Sunday, October 31, 2010

Ila Swan: Effective Protector of Patients in the USA!

From Brenda Durant:

Here are some articles about Ila Swan:

The article below article appeared in the Medical Journal in Australia.
Dear member,

Ila Swan is a very remarkable lady. An ordinary (really extra-ordinary) member of the US community with no medical knowledge. She discovered what was happening through her own experiences, became intensely involved and put her heart and mind into doing something about it. She marched, she carried placards, she went out and gathered information herself - thousands of death certificates - photographs - hidden video cameras. She went to political hearings, interrupted and aggressively challenged politicians with the funding they received from nursing homes and the protection which they gave the industry. She commenced a Qui Tam action on behalf of the government. The information she provided was sufficient to convince influential people. Several GAO investigations and federal senate hearings followed.

Citizens in states across the USA took up the challenge and forced investigations and hearings. The revelations and much of the material I have supplied you about nursing homes are a consequence one way or another of her efforts. She was a motivating force behind the recent CBC news investigation and the focus of one of the segments. She has appeared on Japanese television explaining what happens in a for profit system and urging the Japanese people to reject it. She wants a citizens movement to force the United Nations to confront the stark facts of US corporate nursing homes and address it as an international human rights issue.

It is people like this, not government regulators who expose what is happening and take action. There is a vast pool of motivation and human concern to be tapped. The community nursing home where Mrs. Bishop's father is a resident is an illustration of the contribution which the community can make and an illustration of how much more effective they are than any formal government backed oversight or accreditation process. We ignore the human potential and humanity of our citizens at our peril. If we are to provide a caring service for those in need then they must be intimately involved, honest, trusting, cooperating, assisting, criticizing, monitoring, suggesting, even being difficult and disruptive.

This is simply not possible in a competitive market system where successful detection of problems and their containment is dependent on every one involved, patients, relatives and regulators being distrustful and suspicious - shopping around. In the market the disclosure of failures is a threat to economic survival and every effort is made to hide deficiencies. How can we build or maintain a society in this way? We are a community of human beings and not an impersonal marketplace driven by market principles and competition. The logic of deliberately driving a system with severely disruptive competitive pressures and then expecting to stop the problems by regulation and policing escapes me. In such a system unintended and undesirable side effects and outcomes are inevitable.

I include the text of a letter written to the Calgary Sun by Ila warning Canadians not to adopt the US system. The Sun, once a supporter of health care reform, has done its homework and is now critical of government conduct. The letter is "pure Ila" in expression. It may be difficult for an editor to publish because of its length. It would not be published in any Australian newspaper until it had been edited to extinction. It reflects the kindness, concern and humanity of the American people. Those of you who have travelled in that country will have experienced the warmth, responsiveness and kindness of the people - the willingness to be helpful, the smiling "you're welcome" to any word of thanks.

You will also be aware of their pride in America, its history and its way of life - their sense of who they are. What is happening in that country today is a profound challenge to "self" - the sort of people they really are - a very disturbing experience. Ila's letter reflects the anguish of identity in the community as it is faced with this problem - a challenge to their sense of being a "decent" people - a challenge to their strongly held historical views of the benefit of the marketplace and its role in democracy. They are finding that this great free country selling democracy to the world is no longer a democracy. It is governed by large dishonest groups with money - the buying of politicians, the control of peoples minds by marketing and buying advertising. The market has become a threat to democracy.
It is a great credit to Americans that instead of closing ranks, ordinary citizens rather than leaders have been open and self critical. I have never had to explain what I was concerned about. They have known immediately and with few exceptions have supplied me with information and assistance knowing that I would use it to attack the US health system and this would reflect on their country. They have been more concerned for our welfare and the threat which their system poses for us. These, not the multinationals are the real "global citizens" - our hope for a human world.
US people are better equipped than any other to lead the way into a shared global society. They are open, honest and very willing. At the grass roots level they are ideal global citizens. However until they reform government and harness their corporate system to the will of the people they remain a threat to the rest of the world. With their wealth and technology, and this wonderful resource of human feeling they are in a better position to lead in developing participatory democracy and then a global community than anyone else.

Ila never loses an opportunity to spread her message. I am sure that she will not mind my sharing her letter with you.

Ila's important message to Canadians is in her last paragraph. It is expressed in her usual style.

"I will tell you, like I told Japan, DO NOT ALLOW US NURSING HOMES IN YOUR COUNTRY. Do not allow your wonderful non-profit system to be taken over by for profit hospitals and health care industries. The US is a sorry example of what happens when money is involved with your health care. The minute these for-profit companies move in, they start shoving money into your governments pockets, then they become obligated to this killer industry and your citizens will be the ones that suffer. If for profit health care is allowed in your country, it will be a terrible injustice for your citizens."

This is the message from someone who has walked through hundreds of nursing homes documenting what happens. She has looked more closely at the US for profit aged care system than anyone else in the world. We should listen.

J Michael Wynne
Physician and Editor

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