking there is nothing that can be done, and the insurance companies that deny the treatment suffer only minimal challenges to their control over life and death decisions for thousands and thousands of people every month.

Monday morning, the big game will be over. Either the Steelers or the Packers will be the champions, and we’ll look forward to next year’s football season and the chance that our favorite team might make it to the big game. For me, it’s the Broncos, so chances aren’t so great.

But for hundreds of Americans, there will be no new season. The rest of us will have been very distracted by all the energy surrounding the game and the hype.

If we had a progressively financed, single-standard of high quality care for all in America, more Americans could enjoy life more fully and be more a part of the communities in which they live. I’m betting many of those who will die this Super Bowl weekend would rather have been cheese-heads than deadheads. But I am also betting most Americans will not be thinking too much about that while such a large and showy distraction allows so many of us to look away.

But if there were a face every 12 minutes on one of those super important, Super Bowl commercial breaks, and a brief line or two about why that person just died and how simple it might have been to save that life, maybe we’d be forced to face our super bowl of suffering. And maybe if we posted a price tag for that live-saving treatment denied, we’d be able to compare the cost for advertising time during the Super Bowl compared to cost to save a life. At least we ought to know honestly what our values really are – saving human life just really isn’t one of our super-priorities.

Ah, we must be more civil. No more taunts. No more tirades. No more gun crosshair targets, no matter how innocently placed on our graphics (though I am not sure gun crosshairs are ever really innocent in placement). We’ll be more civil in our discourse. In light of the tragedy in Tucson. Maybe.

But stand at the front desks in a hospital admissions area or a doctor’s office or at other providers’ offices and civility is the last thing we’ll know. We can be sick – shaking with fever, bending over in pain, bandaged for wounds, chest aching with unknown agony, and the questions and responses will be anything but civil. “What insurance do you have? Where’s your co-payment today? Is that a check, debit or credit card? Do you have a picture ID? Have you signed our legal forms and signed our privacy forms?”

And if you make it through all of that, you may still not receive the kind of care needed to make you feel better or even save your life. You may sit waiting for a doctor who may or may not treat you based on what an external organization or agency says you are entitled to receive. The doctor may be annoyed that you are in his or her care instead of farmed out to another specialist. If you do find yourself referred for a test or another doctors’ visit, you’ll start the process all over again from the beginning. Co-pay paid? Insurance in order? Credit or debit card? Picture ID?

Civility? Hell. No one has even helped with the symptoms that brought you or a loved one in for care.

In my more civil healthcare world, the first questions asked would relate to, well, civil sorts of patient-related questions. “How can I help you today? How are you feeling? Does that hurt? How can I make you more comfortable?” But until we transform this system, those questions are secondary, at best.

Even in our most crass and impersonal financial transactions, some polite interaction is programmed into the dialogue. But not in healthcare in America. It seems every time I seek care or take someone I love for care, I am treated like an annoyance or like the enemy – someone from whom the providers must be protected. The evil, non-cash-bearing patients, we are viewed by many as such.

So long as the motivation for profits and more profits and ever-increasing profits remain the primary motivator for those who dole out our care and our access to that care, I am not likely to see more civility but less. I half expect that within a short bit of time, I will carry with me a card that shows not only my medical history but also my credit score, my bank balance, my credit or debit card information, my next payday linked to a payday loan operation, my current insurance coverage and the status of my deductibles and out-of-pockets yet owing at the time of treatment and so on. It may even have my photo and maybe some biological security device to make sure I am the widget labeled on the card. If at any point in the process, I cannot pass from patient to insured patient to out-of-pocket expense paying patient to finally in the exam room patient, I’ll be let go. And it won’t be civil. All but the most exaggerated gaping and bleeding and gasping will wait until all financial systems are clear.

If we were civil in our healthcare delivery, we’d want what is the right and the best treatment for one another delivered at the most appropriate time in an appropriate way. We finance such a system through shared risk and shared cost-saving, and we’d minimize the wasted administrative expenses and the duplication of services now so costly and so un-civil.

I watch with hope when I see communities rally after tragedy. So why is our healthcare system so different then and why are our sick folks less deserving of our best caring and effort simply because their tragedies unfold more slowly, more methodically, and more quietly?

Bending the healthcare cost curve will only happen when we believe that creating a progressively financed, single-standard of high quality care for all is the most rational, civil course of action and we set about to make it happen. So far, allowing tens of thousands of our fellow citizens to suffer and die in a very uncivilized way while the care they needed was within our grasp has not compelled us to act decisively. Civility has not been the hallmark of healthcare in America.

We’ll watch next week as legislators argue the pros and cons of repealing the newest healthcare bill. They might even attempt to show a calmer tone while doing so. But whether they succeed in the political theatrics of the repeal effort or not, sick and hurting patients will keep standing at those front desks waiting to be cleared for care or sent away in shame. And no one will care much at all right now about the civility of that preventable suffering.

When we see good people harmed in unimaginable acts of violent outrage, I hope we’ll pause to remember those among us for whom quiet acts of unthinkable pain and illness are an on-going assault on any sense of human decency. When we finally have reached the point of shared realization that we’re responsible for one another and for our civil society as manifested not only in acts of occasional violence but also in our everyday ability to uplift one another for the common good, then we’ll be moving toward a sense of civility that will do more than change our words – it will change our lives.

Donna Smith is a community organizer for National Nurses United (the new national arm of the California Nurses Association) and National Co-Chair for the Progressive Democrats of America Healthcare Not Warfare campaign.

As Peter Shumlin was officially sworn in as governor of Vermont, there was and is great hope that at least in one state we may see passage and implementation of a truly universal, single-payer healthcare system.

From Shumlin’s January 6, 2011, inaugural address:

“The rising cost of healthcare for Vermont’s middle class and small businesses provides an equally daunting threat to economic prosperity. Just ten years ago our little state was spending $2.5 billion a year to stay healthy. Today we spend over $5 billion. That increase represents an enormous hidden tax on families and small businesses across our state. If left untethered, the rising cost of health insurance will cripple us.

“That’s why we must create a single-payer healthcare system that provides universal, affordable health insurance for all Vermonters that brings these skyrocketing costs under control. Let Vermont be the first state in the nation to treat healthcare as a right and not a privilege; removing the burden of coverage from our business community and using technology and outcomes-based medicine to contain costs. By doing so, we will save money and improve the quality of our care.”

Amazing words in so many ways. Amazing that we are finally hearing them from one of our nation’s governors, and perhaps equally amazing that the American people have waited so long for the human right of healthcare to be granted in even one small state.

But I have hope tonight for Vermonters. Maybe especially for baby Vermonters.

In February 2006, a young reporter working for the newspaper I edited in South Dakota was pregnant and only weeks away from delivery of her first child. I was struggling with the aftermath of my husband’s third open heart surgery. On a terribly snowy night, I called that reporter to travel the mile or so to a city commission meeting so I could stay at home with my post-surgical husband.

She never complained. But the snow was so heavy that her car got stuck as she pulled out of her driveway. She was so determined to do her job, so determined not to let me down and so determined not to risk losing her insurance that she got out and pushed her car several times in the effort to dislodge it. She was not successful. Another motorist did help – it was South Dakota, after all. She covered the meeting.

But within hours, she was in labor. She emailed me. I knew it was too early for labor. I felt terribly guilty. Though others assured me it had nothing to do with it, I always believed the very serious health issues my reporter’s baby faced in the days, weeks and years ahead were at least in part because her mom pushed a car during her final hours in utero. Still, no one ever complained.

Until I saw a message from her this week on the web. On a social networking site, she wrote, “We are still paying for our daughter’s birth and NICU stay. Add my husband’s carpal tunnel surgery (which we just recently killed ourselves to pay off), our daughter’s dental surgery, her Mayo Clinic visits, recent X-rays on the infection in her thumb, and regular checkups and doctor visits (most of which occur successively until someone finally figures out what’s wrong), and we’re drowning in medical bills. :(”

It is now 2011. Five years later, this family is still paying those bills with no end in sight.

She went on to say she had hoped to think about having another baby some day, but because most doctors now require prenatal care not covered by insurance to be paid up front and she has collectors hounding her for payment of the old medical bills, she cannot even think about another baby. It breaks her heart.

My reporter and her husband are wonderful parents. They both work. In fact, she works two jobs, sometimes more. She laments the fact that she cleans resort rooms for one of her jobs, and that sometimes it is troubling to clean rooms for wealthy folks who have never known what it is like to be sued for a medical bill while doing your best to pay it.

My reporter does not share my political leanings. She is a devout Christian. She tries to live her faith. All she hopes for, all she prays for is time to spend with her child and her husband. She has a great free streak that makes her a superb reporter during the annual Sturgis motorcycle rally – especially since she rides her own bike there every year. She is a neat young woman. I would be so glad for her if she could feel comfortable about having another child. And that child would be a lucky baby.

But unless my friend uproots – also not likely – and moves her family to someplace like Vermont or another country where healthcare is a human right, she’s locked into a life of struggle and need by those who only value profit and greed.

So, Governor Shumlin, I wish you so much good fortune in pursuing transformational reform in Vermont. One of the main reasons I am so anxious for you to succeed is so that a young, pregnant reporter somewhere in Vermont can tell her editor “no, I cannot go out tonight” when a call comes in a snowstorm, and that young reporter will still know that she’ll have healthcare even if staying safe and warm means she cannot keep up her duties as a reporter. I’d also hope that Vermont’s babies would be given a better chance to live healthier, happier and calmer times as they became toddlers and children lovingly raised by parents not shackled by medical debt.

If we’d ever really think about the kids and the families, we’d know Governor Shumlin is right when he says, “I call upon Vermonters to join together with the common purpose of our state once again leading where others dare not go; universal, affordable, quality healthcare that follows the individual and is not tied to employment.”

Donna Smith is a community organizer for National Nurses United (the new national arm of the California Nurses Association) and National Co-Chair for the Progressive Democrats of America Healthcare Not Warfare campaign.

Most Americans I know really don’t like to get ripped off. We don’t mind paying for something that is what we thought we were paying for. We just hate the feeling of having been taken. And boy, are we being taken en masse by the private health insurance industry.

Doubt that? Then answer for me what value private health insurance brings to the U.S. healthcare system? I asked this yesterday when I was a guest on GRITtv.

Wendell Potter, insurance industry whistleblower, was also a guest on the program. But Wendell, as much as I like him and respect his efforts in recent months, continues to somehow believe that because the insurance industry is so deeply entrenched in the U.S. healthcare system and about to become even more deeply so that we will have to keep fighting to reign them in and control them. He doesn’t think we can remove them from our system.

To me, it’s like asking a con-artist to reform. It’s not going to happen. I don’t trust the private health insurance industry to do what is best for me or for my nation. I trust the private health insurance industry to do what’s best for the health insurance industry. To the extent that doing some of the right things is necessary to doing business with other profit centers in the healthcare industry, I trust the private health insurance industry to know how to work all the angles.

Private health insurance is not a health product or provider. Private health insurance is a financial product.

I was standing in line yesterday at a taxi stand in New York City and heard the classic street corner pitch person walking behind. “Buy a discounted computer from me today and a full warranty applies just like in the stores,” he said. I suppose it was the modern day version of the trench-coat watch display and the appeal of “Hey buddy, wanna buy a watch?”

I feel the same way about private health insurance. It’s sold to the nation as a tangible healthcare product but actually is a financial product with the same amount of stability as other financial products. Scary stuff. Dangerous stuff. Even misleading stuff. Ripping off millions of people without regard for the trauma caused.

So, would someone, anyone, please tell me what value the private health insurance industry brings to the U.S. healthcare system? Does private health insurance control costs? Clearly not. Does private health insurance assure better health outcomes? Clearly not. Does private health insurance prevent personal financial collapse? No.

So, let me say again that private health insurance is a financial product sold to you and sold to me to protect our health and wealth which may well do neither. That’s a defective product, in my view.

And let’s keep asking one another and our elected officials: What value does private health insurance bring to the U.S. healthcare system? And until we get a sufficient answer, keep asking. If we never do get a sufficient answer, let’s do what the rest of the civilized world already does and find a progressively financed way to provide a single standard of high quality care for all. Let’s create value where none exists.

RENO, Nevada — I ventured backward in my memories to the fall of 2006 and wondered what might have happened differently if the Tea Party ruled this nation. It’s not that I am thrilled with the current state of political reality, but I am worried that if the trend toward more greed, more self-righteousness and more far flung and far-fetched ultra-conservatism continues, folks like me will stand no chance. We’ll be washed away like street dust down the storm drains after a fast-moving, summer thunderstorm, and no one will think of us again.

We are — I am — among the unclean. I tried in vain to keep my financial head above water in the face of impending healthcare doom and financial collapse. I failed to negotiate manageable payments with doctors and hospitals and clinics and even a local pharmacy. I did always pay my health insurance premiums, though. I succeeded at least in that way. But belly up I went. That was 2006.

It has been nearly four years since our journey to reclaim our dignity began. Bankrupt and homeless, sick and tired, we decided allowing our healthcare horror story to be told by Michael Moore would at least document our demise somehow.

If the Tea Party had been in control, perhaps the collapse might have been mercifully more brief. Under their view of the healthcare world, people without the appropriate and adequate means of payment should perish due to the lack of those means. Let’s see. That means when I was diagnosed with cancer, I might have found out immediately that since I did not have my full deductible payment up front that I would have to wait for treatment until I did. The reality was that my symptoms — in my case severe bleeding — would have prevented me from working every day I needed to in order to take home a full paycheck and save $10 or $20 a pay period toward that $2,000 deductible. If I had survived the bleeding, the cancer would have advanced. Under the Tea Party view, that would apparently have been just and maybe God’s will for my life outcome.

And what about my husband? We often struggled to meet his health costs — that is until he was eligible for Medicare coverage and the supplemental coverage we purchased. Again, if the Tea Party had been in control, we would have had no way to apply for Social Security disability and finally Medicare, and my husband would not have survived to retirement age. Damaged goods, I suppose, in the Tea Party view.

Again, I am not saying our outcomes were better because of the Democrats or the moderate Republicans or the Independents, the Greens, or any other political party in America. My husband and I survived because of a Michael Moore film and a series of somewhat lesser miracles stemming from our experiences being included in SiCKO — and because we have sacrificed all other goals in our lives to clawing our way out of that storm gutter. No one is cutting us slack.

It took not just one miracle but several to lift us from our healthcare-financial collapse even without the Tea Party in power. It shouldn’t take that, but it did and still does. The work we both have to do and the time we must spend apart is extraordinarily difficult. But if we flinch now, we’ll be washed right back down that drain of failure as if the past 48 months of intense effort never happened. That’s what hard-working Americans face every day. Most don’t have the miracles we had to build on.

Tea Party faithful believe that not only will the weak not inherit the earth but that the weak shall be banished from it. Tea Party faithful think people are weak who must lean on our social safety nets, even if many of them collect Social Security, unemployment benefits and are Medicare beneficiaries. No matter, they think and they proselytize. Do away with all those “wicked” entitlements, they muse.

So, in my backwards time capsule, I bleed my way through a few months or even a year working with cancer and trying to save cash to meet my deductible. During that year, my husband’s artery disease advances due to the lack of a single-standard of high quality care for all and due to the stress of watching me suffer. In the end, after months of painful decline and loss of my job and our only income, we end up dead. We leave bills behind we could not pay and boxes of our personal belongings with no saleable value that will need to be taken to the dumpster.

Think of all the taxes I wouldn’t have paid and the money I wouldn’t have spent in just four years if I had died back then. Some of the people who have benefited from my staying alive would have also had less happy outcomes.

It would have been ugly but swift. In a Tea Party world, the meek and the weak are so because they didn’t work hard enough or long enough. If their vision prevails, which I hear as only a slight morph of the right-wing Republican agenda, there will be a culling out of those who get sick or hurt and don’t have a way to bankroll their recoveries.

But, wait, back to my reality. The Tea Party vision really isn’t very much different from how it is right now. The stark truth of it is that if the same thing were to happen to me today that unfolded pre-SiCKO, there would be no Michael Moore’s SiCKO II and no rescue and no way to recreate the miracles of 2006-2010.

Until we all embrace reality that our healthcare mess — under any system that does not provide a progressively financed, single standard of high quality care for all — is an economic and also very personal expression of our national cruelty toward the weak and towards one another, we will remain Tea Party loyalists in the making. Right now, some just want to pretend they represent some other view, but as far as I can tell, death and failure are imminent for people like me; it’s just a matter of how quickly and how harshly.

So long as the Tea Party is even one step away from control, I’ll work to advance a wiser, more economically bold and sane system that views the loss of life as a cost we collectively cannot swallow.

I’ll keep on keeping on, as the saying goes. I’ll keep hoping and praying and doing the hard work to back up that hope and prayer. But if we move closer to a Tea Party view instead of away from it and if I face another situation in which a new cancer diagnosis arises again, I think I’ll just shut up and bleed.

Donna Smith is a community organizer for National Nurses United (the new national arm of the California Nurses Association), National Co-Chair for the Progressive Democrats of America Healthcare Not Warfare campaign and Healthcare-NOW! Steering Committee member.

Since the health insurance reform bill passed this past spring, you’d think we suddenly stopped having American patients die and suffer unimaginable horror at the hands of the corporate owned and operated healthcare business system in the United States. No one tells the stories. The reality is that patients were props, and they just aren’t needed as props any more.

An estimated 45,000 preventable deaths occurring in these United States annually due to the lack of access to appropriate healthcare marches on. That does not account for those dead from other preventable causes like medical error. 45,000 every year. That’s 123 dead every day. Today’s dead: 123. Have you seen that reported anywhere? Yesterday’s dead? 123. Any reports? Tomorrow’s dead? 123. Is anyone trying to save those pending dead?

Though more Americans die preventable deaths every day without access to healthcare right here at home than die in weeks on any foreign battlefield, no one is searching for them in the wilderness of greed and profit-driven medicine. No one needs their painful realities right now.

123 Dead today.

Patient stories were used as props by elected officials, mainstream and alternative media members and groups, advocacy groups and think tanks. Relatives of dead patients made especially good fodder for the debates. Moms and dads of dead kids were prime targets to stand up on stages, sit at witness tables and have their names and details of the loved-one’s death shared with the world. Cancer patients who could not access care were pretty valuable too. If they could still stand, think and talk, cancer patients made for great photo-ops for all and better fundraising tools for others.

123 dead tomorrow.

Some may say this is to be understood as the nation has moved on to other issues following the passage of the health insurance bail-out bill – we are now worried about jobs, the oil spill, the Arizona immigration bigotry, the leak of documents on the Afghan war. All critical issues to be sure. Some may add that we’ll just have to wait and see if those numbers drop in 2014 or 2016 or 2018 as parts of the health insurance reform bill unfold

123 dead yesterday. Those insistent dead just don’t stop dying. They aren’t waiting for a third political party to emerge. They are the dead and the dying.

Patients are dying and suffering every single day in larger numbers even as the weeks of recession roll on and medical providers become even more tightly controlled about uncompensated and undercompensated care – meaning they are protecting their bottom lines too and uncompensated care is the term used for patients who come without any means of payment or with inadequate means of payment. Patients are suffering more, not less. Payments are demanded up front. Patients cannot pay the thousands or even the hundreds required for treatment. More death, not less.

123 people today will not die pretty, gentle, fade away in their sleep deaths with tearful loved ones at their sides. They may have spent weeks or even months begging for someone to treat them. They may have been working even weeks ago or days ago but unable to get past the co-pay and deductibles of their insurance to get early treatment and unable to slack off for even one moment on their jobs lest an opportunistic employer decide to lay people off based on unspoken measures of value, like use of sick time for doctor visits. They will die after arguments and struggles with those they leave behind as the financial pressures mounted and their illnesses deepened.

I searched every news outlet page I could find to see if anyone was reporting on yesterday’s dead. No one did. 123 people died, and few people even noticed their passing. I searched to see if anyone was reporting the impending slaughter of 123 innocents in the United States today, and no one is reporting on it.

Along with the 45,000 dead, we allowed 700,000 patients and their families to go belly-up financially in 2009. In the U.S., medical crisis leads to more than 50 percent of the personal bankruptcies (and of those patients, 75 percent had health insurance). So, as we saw personal bankruptcy filings rise 31.9 percent overall in 2009, we also added more patients and their families into our deadbeat files. Even if those folks get well physically, we’ll punish them forever for having gone broke. Bankruptcy bruised credit takes years to repair.

123 dead today. 1,917 going broke today in the midst of medical crisis. In this nation. Yet no one reports. No one.

The one thing I know for sure is that the patient horror stories were certainly an integral part of the fuel that moved any debate on health reform to take place at all. The dead and dying made for a better frame for press pieces than simply selling health reform as a way to bail out the private, for-profit health insurance industry and bolster the medical-industrial complex overall. Patients are necessary in this system and in the debate only to the extent that without them you cannot run the engines of medical profit.

123 dead. 1,917 in financial collapse. Homes lost. Futures torn apart. And no one reports.

There are those who still clamor for real transformation of the U.S. healthcare system from the for-profit model to a social insurance model like extending and improving Medicare for all. But even many of those people have somehow decided that it’s only the money arguments that need to be made – only the profit-takers who need convincing with the language of more profit and fortunes still to be made.

I disagree. I think someone must have the courage to keep reporting the healthcare war dead. In fact, I believe their faces and their names ought to be more prominent as we go forward as measures of what we are allowing to be done to our fellow human beings in this nation.

123 dead yesterday. 123 dead today. 123 yet to die tomorrow. Since the passage of the health insurance reform bill in March 2010, 14,670 American patients are dead. And no one spoke their names. The day we become a nation that turns its back on that much death and suffering is the day we have lost much more than a political battle — we’ve lost our collective soul.

Donna Smith is a community organizer for National Nurses United (the new national arm of the California Nurses Association), National Co-Chair for the Progressive Democrats of America Healthcare Not Warfare campaign, and on the Steering Committee of Healthcare-NOW!.

Oh, the things we did not fix in the healthcare bill are shocking. Just as seniors falling into the Medicare drug benefit donut hole begin to get the $250 checks meant to calm their fears about our new healthcare legislation, the rest of us would do well to remember the abuses of the for-profit healthcare system that will continue and even accelerate in the coming years.

Health insurance is not health care. Health insurance is a financial product marketed and sold to protect health and wealth which may do neither thing very well. I view it as a defective product. Yet, very soon we will be buying more of it and helping more of our fellow Americans buy more of it with the subsidies that support the great health insurance bailout that is being called “patient protection.”

Yesterday, I went to the doctor for an appointment I waited weeks to secure. I am insured. I have what some would say is fairly good insurance from one of the for-profit insurance giants. I waited patiently in the waiting room, and then was escorted to the exam room. There was a flurry of activity around me. A thorough history was taken. X-rays were taken. The nurse said, “Oh, honey, are you in pain? Those X-rays show some pretty awful deformity.” I said I have been hurting for years but that I have waited until I could stand no more to seek treatment. Most of the time I take large amounts of OTC anti-inflammatory medication and muddle through. It’s the American way. It’s the insured American’s way. It’s the working, insured American’s way.

The doctor buzzed in rather quickly and began discussing a treatment plan with me. Some immediate care to relieve some of the pain, and some longer term non-invasive care to see if we could avoid surgery. I was hopeful and thrilled though a bit worried about how it would feel to get shots in the joints of my feet to help the heel spurs and the bone pain. I’ve had shots in my knees, and it isn’t fun.

Suddenly, as quickly as I had felt the anticipation of some relief, the flurry of activity ground to a halt. The doctor left the room. Another office person came in. She said, “I’m sorry Ms. Smith. Your insurance will not cover what the doctor wants to try.” Matter of fact. She’s said these words before – many times. I ask how much it would cost to pay for it myself. She answers. I cannot pay that much. The visit is ending. The hope is shriveling.

I could feel the muscles in my face tense as the humiliation spread through my body. This body, just moments ago worthy of plans to relieve pain and head for some better health, now was deemed unworthy of care. Shame. All that old shame I used to feel before our medical bankruptcy was rising in my gut. It hurt so badly. But I was determined not to show my anger or my sadness.

The doctor wandered by the room and saw me. He stepped in and gave me some soft inserts for my shoes. He said they won’t help much or for long, but that maybe it would be a little relief. He must have seen the look on my face and felt at least a little compassion. A little. I thanked him. But I could say little else, and I could not look him in the eye. I felt so ashamed, and I don’t even really understand why I’ve been so conditioned as a patient to feel it is my failure when these things happen.

On the way home, I alternated between sadness and anger. Clearly someone wasn’t being honest with me. Either the treatments this doctor was suggesting really aren’t a good idea (as the insurance company’s denial to pay would lead one to believe) and therefore are not approved for coverage or the insurance company just wants to push those costs onto patients who cannot usually afford them. Either way, I didn’t get the care I needed. Either way, I left hurting. Either way, I lose. The doctor made some money on the office visit and my co-pay at least. The insurance company avoided paying for anything beyond that.

My husband sat beside me in the car, sad and angry for me. As a person covered under one of our nation’s single-payer programs and a supplemental private policy, he has never heard the words I heard – he has never been denied care. He felt helpless for me. As I cried tears of rage, he sat silently.

And, so, how will any of this change under the new healthcare bill? It won’t. In fact, the pressure for insurance companies to deny more care will grow as they are compelled by law to take more people who have pre-existing conditions like having feet. Cherry picking the healthiest folks will require a bit more skillful contortions for the for-profit insurance companies, and doctors will leave more patients sitting on the edge of exam tables like naughty little children who do not deserve to be treated.

Healthcare is a basic human right in most of the rest of the modern world. Only in this nation do we believe that only the richest people deserve the best of care. It’s a wild twist on the old Bible lesson about it being tougher for a rich man to get to heaven than for a camel to get through the eye of a needle. We’ve made it harder for a working person or a poor person to get healthcare in America than for a rich man to get to heaven. We are a sick society indeed. No Golden Rule values herein.

Only when we finally decide that we believe in a compassionate and just healthcare system for all will we ever have the courage to change it. Right now we just don’t believe in that sort of system at all. As a patient, I am fodder. At least this morning I was able to turn my outrage back on the system that left me in that exam room alone and sucking back tears of anger. No one should go to a doctor to seek care and leave less well. That’s cruel and unusual.

I was raised to have more compassion than this for my fellow human beings, and I think most Americans were raised with similar values. How in the world did we get to a place where we participate in doing this to one another? Is this the system we want to leave to our children? Do you want to leave your child lacking care when he or she needs it? Your grandchild? Then, for heaven’s sake — for heaven’s sake — stand up and let’s get back to work to fix this mess. There is much to be done.