Health Care--Alive Again

Let’s break into our discussion of American mythology with a comment on the passage of the Senate’s 2,000 page health care reform bill (which may contain a few myths itself). Pelosi got her five votes (possibly by denying the members any potty breaks).
That she got it at all is the real surprise. Back in December that looked about as likely as snow in July on the capital mall. I would have bet money that it was dead—and I am much too conservative a Hollander to be much of a betting man.
I prognosticated that it was dead. I was so sure. But Obama, Pelosi and the Democrats found as unlikely an ally as Churchill making a pact with the Bolsheviks—the American health insurance companies rode full tilt to the rescue of health care reform.
After spending millions of dollars and spreading amazing amounts of lies, half-truths and obfuscations to sink reform, in the end they pulled a bone headed stunt that brought it back to life. Who passed health care? The insurance companies!
Pelosi and Obama were given a gift that they could not have imagined. The health care industry decided to raise nearly everybody’s rates at the turn of the year. It happened all across America to millions of people—people with health insurance, people who vote.
I can’t speak for all of them—but I can tell you what happened to me. For years retired teachers in Michigan had had Blue Cross/Blue Shield as primary insurance, Medicare as secondary. Part D—pharmaceutical insurance was also covered by the Blues. They covered every drug I’ve ever been prescribed in whatever the form my physician wanted.
It was great insurance, and it wasn’t very expensive. In the fall, I began to read that the Blues were raising their rates. I didn’t think too much about it. On January 2nd, I went to my regular pharmacy to refill some of my normal prescriptions.
Holy Toledo!!! The co-pays had doubled, in some cases tripled. I left them at the counter and went home to make some calls. A couple of drugs were no longer available at any price. Who was this strange new company? (It has taken me weeks and hours to get it all figured out—not just money but time, hours of it!)
It seems that rates had gone so high that the teacher’s union felt the only thing it could do was switch us to another medical plan—Medicare primary; a different, inferior Blues plan secondary. Even though it’s inferior, the new plan still costs more than the old plan did last year.
This also meant I had to go to ALL of my physicians, blood labs, etc. etc. etc. and show them my new cards so they could get my new insurance right and not get rejected when they submitted a claim. I haven’t finished all of that yet.
I opted out of the union’s prescription drug provider and found one myself. The co-pays are less than that other plan but, unlike last year, I cannot get most of my drugs on a three-month, one co-pay basis, The same co-pay three times in a quarter is a significant increase over that co-pay once in a quarter.
All the way around, it costs me more. It costs millions of us more. I’ll lay you odds there are a whole lot of folks out there whose anti-health-care reform bill fervor cooled quite a bit this January. I can just see some of those tea party folks staring with dismay at their new rates and co-pays and suddenly losing steam in their opposition.
The Republicans in the House may call the Senate bill “Armageddon”, but the real Armageddon in health care reform was brought by some mind-bogglingly stupid insurance executives.
I’ll bet when they get alone by themselves even Obama and Pelosi can’t believe just how stupid those people were.
Of course, the additions to the bill still have to go back to the Senate where any Republican can add an amendment. Should Democrats be silly enough to let one pass, the whole business is back up in the air (and back to the House for another long weekend).
Let’s see if the Senate can avoid being as foolish as the health insurance industry. Well finish up War and Myth next time.

No Sanity In Sight For Health Care

Suppose you found yourself at the mercy of two care givers who had power over you. One said you needed water, but would allow you no food. The other said you needed food, but would allow you no water. Eventually you would die.
It seems to me this is precisely the situation that American health care finds itself in right now. The Democrats will give it no food; Republicans will give it no water. Unless somebody resolves something—quite soon, the entire system will die.
The Republicans will give it no “food”—they propose to leave up to 50 million Americans with no medical care at all. (That’s what being uninsured basically means—no health care at all.) As more and more voting Americans get laid off, and lose their insurance, that’s going to become a politically explosive situation. Bernanke at the Fed has just said he expects high unemployment to continue through at least 2012.
It’s also going to drag down the entire system as more and more of the uninsured are forced to become “charity” patients because untreated symptoms turn into catastrophic disease. Emergency rooms and hospitals are forced to treat these for “free”—and then pass the cost on to paying patients and their insurance companies.
Everyone loses as rates and costs keep skyrocketing. “Free” ain’t free in a hospital. That’s why you hear stories about a box of tissues costing twenty bucks—that’s how they bill you or your insurance for all those “free”/charity cases.
Democrats will give the system no “water”. They will push for nothing that will cut the horrendous (and rising) costs of our tottering system. Pile on fifty million more patients into our present system and bankruptcy will come all the faster.
But, the Republicans protest, if we insure the uninsured we will need to ration medical care in order to cut costs. To that the first answer is: show us a more vicious system of rationing than the present one where we RATION by eliminating those without insurance from the system.
There is something absolutely pernicious about refusing to give up steak in order to give a little gruel to a man on the verge of death by starvation. And that IS the attitude of many of the tea party goers who are so afraid someone may tamper with “MY Medicare” they are willing to let millions suffer and thousands die rather than have any limits imposed on themselves.
(That kind of supreme indifference to the well-being of one’s fellow man goes so far beyond the pale of charity as it is enjoined by Christianity, Judaism or Islam that it is absolutely breath-taking. And so much of the indifference is justified in the name of “religion”!)
Democrats and Republicans glare at one another over what seems to be an unbridgeable gulf. Neither will give in. More importantly neither will acknowledge that without action on both fronts—cutting costs AND caring for the uninsured—our present system WILL collapse.
Can it be done? Are “water” and “food” mutually exclusive, like having one’s cake and eating it too? No, not at all. It’s perfectly doable. You do two things. One) you throw all Americans into ONE insurance pool. That’s spreads the risk as equitably as it possibly can be.
That means, two) a single insurer. Just one, for the whole country. Since that will be the only buyer in the entire US for all drugs and medical supplies, it will have a lot of clout when it comes to holding the line on fees and prices. That will cut costs. (Think how many people in hospitals and doctors’ offices currently draw salaries for trying to meet the different requirements of fifty or more different insurance companies, all with different rules!)
Having no more “charity” cases (that all of us with insurance pay for now) will also cut fees and costs enormously. With a “single payer”, costs will be cut, no one will be uninsured and efficiencies will be forced out of our currently grossly inefficient system.
Whatever rationing this might result in will be far less than the rationing we have now. No single payer could be more subject to fraud or more lethargic about guaranteeing the best care for the buck than what we have now.
But Republicans and Democrats go on glaring. That status quo wins again.