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!.

On April 11, 2010 we were lucky to be joined by Kevin Zeese (Prosperity Agenda) and Ethel Long Scott (Women’s Economic Agenda Project) on our monthly single-payer activists conference call to hear their excellent analysis of the health insurance reform legislation that just passed and how the single-payer movement should respond.

You can listen to their remarks here:

Or download an MP3 copy here.

Instead, we should act based on evidence of what works. Medicare, with its lower administrative costs and higher rates of satisfaction, remains the “gold standard” for real healthcare reform.

We anticipated the healthcare debate this year would focus on the true stakeholders: patients and those who care for them. But improved Medicare for All (single-payer) was pushed off the table, by Congress and the private health industry, preventing the American people from learning how access to quality, universal care can be financed without increasing cost to the public.

Pushing single-payer off the table has resulted in deeply flawed legislation by the House and Senate which amounts to a massive bailout of the profit-making health industries that will increase their ability to lobby and influence legislators in the future. At the same time, patients will receive little in the way of protection or improved ability to afford needed healthcare. The legislation is designed to fail and in the meantime, will waste billions of dollars and delay the process of creating effective health reform.

Therefore, Healthcare-NOW! opposes the current health legislation for the following reasons:

1. During the time that it will take for the health insurance legislation to begin (2013 in the House version and 2014 in the Senate version), tens, if not hundreds, of thousands of Americans will die.

2. Millions of people will remain uninsured: 17 million in the House version and 24 million in the Senate version.

3. Medical bankruptcies will continue as families will face out-of-pocket costs up to $10,000 in addition to the cost of premiums and the cost of uncovered services.

4. People who are uninsured will suffer the further indignity of being forced to pay a fine which may be as high as 2.5% of their income (House version).

5. The number of people who are under-insured will increase. There is no guarantee that premiums will be affordable even for those who qualify for federal subsidies. It offers a “public option” so small and weak (and estimated to be more expensive than private insurance) that it is set up to serve as an example of failure.

6. People will continue to be consigned to only receiving the quality of care that they can afford. Instead of a standardized benefit plan that covers all necessary care, people will have to choose from a tiered set of plans. The least expensive plans will cover only 60% of necessary care and patients will be required to pay the balance.

7. The legislation will not control healthcare costs and will increase the waste in healthcare spending. The regulation of insurance companies, which is predicted to fail by industry whistleblowers, will be expensive to enforce. The “exchange” will add another level of bureaucracy which in Massachusetts has added a 4%surcharge to each insurance premium.

8. Private health insurance will be given 30 million more customers, and its stranglehold on the healthcare industry will be even greater. The legislation transfers hundreds of billions of public dollars to private insurance companies. Between $447 and $605 billion in public dollars (depending on the Senate or House version) will be given to the private insurers in the form of subsidies.

9. The bill writes into law protection for the drug manufacturers from having to deal with the collective purchasing power of the American people. Pharmaceutical corporations have already raised prices on brand name prescriptions by 9% this year. Bio-tech firms receive a windfall 12 year patent on new pharmaceuticals.

10. The legislation continues to allow discrimination based on age and immigration status. Older enrollees can be charged up to twice as much as younger enrollees. And enrollees will be required to prove citizenship in order to receive subsidies. Non-citizens will be required to bear the full cost of purchasing insurance.

11. In order to reach a bare majority to pass the bill, the House accepted limits on the reproductive healthcare rights of women beyond current stringent federal restrictions.

We will continue to do everything in our power to support the efforts of Senator Bernie Sanders to submit a substitute single-payer amendment during the Senate debates. This historic opportunity to debate and vote on single-payer from the floor of the Senate will help set the framework for the future. And we will support all efforts to amend existing legislation in ways that would make it easier to achieve state-level single-payer reforms.

Just as we call on Congress to start for scratch, now is the time for all of those who believe that healthcare is a fundamental human right to think about what we need to do to “start from scratch” and build our movement into the future. Many of those who sincerely believed that supporting incremental reforms and the public option was a pathway towards healthcare for all have seen their aspirations betrayed by a failed bargaining strategy embraced by Congressional leaders and the Obama administration. Once this legislative moment is over, we need to join with them in a renewed fight for healthcare for all.

The mission of Healthcare-NOW! is to educate and advocate for a national publicly-funded health system: improved Medicare for all. We will continue to build the Medicare for all movement until we reach the day when all who live in the United States receive the same health security that is a right in other industrialized nations. We welcome all people who support healthcare reform to join with us in this movement. Together, we will succeed.

Two weekends ago, after the bait and switch of a vote on single-payer for a vote on an anti-abortion amendment, we felt wizened to the possibility of unknown threats in the legislative churn on health reform. As insurance and pharmaceutical companies, Catholic bishops, and the right wing throw in dollars, lobbyists, and pressure for no votes on the final bill, it is clear we who are in the business of protecting and improving our rights to access to health care, including abortion, must remain vigilant and ready to challenge these threats.

First, a little history is in order. In mid-July Rep. Kucinich passed in the Education and Labor Committee an amendment to the House bill for health insurance reform that would make single-payer easier to enact at the state level. On July 31st Rep. Weiner and 6 other members of Energy and Commerce Committee brought to committee an amendment to that would substitute the text of HR 676, the national single-payer bill, for the House bill. Speaker Nancy Pelosi offered a floor vote on single payer — if Rep. Weiner would withdraw the amendment from committee.

Single-payer advocates embraced these efforts wholeheartedly. And we counted upon our champions in the House of Representatives to stand with us.

Vigorous activity ensued, a fourteen week campaign involving millions of people in phone calls, petitions, forums, local protests and vigils, emails and faxes, op-eds and letters-to-the-editor and personal visits. There were conscientious objectors. 158 single-payer supporters were arrested performing acts of civil disobedience, peaceful sit-ins to register their outrage in the offices of health insurance companies and Congress across the nation.

As the grassroots clamor rose, Reps. Weiner and Kucinich sought to surf the wave. The crescendo grew and grew, until one day before the House vote on health insurance reform.

And then — poof! — single payer was back off the table.

Rep. Kucinich’s state-based amendment was out of the bill, “dead as a doornail.” And Speaker Pelosi explained that the substitute amendment couldn’t possibly have a debate and vote, for if it did, amendments to restrict health care for women and undocumented immigrant workers would also get to the floor. Congressional leaders suddenly opined that a losing vote for a single-payer amendment would be “tantamount to driving the movement off a cliff.” Even the President weighed in to discourage a vote on single payer. Rep. Weiner withdrew the amendment.

Yet the next day the Speaker allowed the anti-abortion amendment to the floor, where it passed and was added to the bill. In the end, the only progressive Democrats to vote against the House bill, abortion ban and all, were Reps. Kucinich and Massa, both single-payer supporters.

The people expected universal health care, and the House of Representatives delivered an anti-abortion bill.

Worse, the Democratic Party traded away fundamental women’s rights for a Massachusetts-style mandate, a law to criminalize the uninsured and subsidize unaffordable private insurance premiums with tax money, something we know already will not reduce costs and will not cover everyone, will not lessen disparities and will not improve the health of the nation.

It is astounding to think the Democratic Party has made a bid for the United States to join a few shameful nations that severely restrict women’s access to abortion. Earlier this year we watched, with great dismay, when Mr. Obama chose not to strike the Hyde Amendment from his federal budget proposal. The President has now gone farther, re-affirming the prohibition of federal funding for abortion as a “principle.”

Reproductive rights cannot be bargained away for any reason. Autonomy over our bodies is essential to health care and to democracy.

No nation on earth can call itself a democracy without equal and full access to health care. No nation on earth can call itself a democracy without allowing full personal autonomy over all health decisions, including abortion. These values are severely threatened under the proposed legislation. It is time for protest.

As single payer advocates, we firmly believe that health care decisions must be made between the provider and the patient, with full protection of privacy. Women must be able to access abortion if determined necessary — by either the patient or the doctor.

We call upon the President and the Congress to start from scratch and ask you to join us. Senator Bernie Sanders will introduce a single payer bill in the United States Senate in the coming weeks. Demand that your Senator vote for this bill. In addition, join the National Organization for Women, strong single-payer advocates, in organizing days of action in DC and Pennsylvania to protest the Stupak-Pitts amendment.

The solution to the health care crisis must provide personal freedom from a dysfunctional and unsustainable system that ties health care to the employer and to the spouse. When Medicare was enacted, it reduced poverty in those over 65 by 60%. By this measure, a universal, single-payer system would also provide economic freedom, by raising over 22 million people out of poverty, while providing each of us with full and necessary access to health care. Nothing less will do.

Katie Robbins is National Organizer of Healthcare-NOW! Andy Coates, MD, is a member of Physicians for a National Health Program.