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9/1/2009
Burri: When the bad-guy insurer IS the government
If I were Barbara Wagner, I’d make sure to attend my next congressman’s town hall forum.
If said congressperson is holding one, that is. We’re not all so lucky. http://troglopundit.wordpress.com/2009/08/12/say-is-my-congressperson-ever-going-to-hold-an-obamacare-listening-session/
Who’s Barbara Wagner? She’s a cancer survivor: lung cancer, which went into remission until last year. Her doctor prescribed an expensive drug – about $4,000 a month – to slow the cancer’s growth. Slow it, but not stop it, but hey: who knows what could happen, with another 4-6 months above the ground?
One problem: her insurance company refused to pay.
If I were she, I’d head for the nearest health care town hall. Or maybe just straight to the media. Tell my story. Demand to know why insurance companies are allowed to put the almighty dollar before human life. And ask what my Congressman intends to do about it. Ask: what am I supposed to do when my insurance company won’t pay?
More on Ms. Wagner later.
The personal anecdote – the single most effective way to get a message across. Just ask Sen. Tom Coburn (R-Oklahoma). He got cornered at his own town hall by a sincerely anguished woman, whose husband suffered a traumatic brain injury. If I understand correctly, her husband can’t feed himself. He needs professional care, but their insurance company refuses to pay.
Watch the video: it’s an emotional moment, and a scary one. Scary, because…you know, that could be any of us.
And what do you say? What do you say to anyone with a problem so big, who’s looking to you for help? Who thinks you should be able to help?
“Look, I’m sorry. You have a problem, I understand that. But your problem doesn’t give you the right to demand money from your fellow citizens?”
In a hypothetical world (like the blogosphere) that’s not a bad answer. But face to face with a cancer victim? Face to face with someone trying to care for a badly injured family member?
Could you say that? The gentler equivalent of “life’s tough?”
Because it is, you know. Life’s tough, and bad things happen. Even when the government is in charge.
Back to my first example: Ms. Wagner. See, her “insurance company” wasn’t Aetna, or CIGNA, or Humana. Her insurance company was the State of Oregon. Her treatments were refused by the Oregon Health Plan – Oregon’s more “universal” version of BadgerCare.
The government turned her down.
To whom does she complain about that? To whom does she turn, when it's the government – not a faceless, heartless corporation thinking only of their profits – refusing to provide the care she needs?
It's exactly the kind of story “reform” supporters love. It proves we need more government to make sure people in need don't go without, but it was the government making a decision based on cost, rather than need. The government, that's supposed to save us all!
So, fine. Their side uses anecdotes, our side uses anecdotes. It’s a wash.
But no: there’s a difference. For now, at least, we can to improve our own positions. We can take steps to protect ourselves against immense health care costs. It isn't always easy, and we won't always succeed, but there are things we can do.
The further we move into socialized medicine – the greater the share of responsibility we give over to the government – the less we're able to do that. Once the government runs things, that’ll be that. There’s no place else to go.
Not even for Canadians. Not anymore.
To whom do we tell our anecdotes then?
Lance Burri blogs regularly via his site, The TrogloPundit.
COMMENTS
Wow. Next the firefighters are going to quit showing up when homes are burning. And police will issue number cards to stand in line when you are being robbed. That dastardly government!
Why no outrage about the $4000 drugs when pharmaceutical companies are at 23% profits even after deducting out-of-sight executive salaries and bonuses? Why no outrage at the California case where Cigna refused the 17yo girl a kidney transplant and she died. That could have been my daughter or your daughter. Why no outrage when the politicians drain state budgets to pay back their special interests, and have to use healthcare dollars to do it? Why no outrage when 31% of our (private) healthcare dollars are consumed by a gigantic insurance bureaucracy and are not spent on healthcare instead?
Why? Because I suspect that Burri has a gold-plated insurance plan (at least for the moment), from an employer that is (currently) providing healthcare.
Lance, I hope you remain lucky.
Jack Lohman (Tue Sep 01 10:31:09 2009)
Why is it always the police and the firefighters Jack? Geez. Yes, important community protectors and part of the government. But enough already in trying to compare a complex health care system in both public and private sectors.. Next I suppose you'll be raving about the post office.
Jo (Tue Sep 01 10:47:09 2009)
Police usually do not prevent crimes; they only INVESTIGATE AFTERWARDS. Citiaens who take advantage of their right to bear arms, are usually the ones who prevent the crime...which then never gets reported.
For example, take the Chicago man who heard someone snooping in his back yard. He went out, Glock in hand, loading as he came out the door. The mere sound of the gun being loaded, sent the intruder running in a panic.
I have friends whose preemie twins' bill is already $32,000. They REFUSE government help, and their church is holding a fundraiser. I have no doubt that their bill will be paid.
Jack , why no outrage that FIFTY percent of GOVERNMENT health dollars are wasted? Why no outrage that government doesn't do the sensible thing, and ELIMINATE the middlemen? All anybody REALLY needs is major medical, NOT "health" insurance. The rest should be paid out-of-pocket, and automatically costs WILL come down.
emily matthews (Tue Sep 01 10:55:59 2009)
No, Jo, I've said several times that the Post Office can cut deliveries and personnel and property.
>>> And "why no outrage that FIFTY percent of GOVERNMENT health dollars are wasted?"
Because Emily, I have. Repeatedly. Read my blog. It's filled with it. And I have repeatedly said that even more waste exists in our private system. As a nurse you should know this.
Yea, costs will come down if everybody pays out of pocket, 1900's style. And so will life expectancy. But what the hey, maybe that's what we need. A pruning of our population.
Jack Lohman (Tue Sep 01 11:12:11 2009)
Jack, you just claimed that the private system wastes 31%. When I was in school, I was taught that 50 is greater than 31.
That aside, why do you think adding more/different MIDDLEMEN will help!? The middlemen, whether insurance companies OR the gov't, are wasteful. Therefore, they should be eliminated.
If everyone had gov't-provided house or car insurance, how careful do you think they'd be? What if every time you had to call in a tradesman, you had to pay him through a middleman? Do you think his price would go up or down?
As to life expectancy, today's children are expected to live SHORTER lives than their parents. Life expectancy is somewhat a moot point when speaking of history, as it is ALWAYS skewed by infant mortality rates. If those are deleted, you find that people don't truly live any longer now than they did in the 1800s or even 1500s. After all, Galileo lived to be almost 78. Newton died age 84. Primitive people lived even longer.
As to "pruning population", that WILL happen under the gov't's proposed plan. Numerous references to "outcome-based care" (i.e. if you're old or disabled, we won't waste resources on you) and "end-of-life issues" (we want you to decline all life-saving measures) make that abundantly clear. What is particularly scary to me are the references to "preventable re-admissions", for which drs and hospitals will be penalized.
Who defines "preventable"? Take the case of patients (pts) who have CHF. They may fail to take their diuretics, eat tons of potato chips, keep smoking, etc. Then they land in ER, get admmitted, dried out, and sent home, with a "watch-dog" nurse to follow up via visits and phone calls.
That nurse can only do so much. If the pt decides to keep on breaking the rules, s/he WILL end up in trouble again, and will be re-admitted. So is that the HOSPITAL'S fault?
How about someone who has money for flashy jewelry, a cell phone (I can't afford), tattoos, cigarettes...but "doesn't have enough money to get insulin". Insulin is one of the cheaper meds, and any pharmacist will give it to you WITHOUT a prescription if you need it! Buying your own medication for a condition that occurred due to eating too much sugar and high fructose corn syrup(very few type one diabetics nowadays), doesn't seem unreasonable to me.
Both these scenarios are real, and both would be avoided if there wasn't the notion that "someone ELSE-insurance OR gov't-will pay for it." This is why major medical makes sense: it returns SOME SENSE OF RESPONSIBILTY to the pt.
As it stands, I can picture just what'll happen. The admitting dr will be called by the ER dr, to admit a pt. The admitting dr will refuse, as he won't want to be in a situation where he might get penalized if the pt is re-admitted; ESPECIALLY IF THE PT IS ONE OF OUR "FREQUENT FLIERS". Then the pt will be sent home until they're so bad they're almost dying, after which it'll be OK to admit them ,as they might not make it, and there won't be any fear of re-admission.
Another scenario is the pt already discharged (because Medicare won't pay for them to be in the hospital any longer), who comes back to ER. Again, do you think the admitting dr will want to re-admit?
Doctors are people, not government cogs. Why should they get into such huge debt going through med school, work such horrid hours, face the constant invisible lawyer looking over their shoulder, and put up with the equivalent of $15 to $20 per hour for a Medicare pt? A CNA, (whose training encompasses 3 MONTHS), working for an agency gets that much!
Since the gov't wants to set drs' fees, now, too, I predict a lot of them quitting, or not even going to med school to begin with. Why put up with a no-life-while-in-school, the likelihood of getting sued, long hours, etc. when you could just get a job in a factory, and just work one shift? Already our best ER doc is re-training for another career, as he wants to quit.
So you'll end up with overworked stressed people, or those who couldn't find anything else to do, taking care of you. I once worked with residents; a few of them said if they'd "known it'd be like this", they wouldn't have gone into medicine, but by then, they had loans to pay off, that'd take 15 years at least, so they were stuck!
My mother-in-law died last year. She kept falling, yet the drs in her gov't-run health system refused to do even the simplest tests, such as a UA or EKG. (Often elderly will have balance problems if they have a bladder infection, and of course, heart problems can make you dizzy too.) They just kept telling my bro-in-law "it's part of getting older." Finally after 4 months, he PAID a dr to do tests, and they found she had terminal cancer, which of course, was not treated. (I'm not saying it should have been, but they weren't evenm given the option.)
Be careful what you wish for--you might get it!
emily matthews (Tue Sep 01 13:29:16 2009)
There seem be a lot of people out there who are expressing callous indifference to the uninsured. After all they've got
theirs and everyone else be damned. But are they sure they're secure?
Do they have security with regard to healthcare? Of course not!
If these people want to be afraid of something and obviously they do,
then why not the specter of losing their coverage?
I know personally that I have health coverage, in fact it seems to be pretty good so far as my family and I have made use of it, which isn't extensively.
But do I have security, do I feel secure in that coverage? Hell no!
With premiums going up 15% to 15% per YEAR my employer may decide/be forced to discontinue coverage.
OR
The insurance company selected by my employer may decide not to pay for treatment if I or a family member gets seriously ill.
OR
The insurance comapny selected by my employer could use recision and
drop us from the rolls entirely if I or a family member gets seriously ill.
OR
I could lose my job and therefore my coverage.
Notice that NONE of these potentialities have ANYTHING to do with "PERSONAL RESPONSIBILITY" on my part. It's all pretty much out of my hands.
Am I unique among Americans in this regard? Hell NO! I am the norm. And I and most American's have little if any security when it comes to healthcare. We're all one step away from having our families becoming one of the uninsured with no meaningful access to critical healthcare if
the need arises.
And anyway I feel that the I've got mine, let them (and their kids) get their's is not only short sighted and foolish, but also self-centered and morally bankrupt.
Healthcare Security for ALL!
Sean Cranley (Tue Sep 01 14:04:35 2009)
Emily, the 31% of waste results from the private industry's contribution (extra billing personnel a hospitals and clinics, high CEO and executive salaries and bonuses, broker commissions, shareholder profits, and their lobbying and campaign contributions that are passed on to the patient.) Get that: even you politicians are getting a piece of the action.
Add to the the 20% for fraud and abuse and overuse and tou have your 50%. Eliminating the insurance bureaucracy does not eliminate all of those costs, just about 2/3 of them (20% of the total costs).
So yes, eliminating a useless middleman will save tremendously (though some of the billing costs will remain).
>>> So is that the HOSPITAL'S fault?
No, and I doubt the hospital will be responsible. But infections yes.
And with all of your doomsday scenarios 59% of doctors support a Medicare-for-all system. But that's fine. Let some of them quit. We need plumbers too.
But as well, we should provide free tuition for all doctors, nurses, scientists and engineers providing they finish schooling with high grades.
Can we afford it? We can't afford not to.
And I don't have to fear "getting it." I already have it and I love it. It's called Medicare.
Jack Lohman (Tue Sep 01 16:34:22 2009)
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