Yet another blog for spewing. This one may end up with a lot of religious and social content.

2009-06-11

Single Payer Health Care

Go and read this article: This is what losing your kidneys looks like. I'll wait.

There has got to be an end to the stratification of health care in this country. Why are we willing to have people's very lives dictated by private insurers? Why are we willing to allocated medical care based on who has the most money, the best employer, or a spouse with a good insurance plan? Why are we willing to say to people trying to start businesses, "You must sacrifice your health, and that of anyone you employ, to succeed" because health insurance is too expensive for a bootstrap company?

Before the 1970s, health insurance was based on a mutual, or cooperative, basis. Profit was not permitted. It sorta worked. Once the profit motive came in, prices went up, oligopolies formed, denials increased, exclusions soared, and refusals to insure became so prevalent that it isn't even funny.

If you've ever had acne, asthma, depression, diabetes, cancer, or any of a huge list of ailments you can not get insurance for anything even remotely resembling a reasonable price, if at all. No one will write you a policy that doesn't exclude what you need it for the most!

The "insurance" model itself is faulty. Insurance is supposed to be a hedge against risk. Thing is, nearly everyone gets sick or injured at some point during their lives. The only variables are when, with what, and how often.

What is needed is health assurance - a pool of money that everyone pays into that covers their medical expenses, no "if's, "and"s, "but"s or exclusions. Whether a person gets a boil on their ass, or cancer of the colon, it should just be covered. The best way to do this is with a federal (large pool) single payer health care system.

I am very, very tired of seeing PayPal donation buttons for self employed friends, artists and musicians trying to pay for uninsured medical expenses. The risk nowadays to life and limb from working for yourself due to insurance conglomerate perfidy is unreal.

Please, Congress, for once do the right thing: Single Payer. No triggers (conditions are already met), no mandates (requiring people by law to "buy" private "for profit" health insurance), no half-assed "public option" plans that are designed to fail.

Corporations do not have a "right" to profit from people's misery, stress, pain and death. We the people do have a right to "Life, Liberty, and Pursuit of Happiness", and it's pretty hard to have any of those when you're dying from lack of money to pay doctors.

5 comments:

weofodthignen said...

Yes. No need even to how it used to be--things have changed, and it's become blindingly obvious that the aberrent way healthcare is provided in the US is wasteful, stupid, and costs lives.

The original premise of the HMOs was that they would save money by paying for preventive care. That didn't last long! Free preventive care would save a bundle--and there is no way to fit prevention into an "insurance" model.

I can't believe employers aren't up in arms not just about the ruinous costs of "health benefits" but about all the employees they pay for healthcare for who still come to work sick because the insurance won't pay for meds that work for them, or they can't afford the co-pay to see the doctor, or they couldn't get the flu shot because someone decided they were too young, or who actually die early for want of adequate medical care. They must also have an inkling that if they do provide relatively good medical insurance, they will have employees who don't like their jobs staying on because they can't afford to lose the insurance.

It's not just small businesses, start-ups, the self-employed, and the artistic. It's not just people with complex and expensive conditions that some might like to sniff at. It's the entire working poor.

But the system is riddled with profit motive and profit skimming all the way. Every year more dedicated and well trained doctors retire to be replaced by newbies whose training was underwritten by drug companies, who have massive student loans to pay off and took classes on the business side of medicine and didn't have time for classes on relating to patients or doing a physical exam rather than ordering tests, and who have no idea how much the new drugs cost when you actually have to pay for them on a normal salary. Every year it becomes harder to even find a doctor, especially if you don't have insurance, or if it's a less than favored kind . . . let alone Medicaid. Drugs cost way too much (the cost of US drugs is a strain on the Canadian system!), and the drug companies stop manufacturing good old drugs rather than let them become eligible for generic manufacture. They pour money into patient advertising that causes people to badger their doctors for the latest name drug. Hospitals mark things up unconscionably, and if they aren't making enough profit, buy each other up or simply close.

And of course the fantastic and climbing costs of healthcare make everybody a critic of their neighbor's body and lifestyle.

Not just single payer, but a new ethos is needed. It would help greatly--and is very much necessary--to get the insurance companies entirely out of healthcare. And it can probably be done at this point, with the public incensed at executives' salaries and immorality in the financial sector, which is insurance's incestuous sibling, and with most Americans saying on polls that they would pay more taxes for government-funded healthcare. But it will also take a concerted effort to change attitudes from "Companies have a right to make whatever profits they can" to "People have a right to get the healthcare they need to do their jobs."

M

jemyl said...

As you know, I have Medicare and special low income help with my Medicare part D which effectively eliminates the onerous donut hole that hits almost all Medicare part D participants with full cost medicines because they have conditions which require either a great number of medicines or expensive medicines. Many of them just stop getting their meds at that point until the next year unless they are lucky enough to be able to get some samples from their doctors for the most essential prescriptions. Even with the about $124 I pay the government each month for Medicare A & B and Medicare part D, I still have to have a supplement which costs about $212 a month to include the needed crossover so that I don't have to put out for some of my part B medicines and wait for Medicare to send my E.O.B. so that I may be able to get my money back from my supplement insurance company. Oh, and they don't cover anything that Medicare doesn't cover. That leaves me at the mercy of some bureaucrat who decides if and when each procedure is necessary and if and how much Medicare will pay. One quick example: I needed daily flushes of saline and shots of heparin when I had a pic line for vancomycin IV administration for about 30 days and then to keep my blood thin enough as part of the treatment for a blood clot in my lung after knee replacement surgery and the pic line placement. Medicare will not pay for syringes, and I was prescribed 100 total prefilled sterile syringes to use to keep the pic line clear and then to keep my blood thin until it was time for me to be on coumadin for six months. Medicare didn't cover that expense, so neither did my supplement. Recently I was prescribed a B-12 shot regimen. Because I am a type II diabetic and have humalog pens to use for sliding scale shots in case of an error in soda, tea or unexpected overload of sugars/carbohydrates in a meal, my doctor decided that I should do the regimen at home. I just got the "extra" crossover and additional partner benefits package so I could do this for $8.52 this month instead of the $15.65 it would have been.

What I fear with single payor, is that it will be like Medicare with limits put on based on averages with no allowance for individual differences. If there is not the expectation of anough improvement, Medicare can deny coverage --- and they do. My 51 year old step-daughter is on dialysis three times a week. She is not deemed healthy enough for a kidney transplant so she is now disabled, finally got her social security disability after a year of legal hassles, is on medicare or medicaid so has little say in her medical treatment. That is my fear with single payor. I don't like the profit motive, but I fear not having the option to choose other than the government for at least part of the coverage for everyone will lead to a system like that in Canada where people are now dieing because they cannot get through the backlog to get their surgery approved and scheduled. Those who can afford to pay without insurance come to the U.S.A. to get their procedures, diagnostic tests and surgeries when the wait is too long in Canada. How will single payor prevent that from happening here? I am all for everyone being covered and for the elimination of the pre-existing clauses. Those clauses mean lots of people I know don't get care for a problem for up to a year so that they can qualify for insurance coverage without a pre-existing condition exclusion for one or more of their problems --- arthritis, high blood pressure, a bad knee or back, even diabetes in one case I know. Do you know that with Medicare, one has to sign up within a limited time and also get a supplement within a limited time to avoid just such pre-existing condition limitation clauses? How will single payor change this? It concerns me is all.

jemyl41 said...

Additionally, We need to find a way to take greed out of the health insurance equation at all levels. This involves tort reform as well as health insurance reform so that patients and their families are more concerned with getting good care than with figuring they can always get rich if the docs screw up. I know. I got scrawed. I don't want to sue, just for that doc to be a better attending in the future and for the residents and nurses to learn to listen to their patients. I know -- Fat Chance, and I will try the other hospital system this time. Love you, Ravan, and admire that you fight for what you believe to be right. I am still open minded about this one. I am not sure that it will make it so that I won't still be looking at losing my electricity as I am this month because I had to pay for meds and drive to Gainesville for a doctor's appointment and to get another MRI and Xray in order to have any chance of getting my back fixed to maybe be able to live with the pain. Even with Medicare, the costs of just getting my monthly meds and going to the doc, not counting my supplement which may have to be on grace period again for a couple of months. I have the choice of pay the mortgage or the health insurance or the electric bill and I have to do the mortgage this time as I am having to run late on it because these two are my med refill months and I have to replace some of the food I lost --- almost two months worth when the freezer got left ajar. Also without my chore and housekeeping help, I have to find a lawnmower to get, or repair one or pay someone to cut the grass and that outside. I have to make something pay online and soon as there is not money for jewelry in Putnam County and I cannot afford the gas to go elsewhere to sell, a real damned if I do or don't. Pray to all gods and God for me please Ravan and Data Pard et all too. Find buyers for my jewelry? jemyl.net/Jewelry to see it online.Shameless begging plug and I'm getting desperate. Peace and Love to you and yours. I've got everything crossed and pray daily for my children to find good jobs too.--- Mom

Ravan Asteris said...

but I fear not having the option to choose other than the government for at least part of the coverage for everyone will lead to a system like that in Canada where people are now dieing because they cannot get through the backlog to get their surgery approved and scheduled.

This is right wing talking points that have been debunked. What is delayed in Canada is *elective* surgery, like tummy tucks, face lifts and gastric bypasses for weight loss. They found that the poster child for the right wing had actually come here for a "second opinion" because she was impatient, not because her life was endangered.

All you need to know about this story is that "the Center for Medicine in the Public Interest" has created "BigGovHealth.org", and its biggest contributors were drug maker Pfizer and the Pharmaceutical Research and Manufacturers of America. Big Pharma and the Health Insurance lobby are spreading cherry-picked horror stories in order to block any change. If you like paying more than anyone else in the industrial world for poor results, than keep things the way they are and let your decisions be made by industry lobbyists. Me? I'd rather learn from other countries mistakes and try to put together a system that works. The proposed legislation is still like paying the fox to guard the henhouse, and letting him earn bonuses for only letting a few chickens get killed.

No system is perfect, but there are far, far fewer horror stories per thousand people in Canada than here. In both single payer and for-profit insurance, bureaucrats decides coverage. But government bureaucracies can be regulated, transparent, and be required to have actual doctors on them!

Ravan Asteris said...

Oh, the poster child for the Canadian horror stories that the right wing waves in our faces? Is a liar or a tool: Shona Holmes and Canadian Health Care and Shona Holmes: Useful Idiot or Puppetmaster.