Government health care? NOT A health scare
Filed under: Health, Recession Diaries
With roughly three weeks remaining before Congress hopes to pass comprehensive health care reform, certain truths seem impossible to avoid: 1) Our nation's health care system, if it were a patient, would be lying in bed with a broken back. 2) Three weeks is not a lot of time to fix, or begin fixing, something that has been broken for decades. And 3) A lot of people with vested interests in the Way Things Are will likely say some very scary things about health care reform to the American people. (Actually, I can think of few things scarier than VP Joe Biden opening his mouth about any issue, and when he says "Health care is on track," I'm wondering if it's a runaway train about to hit a busload of senior citizens.) Health care reform, we tend to forget, was once a very bipartisan issue. The last president to take a stab at universal health care before Bill Clinton? That would be Richard Nixon--the very, very Republican Richard Nixon. We haven't heard the likes of, say, former Sen. Bill Frist of Tennessee open his mouth on the issue, but you can trust him as far as you can throw him: His family made a fortune in the health care biz under the Way Things Are, and at one point his Hospital Corporation of America (founded with his dad and brother) paid more than $800 million in criminal penalties for Medicare fraud.
Perhaps the biggest piece of fear mongering out there goes like this: "If the government gets in the health insurance business at some point, it's going to screw up my insurance plan at work." Well, I don't know about you, but if the government gets involved, I don't see how it can be any worse than what the insurance companies have done to me and my family already. As a Chicago Tribune reporter, I heard many people at insurance companies acknowledge off the record that the system is designed to make people give up and pay up. What should be routine claims get denied on a technicality, often on purpose. And so you fight and fight until you either just decide to pay the bill, or maybe reach a compromise you shouldn't have had to reach in the first place.
Over the past three years, I have had at least one major fight with my insurers annually. The first two I won, though one of those required me going to a third appeal before the claim was accepted. It involved my then 4-year-old son, who has Sensory Integration Disorder, visiting a neurological pediatrician who was out of network. SID is a condition where kids either have heightened sensitivity to stimuli (like the labels on their clothes) or not enough sensitivity (such as awareness of a full bladder). The doctor was out of network because there were no doctors in network to treat this condition, and we had to see the doctor before the principal of our school had my son suspended for what she saw as unacceptable behavior. (A compassionate soul she was.) There was not time for a pre-approval; my wife and I had to act. The insurance company didn't care, though, and fought us every step of the way before finally honoring claims many months later.
Fast forward to 2009, where I've just received a whopping $1200 bill for visits to an ear, nose and throat specialist over snoring issues. With each visit, and these took place months ago, I paid a $35 copay and was not told there would be any additional charges. When a $260 bill came last month, I paid it without question. But now, it seems, the insurance company is playing footise with deductibles, charges it won't cover on technicalities, the fine print. Good thing I am a reporter and can go back, read up, and fight back. But what about all those people not as skilled as I am?
Yes, yes, yes: I cannot foresee government health care that runs smooth as a top. There will be incompetencies and bungling as sure as the clerk at the Post Office puts up the "NEXT WINDOW PLEASE" sign the moment you get to the front of the endless line. But leaving things alone can't work as an option, and having a U.S. president who lives in the city--much closer geographically to the poor than those who hail from country club suburbs--gives me reason to be encouraged. Health care reform can work, if the same scrutiny and accountability is applied to it that President Obama has demanded of the agencies spending federal stimulus money.
He, and all of us, must be patient. No matter how visionary the bill that emerges from Congress this summer, if at all, health care reform will be a work in progress, requiring tuning and tweaking for years to come. Broken backs, after all, do not heal overnight.
Yet the future surely lies in our sights: A vision of it appears in this excellent Huffington Post piece. In it, author Katherine Zaleski recounts a scenario that might give any of us the chills: getting sick in a foreign land. She was in England, and suffered a crippling migraine headache. To her surprise, navigating their national health care system proved easier than anything she could have imagined.
She writes: "It was amazing. I filled out paperwork with my New York address, waited five minutes, met with the doctor, got a prescription, walked downstairs to the pharmacy under the clinic and was back at my godmother's house an hour later. Believe it or not, I didn't have to pay a cent for the visit. I did, however, pay a 'private' prescription price for the medication that added up to about $30 dollars."
Let's hope that once the Health Care Express reaches the station, all our doc stops thereafter will be as easy and worry-free.
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20 Healthiest States for 2009
How healthy is your state? That's what publisher CQ Press reveals in its 17th annual list. Twenty-one factors from infant mortality to obesity to cancer rates are compiled for the rankings.
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Reader Comments (Page 1 of 1)
7-10-2009 @ 2:33PM
sarah gilbert said...
Lou, I couldn't agree more heartily. I have two boys with sensitivity integration issues. my oldest had a principal like the one you mention. money phrase (oh for the record, this is a 45-pound five-year-old boy): 'I will NOT allow my staff to be ASSAULTED!'
we owe $1500 for a pediatric nurse practitioner who didn't have a doctor's office to bill from; $300 for a hearing test United Healthcare said was "behavorial health" and not covered under them (now hearing is a behavior?) and plenty more examples of dumb rejections.
if you or a loved one has substance abuse issues, it turns out that you have to fail outpatient rehab not once, not twice, but three times before they'll allow you to go into a residential treatment program -- even for a week. so you have to do untold damage to your family before you can qualify for real help. and often, even after the third time, they still won't pay for it. but according to the plan details, you have up to 45 days of inpatient substance abuse treatment. ha.
now we have tricare, through the army. yes it's government run. and do you know what? I haven't had a single problem. I pay far less out of pocket than I did through private insurers and I haven't had a single claim rejected, EVER.
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7-10-2009 @ 4:03PM
Tom Barlow said...
My wife spent 11 days in a hospital in London. Our bill; $1,000, which our insurance paid. The attention she received was better than what we've experienced here.
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7-10-2009 @ 4:50PM
Julie Tilsner said...
Ten years ago or so, my then 13-month-old daughter got very ill while on a visit to England to see her grandparents. Like the example you give above, the experience was quick and painless. After waiting about 5 minutes in a modest but clean waiting room, we were ushered in to see the doctor, who examined my daughter, and then talked to us for more than an hour about what could be wrong, etc. etc. The charge? Nada. And my mother-in-law kept apologizing for the long wait and dowdy environs. I told her that in the States, not only would we not be able to see a doctor for weeks, but without insurance, we'd be charged $600 or $700 for a five minute chat with the doctor.
Obama is right. Not doing anything is no longer an option. I don't understand why we can't have universal health care AND a private insurance option for those WHO CAN AFFORD IT (like politicians, or financiers, for example) to supplement. The rest of us want to be able to have a checkup or get our kids' broken arm mended without going bankrupt.
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7-11-2009 @ 9:52AM
Raquelmed25 said...
my husband got sick ..3 day in the hospital ..the bill was 15,000.00 my husband still refuse to pay he says. they did not fix the problem for 15,000.00 lol .He was not cured...
and we owe ..it also shows on our credit report ..which Sucks ...
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7-13-2009 @ 11:38AM
b said...
Anyone who would love the state to take complete control over their lives feel free to support health care reform. This is where it all leads.
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8-06-2009 @ 11:45AM
Michaelsviews said...
Regarding this government healthcare, the situation / story changes over and over. Myself being a veteran and getting treatment at the local VA is outstanding and I have NO complaints. As for the family I have the local BCBS and having a wife that went through Non Hodgkin s Lymphoma was treated and cared for very well.
Too me if all of these politicians would go through what others went through for healthcare you'd see a true Reform, but this is all going to be about what Obama wants and the lobbyists and crooked ones.
In the end , from what has been said in any form of the media I have a serious problem with what there throwing against the wall.
You are going to have horror stories from all corners of America. The systems broke and needs two boots in the ass to fix it. However lets not get carried away in the mean time.
There was a movie with Jim Carey where his son wished that Jim could not lie, what if that wish came true for every elected official in office both past and present?
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9-06-2009 @ 5:28PM
coastx said...
Submitted on 2009/09/06 at 2:05pm
Bilderberg and Comprehensive Health Care Reform
Legislation of comprehensive health care reform with the so desperately coveted public option is a coupe de grace to an otherwise standing and yet enduring constitutional government facing an immensely saddening closure to free world politics. (AP, 6 September 2009)
Euthanasia – Reduction in Medicare will place services at the will of the IRS who will moderate all claims, and due process and tort will be eliminated. People will be exterminated in de facto circumstances arising from this legislation. Health care reform is a contract that will circumvent the constitution.
$1 Trillion Over Next 10 years – This cost will paid for through comprehensive taxation, money redirected directly to a world bank that will be under the control of the Bilderberg Group. This political financial entity has set itself up as a shadow government and has the ambition of controlling all governments through contracts and legal obligations that are enforceable through the Trilateral Commission, it’s control over a national private military force, and through detention and extermination of first and third world citizens who come under scrutiny of PNAC.
Veto – Obama will veto health care reform bill if it does not contain a public health care option, for obvious reasons. The Bilderberg group needs this legislation to initiate it’s overthrow campaign for the simple reason that this was to provide the financial base for launching a final blow to US economic stability and government as we know it today.
Comprehensive health care reform will successfully circumvent first, second, tenth and fourteenth amendments of the constitution, setting up a despotic government financed by the Bilderberg Group and enforced by the Trilateral commission and it’s despot leader of the new world order. We have to look forward to dealing with such despotic politicians as Hillary Clinton and Al Gore, people whose political careers will be rightfully ruined after this overthrow scenario breaks. Remember, both Clinton and Obama do not like media attention, for a reason. To this end, both arranged to have the media sequestered on an aircraft in preparation for take off while they met at a remote location with Bilderberg icons to discuss federal affairs, which is treasonous.
What Obama is telling us about all or nothing is true. The Bilderberg Group is poised to attempt to destroy America from abroad if he fails to produce their legislation agenda on health care reform, which means we need to arm up in preparation for a war with other countries on our own soil. Also, Sotomayor is as delusional as Obama.
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