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Tuesday, September 11, 2012

This is the Way the World Ends (apologies to T.S. Eliot)


Days are getting shorter. Nights in the high country are crisp. Fall has always been my favorite season for just about everything—except politics. Even though I’m relatively shielded since I don’t subscribe to any sort of television provider, I can’t escape the political advertisements on the Internet or in my e-mail in basket.
Yesterday, the Democrats were crowing that they’d “outraised” the GOP in August, but, “keep those contributions coming, folks.” Geez, reminds me of Billy Graham and all the televangelists who suggest you can buy your way into a spot in heaven. Frankly, the whole thing makes me sick. It is such an egregious waste of money. If America’s two political parties took the billions they’re squandering on political advertisements, it would go a long ways towards reducing the Federal deficit. No one but me seems to see it that way, though.

Those are also funds that could go to help provide healthcare for everybody, not just the fortunate few who can afford private coverage or who work for an employer who provides healthcare as a benefit. A few days ago, a friend of mine posted on FB that her monthly insurance premiums went up $96, effectively making her insurance unaffordable. This is a woman who needs to have insurance. She’s a cancer survivor.

The thing politicians don’t seem to get is that when health insurance costs so much it becomes a choice between basics like rent and food or insurance, people will drop their insurance. Then they quit going to the doctor for any sort of preventative services and end up in Emergency Rooms—our most costly form of intervention—when something goes wrong. There’s a domino effect because this simply jacks up the cost of care for the rest of us who end up subsidizing those without insurance through our own insurance plans.

Let me make that a bit clearer. A hospital or medical office eats a certain amount of loss from non-paying customers. They pass those losses on to third-party payor insurers who then charge their subscribers more. And so it becomes a vicious circle. The reason my friend’s premium went up so much has nothing to do with her and everything to do with the burgeoning numbers of people who can’t pay their medical bills and can’t afford insurance.

The United States spends twice as much per capita on healthcare as any other industrialized nation. And we have much poorer outcomes on every measured indicator. I won’t go into the annualized double digit profits in the insurance and pharmaceutical industries, but needless to say, they both have strong lobbies and will fight to the death to protect their turf. After all, it’s the American way.

My sister-in-law, who has chronic obstructive pulmonary disease from years of smoking, called last night. We were joking around (black humor) that the pharmaceutical companies don’t want anyone to get well. Nope. They don’t want you dead, of course, because then you’d stop buying their products. But they want you sick enough to continue feeding funds into their bloated coffers.

I’ve heard lots of complaints about Obamacare. And there are many parts about it I don’t like either. But mostly, I don’t think it goes far enough. It’s criminal that the United States doesn’t have some sort of basic universal healthcare for everyone. And tort reform so MDs don’t have to pay outrageous malpractice premiums. Lawsuits force MDs to practice "defensive" medicine. This, too, inflates the cost of care. A cardiologist friend told me he orders many tests he thinks are unnecessary, but he's trying to cover himself for that 1% chance he might be wrong.  

Next time you look at a medical bill and feel cheated, remember it’s not the MD who’s making most of that money. He (or she) is just the front guy. After all, they’re mostly employees these days. It’s the large medical corporations with their expensive infrastructures, the pharmaceutical companies and the insurance companies that are soaking up most of your healthcare dollars.

Have any medical horror stories you’d care to share? I’d love to hear them. Or political rants if you're in the mood.

4 comments:

  1. Good post, Ann. Although I don't see the human healthcare side of things as much as I do the veterinary side, I'm very fortunate that I have insurance. I was able to have my ankle surgeries and the out-of-pocket cost was a fraction of the total. But I know several people - my husband in particular right now - who are putting off doctor's visits because they either don't have insurance or (in his case) are reluctant to pay an out-of-network deductible.

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    1. Thanks, Clare. I've always had good insurance too. The kind they can't boot you off of. But two of my adult kids pay privately and both complain that it costs an arm and a leg and reimburses for nothing. One just transitioned to a catastrophic care policy with a $5K deductible. She said since she has to pay for everything now anyway, she won't notice any difference other than that her $560/month premiums will be cut in half.
      And don't even get me started on the in-network issue. If there's a provider you need to see, I think you should be able to see them for the same cost as any other provider in that same subspecialty. This is particularly true in the mental health field where having a trusting therapeutic alliance between patient and provider is critical to achieving good outcomes.

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  2. Part of the reason I moved to Canada was because of my MS. I'm lucky enough to have a Canadian husband.

    Even ON a work insurance plan (a really crappy one), we were paying $1000 a MONTH for my injectable drugs. I had to get on the pharmaceutical company's charity plan for only a small deductible. That was more than our rent, which was around $850. At least Obamacare took care of the pre-existing condition song and dance. But that could change every time there's a change in administration. We weren't willing to take that chance.

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    1. I can't even begin to describe how hideous it is trying to get decent medical care here. The pharmaceutical companies have managed to brainwash the prescribers with all their "gold standard" double-blind placebo-controlled studies. Funny thing, though, a whole bunch of new "wonder" drugs get pulled off the market once they've been prescribed to millions of people. Seems those gold standard studies don't control for lethal side effects. Doesn't matter, Big Pharma laughs all the way to the bank. The meds for osteoporosis are a prime example. Turns out they cause necrosis in throat tissue and, big surprise, cancer. But they're still being prescribed.
      I could go on and on. I taught at a Family Medicine Residency program for a long time. We didn't have so much as a kleenex box that wasn't emblazoned with a drug company logo.
      It's wonderful you *could* move to Canada. Most of us don't have that opportunity.

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