Why Do We Need Universal Healthcare?
Why do we need universal healthcare? Let me share a personal story.
First, I have health insurance through my employer. They chip in and I chip in, and both my partner and myself are covered by a major HMO. Like all insurance, each year for about the last 10 years, the premium and deductibles have gone up. Sometimes more than 10% in a year. This is pretty typical. However, folks should realize that 10% per year increase means that the cost of health insurance doubles in seven years.
As some of you know, I underwent radiation surgery for a tumor in my brain this June. (For those who have been concerned and sent good wishes and prayers, I am slowly recovering, but the trend is generally positive). My HMO split the procedure with another provider who had the equipment to perform the procedure. Let me share the procedure and then the big shocker.
Prior to the procedure it was required that I have an MRI and a CT scan. The CT scan had to be performed with the head harness installed on my skull. All of these procedures occurred at my HMO's facilities. My family then needed to load me in the car - head frame attached - to drive me to the partner facility where they did the procedure and then removed to head frame. I then got to go home. This was an outpatient, day long, surgery.
Today I received the statement from the partnering facility for the surgery - just the surgery. That bill dropped my jaw. The radiation surgery cost ... $35,501. I have received other bills for the personnel involved and various office visits in preparation for and followup from the surgery. They have totaled in the vicinity of $2500.
My HMO has not informed me of the costs of the MRI and the CT scan. However, I would estimate that the MRI cost about $3000 and the CT scan about $800. I have no idea what the day surgery and head frame installation cost, but let's say a modest $1500.
That brings us to an estimated cost of $43,301.00. $43,301.00 for a DAY surgery. (And I will need to have another MRI this winter as a followup.)
If I had to pay this full bill, I would be filing bankruptcy. If I did not have insurance, I would not have had the tumor addressed. If I had not had insurance, I likely would not have had the tumor diagnosed because I could not have fronted the money for the first diagnostic MRI that was done.
Believe me, I feel incredibly lucky to have decent insurance with my employer. I know that my health would be far different if I did not have it. I feel for the 50 million people in our nation who do not have insurance, and for double that number whose insurance is poor (or craps out on them when they need it most). That should not happen.
We have treated healthcare in this country as a commodity. Something to be bought and sold and whatever cost the market will bear. Those without funds can't get it, those with modest funds can get a varying range of access, and those who are wealthy can get anything they want. Those who qualify may get access through state systems or Medicaid. Those funds (and services) are limited.
Many people in the U.S. feel that the commodity approach to healthcare has failed. The pressure is that the people of the U.S. join the ranks of many other nations where healthcare is a right. We are willing to contribute to that effort. Many are willing to kick the private insurance companies out of their current role as middleman and gatekeeper - charging ever-increasing tolls to access a necessary service.
I had a totally unexpected condition that required treatment. This (or something like it) could happen to anyone. Should people's "choice" be to let the tumor in their brains grow because they can't afford either insurance or healthcare? Should people die because they can't afford healthcare? They do - every day - about 18,000 people a year. All so private insurance companies can see record profits year after year - as they did in both 2007 and 2008.
It is way past time that healthcare was a basic right within this country. The big money interests have had their run and sucked all the blood they are going to get. We need access, and we need to control costs. Healthcare reform should have two goals: 1) everyone gets access to quality care; 2) healthcare is not for profit any longer.













Rowan we need one million stories like this because we know the stories are out there.
I do question one thing. Candide saw a bill have this big and found out his insurer only had to really pay 750 bucks. I mean the insurer had to pay it was just through some agreement, that was the amount actually paid.
If fifty million have no coverage at all, I bet another fifty million would have been stuck with paying half your total bill. Or the entire bill for that matter.
This is a great post, an important post.
August 6, 2009 7:27 PM | Reply | Permalink
You are right about this, dd. Here is a recent bill summary for me:
Amount charged by provider: $156
Amount allowed by plan: $46.80
Your responsibility: $0
Now, if I didn't have insurance, I would have had to pay $156.
Since I paid more than $7,000 to my insurance company last year, and they only paid out less than $400 of *"losses" for my care, who is the winner here?
The clinic that got paid $47 for a treatment that has a price tag of $156 on it?
Me, who paid $7,000+ for $400 worth of care?
Or the insurance company, which pocketed $6,600 of my money and uses that to pay CEO's and lobbyists to protect them from having to do what they pretend to to: facilitate health care. They DON'T facilitate it; they are gatekeepers and care nothing about us.
*"Loss" is the insurance name for any money they pay for your health care. That perfectly summarizes their view. Anything that they have to grudgingly pay for the very service they pretend to provide, is labeled a "loss."
August 6, 2009 7:49 PM | Reply | Permalink
In the statement I was sent, it did not say what my HMO paid the other partner. However, I have seen numerous medical bills and the insurance companies frequently pay out FAR less than the bill. There is some sort of a deal between insurers and providers. Why would a bill for $40,000 be reconciled for $26,000 (this is what state workers comp insurance paid on one hospital bill of a friend of mine). Guarantee that if an individual is making the payment they don't want one cent less than the bill. However, these insider deals are real and common. I am sure there are accountant type ways of dealing with the discrepancies so that it all looks acceptable.
August 6, 2009 7:50 PM | Reply | Permalink
Thus, something that actually costs $10k requires billing for $40k so that you receive $26k so that $8k can go to paying for all the overhead involved in keeping track of this system, leaving $14k, which covers the $10k in real costs, plus $2k for the 2-out-of-ten times they have to eat it, plus $2k in profits for the hospital.
All numbers highly approximate of course, but that's really how it works. Note that if we simply insured everyone via single payer, the "times they have to eat it" would go away, while the costs for doing the procedure for the previously uninsured would suck up the gain made by not needing to charge the $2k. Which means that as far as ER care goes, insuring the uninsured is completely revenue neutral, something that people seem to deliberately ignore.
August 7, 2009 12:50 AM | Reply | Permalink
Thanks CT for the explanation.
What I have seen though is that if the insurance company can "recover" the costs, they do so at the billed rate - not the actual rate they pay.
August 7, 2009 1:08 AM | Reply | Permalink
That's another big profit center (for insurers).
Fun, eh?
August 7, 2009 1:45 AM | Reply | Permalink
So, on paper they show this huge loss for not getting the amount they bill, because of those reductions. So how do those "losses" effect their taxes? Do they pay taxes?
August 7, 2009 1:27 PM | Reply | Permalink
Rowan, thanks so much for posting your moving story. I am doubly impressed that you can write it in such an empathic way while you are in the middle of it. I think of you often, and wish you all the best. I don't pray, but I do hope my positive vibes reach you on some level.
May I make a request of you? I got an email today from bravenewfilms, and made a donation to them. They are asking for personal stories. This is the url; you don't need to change a word; just cut & paste if you are so inclined:
http://sickforprofit.com/
I hope your healing continues; you are on my mind...in a good way!
August 6, 2009 7:36 PM | Reply | Permalink
Cville , for you, I will share over at Sick for Profit.
Thanks so much for your kind thoughts and ongoing support.
Things have definitely got to change. Healthcare is a right (IMHO) and the system we have does not work.
Further, I feel damned fortunate to have decent insurance. Too many don't.
August 6, 2009 7:55 PM | Reply | Permalink
Rowan - first, my best wishes for your health, and I thoroughly agree with you about the need for universal access to adequate healthcare through appropriate and fair insurance mechanisms. Just about every other civilized democracy already knows this, and we've talked about it at TPM enough for me not to repeat the same explanations.
Instead, your story is so compelling that I will use it to vent rage that has smoldered inside me since yesterday, when I read comments from a participant in another thread that left me almost speechless in its callous indifference to the welfare of others.
This individual suggested that we should abandon the health insurance concept. In her view, every ill person should simply apply for a government loan to pay for the services they need. If necessary due to the expense, they might have to pay it back gradually throughout the remainder of their lifetime, or from their estate after death, rather than "ripping off" the rest of us to pay it for them. She suggested that the government might step in to help, but only if the ill patient was so poor that he or she could never pay back the loan.
I apologize to others for taking space to rant on this atrocity, because there is no possibility it would ever earn any credibility in the social or political arena. Nevertheless, there are millions of Americans currently in the situation she wished to impose on all the rest, and this emphasizes the urgency of reforming healthcare to meet the needs of these people. By personalizing it, you have lent added force to the sense of urgency we should all share.
I wish you well in your political advocacy, and even more in your personal battles.
August 6, 2009 7:45 PM | Reply | Permalink
Fred - rant away!
The bullshit being injected into this debate palys on a long campaign to get folks to focus on "mememememememe." We do not exist in isolation. In fact, each of us alone would not be where we as a nation are. Most of us would not even be alive - much less arguing about healthcare.
While I am likely to make this a subject of another post, a good argument to the backers of things as they are is NATIONAL SECURITY. As a nation we have a HUGE security risk with the inadequate nature of healthcare access and the decimation of public healthcare systems. A serious, highly contagious, disease is not an "if," it is a "when." The odds are that it will strike the most vulnerable populations and that those populations are unlikely to have healthcare access. With the huge number of people in this situation, a virulent disease could spread beyond any ability to control before it was ever even noticed.
Thanks Fred.
August 6, 2009 8:04 PM | Reply | Permalink
This is the meme with which we could turn around the agitators, although I am not too eager to play with people's fears, it is a very real concern. An epidemic wil not show favoritism to people with healthcare. Even with a cadillac insurance plan, it is better to avoid the disease in the first place.
August 7, 2009 1:33 PM | Reply | Permalink
Agreed Gregor. It IS an issue that is real. I would not promote fear mongering. However, there are things to be afraid of. If people are going to be afraid, let's at least be afraid of the real things -not manufactured monsters.
August 7, 2009 2:01 PM | Reply | Permalink
I saw that too, Fred. And I immediately thought to myself: "What about a premature baby?" Would they loan to the baby? After all, they don't all survive....
August 7, 2009 12:36 AM | Reply | Permalink
Rowan -- I wish you steady recovery, increasing strength and a crystal clear scan in December. And winning the lottery to pay your bill.
What your experience makes crystal clear about the health insurance industry is that risk is something to be assumed entirely by the patient/client, and not by the policy issuer.
I would tell you that I am scandalized that such a serious procedure was mandated as an outpatient one. That I am shocked that you were required to go from one facility to another in a head harness, exposing you to god knows what risk of injury or infection.
But I'm not scandalized; rather, I am saddened. As I am angered that more and more patients are asked to assume real physical risk -- not to mention such an egregious financial hit -- so that insurers can minimize their risks and their costs.
My sister's husband was supposed to be treated with a similar procedure last week. So he showed up (at a highly-respected southeastern hospital) in the early AM, was anesthetized, bolted into his head harness and only then was a scan done that scared both the physicians and insurer. The scan revealed that the bombardment site was some minute fraction of a millimeter from his optic nerve. So that the radiation bombardment might well blind him. (One might ask why this danger had not been obvious on his scan the week before, and discussed, but never mind.)
Five hours passed as a team of doctors sat on the phone with the insurer (and possibly their liability insurer) discussing the odds and the potential liability. Anesthesia was pumped into my brother-in-law, episodically, to keep him quiet and still. No one talked to my sister, despite her increasingly anxious requests for information. So that it was only at 5pm that my sister was informed that the procedure was deemed too dangerous. My brother-in-law was revived, unhooked and sent home, that same evening....untreated, still vulnerable to a significant stroke at any time and now considerably more vulnerable to infection.
The bill for a treatment that did not happen, but which did kill off many brain cells from anaesthesia? I think my sister said $28,000.00. But even if that is off by some fraction, it was well in excess of $25,000.
For nothing. Except increased stress on his system.
Thank God that this fiasco was not also an increased stress on their finances --- my brother-in-law is over 65, and he has Medicare.
Someone suggested here yesterday that, rather than having health insurance, or Medicare, people should just take out loans to pay these bills. Which pre-supposes, of course, that people could be approved for such loans, and that the expenses would be "one of" occurrences. Ha. Your one-day procedure, all told, was billed @ $43,300.00... as an outpatient. What if your partner also had unexpected dire expenses? What if one or both of you actually wound up in the hospital, as in-patient(s)?
What is wrong with this picture? Gee, I don't know -- let's scan it and see what comes up... $$$$$$$$$$$$$$$
August 6, 2009 8:29 PM | Reply | Permalink
Wendy, your brother in law's experience is OUTRAGEOUS! I sincerely wish your brother in law well. I am very sorry that he has been left in such a vulnerable situation, and had to go through such an atrocious situation. GADS!!!
If he was having radiation surgery, this is supposedly a highly technological procedure with a couple hours of computer programming of the "gamma knife" (or its equivalent). To get the site data necessary for the procedure I needed to get an MRI with contrast within 2 days of the procedure, and a CT scan on the morning of the procedure. These two different images are then combined in the computer to get an exact targeting and radiation exposure rate.
For them to catch the risk at that point is more than alarming. To not inform your relatives of what the issue was, is beyond reprehensible.
I was in that damn head frame for roughly 5 hours. I can imagine being in it all day. As it was, the resulting headaches were awful. The pressure actually changes the shape of your skull and there is lots of sensitive stuff in that skull.
You stated that your brother in law is "over 65" and on medicare actually raises questions for me. Having a mother outlaw who is 94, procedures are often framed in terms of her age. They are reluctant to (or don't) pursue often necessary treatments because of a person's age. Not because of the risk, but because they are going to die at some point. Knee replacement for example. Sometimes prudent measures are also not pursued.
A friend of mine's mother fell and received a concussion. She was on blood thinning medication. The hospital (and doctors) did not do either an MRI or CT scan of her skull. She died within hours of a brain hemorrhage.
Luckily, I was not stuck with that $43300 out of my pocket - just my deductible portions of it. However, if I did not have insurance, or had the poor coverage that many do, I would be either bankrupt or walking around with a growing tumor in my brain.
August 6, 2009 9:26 PM | Reply | Permalink
I agree Rowan.
I want to see health and justice for all.
I will keep fighting for universal, single payer health care and taking the profits out of our health care system however long it takes:)
I am glad you were able to get the treatment you needed. So many people cannot. I am well and grateful to be so.
But I fight for so many people who are suffering right now over their health or the health of a loved one and for those declaring bankruptcy today due to health care expenses.
We need to get universal health care in place for sooooo many reasons and then as Jason keeps pointing out, let's look for more of the causes of so much disease and unhealthiness and do something about those things causing our population the most harm.
August 6, 2009 9:19 PM | Reply | Permalink
Synch, I agree with you. I am beginning to think we need to question the whole idea what "insurance" is. James Kwak at Baseline Scenario has a good post on this. While I disagree with some of what he says, he makes a very insightful point in You Do Not Have Health Insurance:
August 6, 2009 9:36 PM | Reply | Permalink
And if you become disabled, as one patient of mine has, guess what? The employer, yes, pays long term disability - for two years, but drops the person's insurance after 6 months! Oh, of course the person, if they had the money, could or should continue the insurance. But this person is bankrupt already.
I agree, there is no such thing as "insurance" - just temporary "benefits".
August 7, 2009 12:39 AM | Reply | Permalink
P.S. I am now seeing this person for nothing - as is her psychiatrist. (just so no one is worrying here)
August 7, 2009 1:00 AM | Reply | Permalink
I don't know about worrying, but 'wondering' would be a good word. Thanks for all that you do, TheraP. And I hope Mr. T feels better soon, also.
August 7, 2009 3:01 AM | Reply | Permalink
He says it's a bit better this morning. But he also slept for nearly 12 hours last night. He's been sleeping a lot lately. But I'm vigilant! We have a great dentist. And the nearby health care is also excellent. Plus a good Medicare secondary. All of this simply reminds me of the plight of so many others!
Thanks to all those who expressed concern.
August 7, 2009 11:52 AM | Reply | Permalink
It is within this "divide and conquer" "shell" game that the insurers lead people to resent those who use healthcare. Insurance is a program wherein, because everyone contributes, the needy get treatment and should not have any change in their expenses for monthly contributions. Everyone should be paying the same every month. The payments are mostly related to the size of the pool. What the insurers have done is segregate the pools and divided their populations into all these smaller subsets so they can illustrate that this pool is not profitable.
The system should only be considered as a whole. There should be no subsets. If everyone is equal, then premiums can be set realistically, equal for all, to cover those in need. Insurance is not designed to work more effectively when it is divided into all these smaller pools. It works less effectively. Every time you reduce the population, you lose the economy. I want insurance there for those in need now, so it will be there for me later. Seeing it refused to others gives me no confidence it will be there for me.
August 7, 2009 1:49 PM | Reply | Permalink
Health is partly a crap shoot. To blame people who get sick for using health care is like blaming people who roll the dice and get any particular number. There but for the grace of God go we!
No one should be blamed for using a social good. Whether health care or public education or public parks or roadways. Imagine if people were blamed for using the roads to get to work!
August 7, 2009 2:16 PM | Reply | Permalink
One of the things about this whole healthcare debacle that makes me CRAZY is that the very people who are screaming that they don't want the government involved in their health care are the same ones that would be screaming bloody murder if their parents (or themselves) were taken off of medicare...go figure.
AND, the ones that are saying to leave things the way they are, will not listen to anyone who says that the status quo is leading to a place where none of them will be able to afford the insurance they have now in a very few years...
Too many people have already made their minds up based on faulty information and scare tactics, and few are listening to each other, or the people who know what is going on. It's a mess and it's about to turn my brain into oatmeal and cause my husband and I stop speaking to each other...
Rowan, I wish you all the best in your recovery.
August 6, 2009 9:35 PM | Reply | Permalink
Stilli, somewhat OT but apropos: Did you know that Cliff Asness responded to your Uncomfortable Truths post? (It's the very last comment.) Apparently he registered here just to call us Stalinists who were shouting a poor inquiring soul down.
As one of the Stalinists involved, may I commend you on your 'amazing' transformation from "poor inquiring soul" to one of us? You wear it well!
August 6, 2009 10:32 PM | Reply | Permalink
That is SOOOOO cool! Thanks for bringing it to my attention. I responded (not that I think he'll come back and read it.) I wonder how he knew it was there? What a jerk!
August 6, 2009 11:06 PM | Reply | Permalink
Hi Stilli. I'm with you. I think that most people know that the status quo will literally be the death of us. I think that the drop in approval for Obama's plan is not the effectiveness of the scar tactics being used, but that critical changes keep getting taken off the table.
I believe the only ways to combat the fear mongering is with facts, and by reminding people what they already now - they are getting less and less for a higher and higher price. That profit and healthcare do not mix.
August 6, 2009 10:35 PM | Reply | Permalink
I don't know what the outcome is going to be, but he's getting whacked, right AND left (pun intended!) I guess that's why he gets paid the big bucks. He must ask Michelle every night, "Tell me again, why did I want to be President!?"
August 6, 2009 11:11 PM | Reply | Permalink
I think people wre expecting Obama to be more in the lead with this. We're not hearing that Rahm is twisting arms to get this done, and with the dismissal of Single Payer BEFORE any discussion was permitted, his transparency promise is less then accurate. Still, I am not sure anyone else could have done better.
August 7, 2009 1:58 PM | Reply | Permalink
Rowan, I too think of you often and wish you a total and rapid recovery.
Like Stilli, I am amazed at the people with Medicare that don't understand the connection between it and the government. However, the politicians do understand and that's why the conservative ones are so afraid of it. Just like in 1994, they understand that the best way to remain in the minority in Congress is for health care reform to pass under the Democrats.
August 6, 2009 10:56 PM | Reply | Permalink
Truth can take us a long way in this. There are those who will be driven by manufactured fear to act against their own experience and best interests no matter what. However, most folks are not in that category.
I would love to have a decent universal plan pass under the Dems. It would shut down the lie machine for a long time.
(Thanks shell)
August 6, 2009 11:33 PM | Reply | Permalink
Rowan. Don't quit your job
Oy! Whatever you do. Don't quit.
(hugs)
August 6, 2009 11:51 PM | Reply | Permalink
But what if she gets too sick to work? There goes the insurance...this sucks the big cassaba.
August 6, 2009 11:54 PM | Reply | Permalink
What if, Still?
Are you sure you want to ask me about that? I think the what if has been covered. What if Rowan was talking about her child? What if she was self employed to begin with, as so many are because there ARE NO JOBS. What if, indeed.
I don't think we need any more stories. We need action. We need UHC. Now. We need work, NOW!
If you haven't been affected, you will be. Eventually. I know you understand this, Still. I think there is a poison in this country in the form of big business. Harry and Louise masquerading as ma and pa kettle. They've taken it to the streets, so we have to.
I think that the thing that shames me the most is that this crrrrap has been going on in what we term "flyover country" (in our superior way) for 20+ years and I didn't care too much. (I did care enough to vote for Bill Clinton, because of his promises for healthcare for all, when I had a plan like Rowans), but I didn't care enough to consider what was really happening to them, until it got me, too.
I don't expect anyone else to understand, either, but understand this: if you don't treat this as if it WAS affecting you and yours in the worst way, it won't get done.
The forces arrayed against us are far too organized, too wealthy, and too entrenched.
This isn't a "nice intellectual conversation."
This is it. If not now. Never. Kiss America goodbye.
August 7, 2009 12:28 AM | Reply | Permalink
I hope you didn't misunderstand my comment...I'm agreeing...It sucks that so many people are calling for the status quo, when the status quo makes it so that even people who are doing everything right are getting screwed...I DO understand.
August 7, 2009 12:46 AM | Reply | Permalink
Bwak! I hear you and LisB have pitchforks and seashell seems to have found a cheezeburger supplier with deep pockets. :~>
I have seen reports of people protesting outside of insurance headquarters - of course they're not the only ones trying to buy a profitable health plan. Congress will go on vacation. Supporting those who are on the right track and letting those know who aren't is a positive action. Since highly coordinated and financed political hooliganism is going on a public meetings with our representatives, it is important for those who support true reform to be at those meetings and be willing to speak out while the jeerers do their thing. We can coordinate too to respond to disruption. Namely by saying that we want to hear what our representative has to say.
We can be FIRM and PEACEFUL. I truly believe that the majority is on the side of UHC - they just need to find their voice.
August 7, 2009 1:00 AM | Reply | Permalink
We can find the people who would be adamant about HCR at the hospitals. It is there that people are in the moment of a healthcare crisis and they would be most willing to get involved and bring their energy to HCR. It is the people with the stories who are the most likely to get active. We can attract the families of the ones who are needy there. i agree with Bwak. We do not want them for their stories but for their energy.
August 7, 2009 2:03 PM | Reply | Permalink
Stilli - believe me. The thought has crossed my mind more than a few times. While I will ultimately get stable from the procedure I discuss in this post, the trigeminal neuralgia is a whole other story. One might say I have "skin in this game." What people need to realize is that we all do - and not just health care. Part of what I see as my "calling" in this life is to help show that we all have skin in the game - whether it is oppression, or global warming or healthcare - all of us are vulnerable. It is just that some of us are closer to vulnerability than others. We truly do all need each other.
August 7, 2009 12:31 AM | Reply | Permalink
My husband and I are having a HUGE disagreement on this. We have good insurance, and even if we lose it (which will mean that the state of CA has finally gone down the tubes) we have the financial ability to purchase our own insurance (barring any pre-existing conditions we are unaware of at this time.) My husband is hesitant to rock the boat for fear of losing the ability to have your own insurance and being at the mercy of the government, which he distrusts even more than I do.
I keep bringing up to him the potential price increases coming down the pike that COULD put it out of our reach, not to mention the unfairness that we have good coverage when so many have nothing, or basically shit insurance, AND that our insurance (as good as we think it is) is basically untested, as we have used it sparingly, and not for anything major, as yet. AND that's not even mentioning that he'd rather trust a big insurance company than the government...
We can't even discuss it w/o practically fighting,and we've had to adopt an agree to disagree arrangement and stop talking about it...and we almost always agree on the important stuff...
August 7, 2009 12:59 AM | Reply | Permalink
Stilli, sorry for the situation on this issue with your hubby. I do not understand why anyone thinks that an agency that makes a profit by NOT providing care is somehow trustworthy. Not to mention that most folks who are over 30 probably have SOMETHING in their medical history that could be considered (or misinterpreted as) a "pre-existing condition."
August 7, 2009 1:05 AM | Reply | Permalink
I don't know Rowan...he's a really smart guy on the vast majority of issues, and very well read. That's one of the things that scares me so much about this. If HE can buy the bullshit, a whole bunch of less intelligent people will, too...
August 7, 2009 1:23 AM | Reply | Permalink
Stilli, here is an article detailing how one health care provider sent out letters notifying their patients that as of Aug. 31st they will no longer accept Aetna Insurance.
But, according to a health care consultant, the patients have little to worry about as WellStar is simply using negotiating tactics! And this is not unusual behavior from either providers or insurance companies.
The paper noted that sometimes these negotiating tactics get rough, especially for the patients. It recalled that back in 2006 another provider got into it with Blue Cross/Blue Shield, which left 130,000 people in medical limbo for a month.
So much for trusting these bozos.
August 7, 2009 2:58 AM | Reply | Permalink
Ask him these questions.
With which organization does he feel he would have a better chance to effect a change, a private company or the government?
Who is more likely to silence him with attorneys and lawsuits, the private company, or the government?
If he did need to protest and wanted an ally, would it be easier to find his neighbor, and someone else with the same insurer?
For me, I prefer the government because I can hold them accountable with a little help from my friends. Okay, it is a very long shot, but I have tools. Against a private company, I have no chance.
August 7, 2009 2:08 PM | Reply | Permalink
Bwak, I'm not planning to quit, but all of us are vulnerable. The main access to any kind of healthcare for most folks is through their employer. We have over 6.9 million people OFFICIALLY unemployed, and more than twice that actual. About half a million people a month are still losing their jobs. And almost all of them their insurance as well.
People know this - they are experiencing this. Lose the job, lose your "insurance" open up a huge hole in any sense of security. This is what we need to counter the BS fear mongering with - in my opinion. We have a real fear to deal with. Namely that most of us are one serious illness or accident or economic downturn away from health-based disaster. The system we have leaves us with out back ends blowin in the wind. Therefore we need a different system. Period.
August 7, 2009 12:23 AM | Reply | Permalink
Che-yeah.
We need to take that fear and up it a notch, Rowan. I am well beyond afraid.
August 7, 2009 12:33 AM | Reply | Permalink
Now you see how the employers can be so suportive of the present system. Take away their ability to hold your healthcare against you, and you're much more willing to remain working where you are when conditions are less then agreeable.
August 7, 2009 2:10 PM | Reply | Permalink
Rowan,
My bill for a recent five-day stay at the hospital was $72,000+ (and counting) and I didn't have surgery or cancer treatments. I "inherited" a life-threatening blood disorder and required daily infusions of immune globulin as well as the occasional infusion of blood platelets. What happened was that my blood wasn't clotting and I was in danger of bleeding to death internally.
The doctors at the military hospital emergency room strapped me onto a gurney, told me not to move or cough, and sent me via ambulance to a city-owned private hospital for treatment.
Apparently, I had experienced a "rare" reaction to one of the 4 antibiotics previusly prescribed for a staph infection by three different doctors(all because I couldn't get an appointment to see my doctor). And I wonder who is keeping track of the "rare" instances of negative reactions to sulfa, the antibiotic generally prescribed for the treatment of MRSA staph (it turned out not to be the MRSA strain).
Long story short: I nearly bought the farm because I wasn't allowed to see my primary care physician (wait time is generally 5 - 6 weeks), not at the onset of the staph infection and not even after my release from the second hospital with orders to see my physician two weeks later (no amount of pleading or explanation could get me an appointment).
Actually, I have never met the man (my assigned PCM), even after the month-long ordeal invlolving 10 doctors and 30 or so nurses. Needless to say, I now have a new PCM. Once able to do so, I catapulted off the hospital bed in a barely-contained rage and confronted the people who refused me care when I needed it (nevermind the outlandish hospital bill that could have been avoided). All hospital approvals had to be approved retroactively. I dared them to refuse.
I would have dropped dead either of the staph infection or of the blood disorder if I hadn't gone to the emergency room (twice). The staph infection that started as a tiny blemish on my check advanced quickly and spread to the lymph nodes in my neck, which required 2 days in a military hospital and intravenous antibiotics. That was just a few days before the bad reaction sent me back to the hospital.
Lucky for me I have health insurance, though I was refused use of it until I went and pitched a holy fit, and that was after the fact. Without health insurance, I would now be responsible for paying more than $80,000 in medical bills. We don't happen to have that kind of cash lying around as I'm sure is the case for most Americans.
This is one reason to fight this fight with both barrels blazing. There are 50 million+ other reasons. Three days ago, I found out that my mother has cancer. Her doctor ignored her medical complaints for over a year. Her new doctor finally ordered a CT scan and found a large mass. A biopsy revealed that the tumor is malignant. Her previous doctor refused even to order an X-ray... for more than a year, despite her contant complaints!
I'm so pissed I can't see straight. I'm done playing nice. Our entire health care system is one giant boondoggle no matter what kind of health insurance plan you have, and we need to stear it clear of the profit motive, period. At the very least, a public plan is an absolute must.
Rowan, I wish you a speedy recovery. Thanks for the post.
August 7, 2009 12:05 AM | Reply | Permalink
Thanks for sharing this. You don't need my approval, but your rage is justified. I thank whatever forces of the universe that you are still with us!
Your experience gets at several issues, but the big one that jumps out is debunking the lie that the medical profession is practicing "defensive" medicine, and that is why healthcare costs are out of control. According to that crappy rhetoric, we need to get rid of malpractice and medical costs will go down. At least 2 problems. 1 - removing accountability is not going to improve healthcare. 2 - no place that I know of that has limited malpractice awards has had a decrease in healthcare costs.
There are a number of things that should not (and must not) be in the "profit" environment. Healthcare is one. Prisons another. Basic necessities another. I could go on, but the point being that healthcare should be available. It should not even be an "insurance."
August 7, 2009 12:45 AM | Reply | Permalink
I am up at this hour for one reason only. Mr. TheraP has an infection in his gum. Not gum disease. In fact the dentist doesn't even know what it is. But gave him 10 days of antibiotic. Of course Medicare doesn't cover dental care. And thank goodness we live 5 minutes from a hospital and can go there if this thing gets worse over the weekend.
In my concern for his health, I wasn't falling asleep and went out to the kitchen - only to see 2 deer lying on the back lawn. That led to a concern, what if his yard work last week has led to lyme disease? Could that cause a gum infection? Which is why I got on the web. It doesn't look like it...
Rowan, I am glad you feel well enough to have written this stunning blog! You laid out the issues so well. There's nothing like a bright person able to make use of their own difficulties to get to the heart of the health care problems. They are legion!
I think the biggest obstacle is willful blindness on the part of people who are well and blindly assume they will continue to be well. And continue to be insured. Who also seem to lack empathy or a willingness to really consider that all of us are here on this earth as fellow persons and that we both need each other and bear responsibilities for each other. It's a moral issue. It's got a spiritual dimension. And it's become a political football, in which political terrorism lies at the worst end and simple lack of empathy at the other end, when it comes to people opposing something which should be a basic social good (not, as you say, a commodity).
Grrr..... Rant! Rant! Rant!
Super blog! Super discussion. And what galls me the most is we're likely wasting our breath here. Because we iz the little guyz - and we getz the short end of the stick!
All my best in your healing, Rowan! May the writing of this blog bring you endless good karma! Much love too of course. :-)
August 7, 2009 12:59 AM | Reply | Permalink
Hi TheraP! Sorry to hear Mr T is having problems and I hope they clear up quickly. So glad you brought up dental care (frequently not part of coverage) and mental health services are also frequently not covered. Another thing not covered - long term nursing care.
There are lots of dimensions to the issue of "health" and as far as I am concerned, for most of the population, the U.S. gets a D to an F.
For example. If you are going to have an accident, the best coverage you can get is if it happens on the job (and the employer is covered by workers compensation). Now here's the "gotcha." Workers Compensation was created to limit the risk to EMPLOYERS. It really isn't aimed at protecting workers. If you have ever been injured on the job (and I have), the health coverage can be pretty good. However, the harassment can be intense as well - all the way to private investigators following one around. So the best coverage that most of us can get is through a program structured to protect companies from the costs of employee injuries.
Thanks for the healing thoughts and prayers. I send the same for Mr. T ... and a restful night's sleep for you.
August 7, 2009 1:23 AM | Reply | Permalink
That reminds me...
This is something I still don't understand: why is it that eyes and teeth are not body parts? I have (via employer) Blue Cross insurance for my nose, elbows, knees, kidneys, spleen, etc., but not for my teeth (that's covered by Cigna) nor vision (that's VSP).Obviously, then, while the spleen and nose and elbows are body parts, the teeth and eyes are not.
August 7, 2009 1:52 AM | Reply | Permalink
Beats the hell out of me. Sorry I left out vision coverage. Guess they don't have the lobby power of the AMA or big pharma.
August 7, 2009 1:59 AM | Reply | Permalink
Let's not forget hearing! I have two hugely expensive "laptops" - one in each ear. They will be lucky to last another 5 years... likely only 2 as they are now 5 years old. (Nobody pays for these except me. Poor folks simply would not have them!)
Health care should be considered part of National Defense. How can sick nation defend itself? And what risk are we at, as a nation of laws, if hooligans and thugs are out to defeat health care for all? Imagine a pandemic! The nation is defenseless if it lacks health care!
The ship of state has hooligans after the steering wheel! Hooligans - who could care less if their behavior leads foreign investors - or any investors - to pull money out of a society in danger of collapse due to lawless elements fomenting insurrection.
August 7, 2009 11:50 AM | Reply | Permalink
Health care should be considered part of National Defense.
RIGHT! ON!
August 7, 2009 1:25 PM | Reply | Permalink
WAY off topic, TheraP, but years ago I learned from my pediatrician- who in his elder years is now exclusively a Lyme doctor- that Lyme can be treated early and effectively with antibiotic. He observed a Lyme lesion on my then young son's arm and put him on a course of Keflex. -Just so you know to look for the bulls eye lesion. And (of course!) only in case you did not already have this info.
Best wishes to you and to Mr. TheraP.
August 7, 2009 1:23 PM | Reply | Permalink
I pray for your complete and speedy recovery Rowan.
I know for a fact that what you say about people dying is true. When I was running a program for low-income young people there were several instances where my students (18-24 years old)would tell me of a sick relative, whether a Mom, Dad, Aunt, cousin, etc... who was diagnosed with cancer that was treatable but they had no insurance so all they could do is go home and let the disease run it's course. This was so appalling and horrifying to me I can't really descrive my reaction to this kind of news. Making matters even worse was the absolute resignation of all concerned in these families that death was the outcome. They felt so hopeless and expected so little they rarely even made an attempt to get the care that was needed. I had many students who had parents who had died far too young as a result of high blood pressure and obesity too. But, because regular doctor's visits were simply not a part of their reality these treatable conditions often went completely unaddressed and killed these people. If we provided healthcare for each other as citizens of all the other industrialized nations do these deaths likely would not occur, my students would not have to suffer the profound loss of a parent or other relative prematurely. Our system of for-profit healthcare is barbaric and inhuman in that respect. Citzens of the other industrialized nations are appalled at our lack of humanity toward eachother on this matter.
August 7, 2009 2:15 AM | Reply | Permalink
Oleeb, it IS barbaric. When you create a system that is as unequal as this one, effectively we as a nation are saying that some people's lives are just worth less (or even worthless). This is buttressed in the U.S. by the belief that social class itself is a "choice." Therefore the poor choose to be poor, lack of healthcare is just one of the consequences of that choice.
We now have a situation where the profit taking of big healthcare is such that it is not just "the poor" who can't access the system. That is why more people are angry and it has traction. When the middle class struggles with healthcare costs then we deem it an "issue." This is because the middle class is seen as "worth more."
The whole thing is immoral in my mind.
August 7, 2009 9:43 AM | Reply | Permalink
I read somewhere last night that the healthcare bill, no matter what version passes, is so packed with special favors and largesse for the healthcare industry that the insurance companies, etc... will make much more money as a result even if a worthwhile public option is included. Between the straight out subsidies to various tax breaks, etc... they are making out like bandits and it is going to cost us all a fortune but not move us much closer, if at all, to either providing medical care to all or to reducing the cost of our perverse for profit system. Very discouraging.
August 7, 2009 1:07 PM | Reply | Permalink
These are all reasons why the majority of health care should be either non-profit or limited profit. After all, in a for-profit business, it's all about raising revenue and cutting costs. That being the case, where's the incentive? Is it to provide the best care, or to make and keep the most money?
By limiting or eliminating the profit motive, many of these stories wouldn't be told.
I'm not saying that health care professionals shouldn't be well paid, they should be. They undergo a lot of training to gain their abilities. A hospital, HMO or health insurance company operating with a profit motive will be more loyal to the bottom line than to patient care, as we see everyday.
August 7, 2009 4:15 AM | Reply | Permalink
Agreed Jwalk.
The argument is that the current system allows "choice." What is not said is that the choice is highly limited. If you have employer supplied insurance, then your choice is to select from the plans (not necessarily the carriers) that they contract with - or to opt out of coverage. If you are an individual purchasing insurance, then you generally have to pay even more for less, and then there is those pesky "pre-existing conditions."
For many with employment based insurance, you can't even change plans except during a plan enrollment period (usually once a year).
The other argument is "choice of doctors." Generally, you can choose your doctor - within the plan. If your doctor is outside the plan, then the payments are either significantly reduced or nonexistent.
Choice indeed.
August 7, 2009 9:52 AM | Reply | Permalink
Let's consider some facts. According to the Centers for Disease Control and Prevention, and the U.S. Census Bureau. 253.4 million Anericans or 83% of the country have health insurance. 202 million of that pay for private insurance. Breaking down the 45 million we find, nearly 10 million arn't American citizens, 17 million could afford insurance but choose not to get it, that leaves about 11 million. Do we need get health care to those people YES Do we need to trash the whole system to do so NO. I don't know of anything the Government runs effectivly or efficiently. I do know that Countries that have allowed their Government to take control of their health care system are not happy with it, and pay 60 to65% of their income to the Government. I would like to see true health care reform, starting with tort reform, and allowing insurance co. nation wide to compete.
When the Government say's if you like your insurance plan you will be able to keep it, that's a lie, all private insurance will be fazed out over 5 years. I have been reading this bill aswell and much of what I see I want no part of. This bill is nothing but a PMC, power,money and control for the Government.
August 7, 2009 11:12 AM | Reply | Permalink
The public option is an option. They're not going to take over the health care system. They're going to provide health insurance to those who need it. Those 17 million who can afford it, but choose not to get it? They can still choose not to get it.
By the way, who decided they can afford it, anyway?
August 7, 2009 1:34 PM | Reply | Permalink
P.S.: Your facts are out of date. The United States population is over 304 million now, and the number of uninsured has increased with the recent economic crisis (as of January 2009, there were more than 52 million uninsured[1]).
[1] Mark Holmes, Thomas C. Ricketts, and Jennifer King. "Updating Uninsured Estimates for Current Economic Conditions: State Specific Estimates," Cecil G. Sheps Center for Health Services Research and North Carolina Institute of Medicine (March 2009).
August 7, 2009 1:49 PM | Reply | Permalink
Ask yourself if the people disrupting the town halls care a rats ass if you die tomorrow because you don't have health care.
Ask yourself if the far right media keeps the hate boiling because they care if you lose your house paying off a health bill.
The real issue is why do we spend ONE TRILLION dollars a year in so called defense of a country that has no real enemy that could attack it?
I have long argued that defense should be cut to a max of 200 billion dollars to pay for health care and to rebuild a falling apart nation.
The real fight Obama should have taken on was a massive reduction in the defense budget.
Nothing can change in a meaningful way until the concepts that define the discourse in this country change.
That's why I do not have any faith in a meaningful reform.
I don't believe the congress has enough decent people to achieve it.
And BTW, I do not need health care, my coverage is as good as the presidents.
I do however believe the first priority of any civilized people is to take care of each other.
It has never been a question of enough money.
It has always been about politics and enriching the wealthy few.
I am disgusted beyond belief as to what is going on in the health debate and see massive violence coming,as I have posted before, because a health bill will be passed and Obama will be around 7 more years, and all the crazies will not be able to contain themselves.
August 7, 2009 11:46 AM | Reply | Permalink
I am with you 1000% Jade! (Except for the health care as good as the president's. I am hanging on for dear life till Mar. 1 - when Medicare kicks in.)
I was with you on torture. I am with you on this. I envision needing to sing "We shall overcome" on street corners - because this is getting to a very scary point - where mobs are being unleashed. Yes, health care is part of national defense - as I said above. All of us is also a huge danger to the economy: Who will invest if there is insurrection? The lobbyists behind this care nothing about the consequences!
I salute your wonderful comment! Do a blog on it - if you haven't already.
August 7, 2009 11:57 AM | Reply | Permalink
very kind of you.
Thanks TheraP:)
August 7, 2009 12:30 PM | Reply | Permalink
I love you, Jade! :)
August 7, 2009 12:38 PM | Reply | Permalink
Good points all Jade! I would add that it is not just the defense budget but the corporations that are fed through that budget.
August 7, 2009 2:24 PM | Reply | Permalink
Rowan, I salute you. I'm inspired by your courage, and I applaud you for sharing your story. I hope many others will follow your example.
Wishing you nothing but good news on the road to recovery. Will keep you in my thoughts.
---s
August 7, 2009 2:03 PM | Reply | Permalink
Thank you fingers!
August 7, 2009 2:26 PM | Reply | Permalink