Tuesday, August 18, 2009

just not understanding

I'm used to being out of step with mainstream America, and often I can see merit in both sides of an issue. However, I'm just flabbergasted by the vehemence and venom being spouted off in the current health reform debate.

Riddle me this: why are public schools good (no one bitches about "socialized education") but public doctors are evil tools of Satan who will bring us all down to hell?

Lots of people scream that they can't trust the government with their healthcare. So we can trust our employers instead? Also, don't we trust the government with our drinking water, roads, police, fire departments, libraries, prisons, etc.., etc...? Why is it okay to entrust those things to the government but not health insurance?

I am lucky to have crappy health insurance through my husband. Crappy health insurance is better than no health insurance at all, which is what I would have on my own (we have applied for private health insurance, and a health insurance broker could not find a single company willing to insure me. I have many friends who have had the same experience).

However, even though I feel lucky to be insured at all, I still wrestle with the occasional desire to burn down my insurance company's headquarters. My crappy health insurance recently sent me a letter asking me to change my antidepressant to a generic one. Going off antidepressants is a bad idea for a person who has struggled with depression since age 13, but switching to a generic sounded okay to me. So I discussed it with my psychiatrist, who told me that there was no true generic alternative for my medication and that the medication my insurer wants me to go on is less effective and has more side effects (he explained this on a biochemical level which went over my head a bit), but yes, the other medicine costs sixty cents a pill, whereas my old medication costs three dollars a pill. He wrote me a prescription to try the crappier, cheaper meds, and I took that to my pharmacy, only to be informed that my insurance company, who wrote to me and asked me to switch to this inferior product, was charging me a $153.00 copay. How on earth did my share of a prescription which should cost $18 for a month's worth end up being $153?

Another cute thing my insurance company did lately was to refuse to pay a cent for my mammogram. My doctor nagged me for years to get one, and I finally gave in (she whipped the test requisition form at me quite firmly), and then it turns out that I must pay quite handsomely for the privilege of having had the mammogram. According to my insurance company, mammograms are whimsical, unnecessary things unless you already have a lump. Since I didn't have a lump, I had to pay every penny of my mammogram's mighty, mighty bill. I was under the impression that mammograms served an important preventive function in society and that they were supposed to find the tiny lumps before they grew large enough that you could feel them, but that must just be me. Silly me.

I posted a note on my Facebook status about my $153 copay, and that made old friends of mine from high school froth at the mouth. Within minutes people were screaming that I should just pay my fair share and that anyone who wants socialized medicine is an idiot who is threatening our American way of life, only morons think there's anything wrong with our current system, etc.., etc..

It is mindboggling how in America we pay more per capita than any other country for health insurance yet overall get less health care and are less healthy, but yet so many people defend it so rigorously. It's also mindboggling how many of those vehement anti-socialized medicine people are on Medicare themselves, which IS socialized medicine.

My friend Epiphany (an occasional commenter here) shared with me a brilliant article which sums up the health care reform situation in remarkably few, well-chosen words: Here Are Our Healthcare Choices. Another must read comes from Dr. Atul Gawande, who traveled to the city in the U.S. which spends the very most on health care and wrote about it for the New Yorker. President Obama asked everyone in his administration to read Dr. Gawande's article, and the Sober Husband nagged me to read it for weeks. When I did read it, finishing it up in the waiting room of the pediatric dentist, I found it highly edifying, and I passed it along on the spot to the children's dentist, who, as it turns out, has strong feelings about getting healthcare for all. Read it for yourselves online.


Helen said...

Hear. Hear.

J9 said...

I had a similar issue on fb just last night. I finally unfriended the right winger, but then he sent me a post to my inbox slamming me again. I'm not even sure if it warrants a response.

Anonymous said...

This is such a good post. I never thought about it that way before. You've won me over.

Melodie said...

I'm Canadian and I think your president is absolutely on the right track. We consider our health care system a national treasure. I'm very happy the US is headed in the same direction. I hope it happens for you. Those health insurance company stories are freakin' awful!

Freewheel said...

We're the only first world country that doesn't have universal health care. We're also the only place in the world where people would show up toting guns to demonstrate their opposition to universal health care.

Virago said...

I read the comments on that article. So you don't have to -- they're that bad.

Lots of ranting about a) how people with pre-existing conditions are trying to game the system with their moochy demands for health coverage and b) how most illnesses are the result of poor lifestyle choices, so people who are sick don't really deserve coverage anyway.

Yeah, I know I brought on my own diagnosis of depression -- by being born into a family with depression on both sides. If I were smarter, I'd have picked different parents!

I also have epilepsy, of which there is no history anywhere in my family. But I'm sure that one of the geniuses who opposes the public option can tell me how my love of Edy's lime bars/anchovy pizza/Reese's Peanut Butter Cups was a contributing factor in my seizure disorder diagnosis.

Please. Why can't the debate over health care reform draw on the facts, not misguided "pull yourself up by the bootstraps" rhetoric?

the Drunken Housewife said...

I also suspect Christianity, of the American born-again sort, comes into play here. Once when I had meningitis, my father said to me, "Obviously you have no faith, or you would have been healed by now." If you have cancer or meningitis or any other serious illness, it's because you are a bad, faithless person, and it would be wrong of people to try to help you out because the Lord wants you to suffer for your faithlessness. There's very little charity in today's Christianity.

Anonymous said...

I believe in a little social medicine, and also believe alot in capitalism. At the end of the day the insurance company has to make money. If they don't have a profit then they can't pay for the next guy down the road. It's quite simple if your insurance company pays for your medication, you have to pay more for the insurance company to insure a profit. Or I have to pay more to help them pay for you. I know that makes me sound like a cold hearted b*tch, but really that's how it is. I pay out of pocket for my meds. I luckily can make it on generic ritalin for $40 every 2 months. I wouldn't dream of switching to another med, it's how I know I stopped at the red lights while driving. I've heard from other people on AD's that generic wasn't the way to go for the exact reasons that you said. If I were you I would get my old RX, and then find the insurance contracts and read thru them like crazy. If you find where they should pay, take your documentation to your state insurance commisioner. They wouldn't be the 1st health insurance company sued by a state.

Medical bills are the #1 cause of bankruptcy in the country. That women that is praying at the playground, she's not a fundamentalist christian. She's praying that her kids don't get hurt and require medical care. I believe that it's time for bankruptcy to go back to its roots-to the idiots that run up to much debt, not the cancer patient with $4 million in debt that the right to life, right wingers say your going to hell if you pull the plug on treatment.

NonymousGoatsePants said...

I had posted the video of Barney Frank (God Bless the Queen!) calling some poor demented woman a dining room table on my Facebook page. One of my friends posted that he thought that Repubs and Dems were just arguing over health care just to "defeat the other". I didn't agree. My wife is an NP, so I'm pretty aware of how medical billing works. My response to him:

My wife has to call and get pre-approvals for all of her private insurance tests for her patients. Then they're routinely denied by the insurance company death panels. When her boss calls up the insurance company, he speaks to a gastro-enterologist. Why is a gut doctor making life and death decisions -- no, coverage DENIALS, about oncology? Why? Because he gets paid based on the dollar amount of his successful claim denials. Those are your death panels. That's what's gonna kill grandma one day.

The best thing we could do for this country is to get rid of health insurance companies. The idea of all of us banding together to pay for the catastrophic illness of someone in the group has been perverted to become us banding together to make the most money for the insurance company.

That's the ideal that the republican party is fighting for. The Dems, not so much.

Missy said...

With all due respects, your issues are with the benefits of your husband's company. The solution for health care does not necessarily lie in making it a government provided benefit (does the government pay for your home or auto insurance?) but it lies in from freeing it from government restrictions.

As it is, the government restricts small businesses from banding together in a co-op to provide health insurance for their employees. It also provides tax breaks for companies, but not individuals, who buy their own health insurance.

I have been covered for mammograms for the past decade (and I'm 47 now.) Clearly, your husband's company bought a package in where this was not covered to lower their own costs. When my husband worked for a small start up tech company, the vaccination costs for our children were not covered. There were other costs that clearly reflected the company's focus on younger, childless employees.

I understand your frustrations with the cost of the depression medicine. We have been through that in many cases. You can protest your company's decision which is not something you will be able to do with government mandated healthcare.

Finally, I would say that not all Christians even of the born again sort believe that faith plays a role in healing. The section of Christianity that believes in that is the Pentecostal or Spririt Filled branch; I would guess it is less than 25% of practicing Christians. As well, since not all Pentecostals believe in the Trinity, they are not all recognized by the World Council of Churches as practicing Christians.

There might be just as many "liberal" people who believe if you smoke or don't exercise or have other habits you don't deserve the health care/

DH, I'm sorry that your father was such a lousy dad and so ignorant.

Virago said...


Have you had a chance to look at the article that DH linked to yet? I'd be interested to hear your thoughts.

Hanna said...

"Crappy health insurance is better than no health insurance at all"

On the surface, I agree. But then I wonder if we wouldn't all be better off if *no one* had health insurance at all(for non-catastropic events). Is it possible that health-care costs are not affordable for most because the industry is not actually market-driven? Insurance companies drive up the cost of care and limit the opportunity for individuals to negotiate prices. The current system is surely not a capitalist model, and I think people overlook that when discussing this issue.

hokgardner said...

Man are you preaching to the choir here. I've been reduced to panic attacks over the past 10 months as a result of letters from my insurance company denying some parts of my daughter's NICU bill not others. We're still arguing with the insuance company over what they will and will not cover, and we're still paying for the things they've denied. We pay more than 900 a month in premiums, and so far, we've paid close to 10,000 out of pocket for pre-natal, NICU and doctors. Something HAS got to change.

Anonymous said...

I'll start by saying that I totally believe we need health care reform. But I'll also say that we should be cautious.

I lived in England for 4 years (I'm an American) and the health care there (the NHS) is truly terrible. It takes ages to get an appointment with a specialist (I had to wait 9 months to see the dermatologist's nurse, just so she could look me over and let me wait another 10 months to see the actual dermatologist. No kidding.). The doctors are not trained as well as in the US and the hospitals are atrocious (my flatmate for 3 years with a junior doctor so I was around doctors a lot). And the NHS has been having serious, serious problems for years. There is simply not enough money for the system. Truly, it sucks except for the fact that when you actually get care it doesn't cost anything, or very little (for drugs).

All the expats I knew agreed that if they had anything moderately wrong they would go out of the country for health care.

We need reform but we should also be realistic about how nationalized health care has worked elsewhere in the world. We don't want to make the same mistakes.

Missy said...

Actually, a lot of people are incensed with public education. It's one of the better examples of why more government, even when well-intentioned, doesn't work well. (although FEMA would definitely be in the lead in terms of efficiency, let alone cost.)

I get paid as a public school teacher based on my years of experience. This means that there is no incentive for me to excel other than personal drive--and no disincentive for my coworkers. It is enormously frustrating to be locked into this kind of system. I am fortunate that my husband earns enough that I can afford the luxury of indulging my love for teaching and his salary compensates somewhat for that. The government on both state and federal level mandate spending in the local school districts. This top-heavy approach is very Soviet style inefficient. Perhaps your local school would benefit more from having a music teacher or a decent playground? Too bad. The funds can be spent ONLY on at risk students or ESL student materials. Maybe the ESL students are doing just swell and would really benefit from a decent playground for recess, but they won't get that. The people farthest away from the school have mandated what is best for those children.

We don't trust teachers as profesionals now, and President Obamna displays the same lack of trust for professionals when he talks about doctors ordering tonsillectomies based on compensation (which was a falsehood; pediatricians do not remove tonsils) or performing amputations for diabetic patients.

It is bad enough that we have heavy-handed government bureaucrats overseeing education; we don't need the same mind set overseeing health care.

We shouldn't have to rely on either our government OR our jobs to provide health insurance. Do you buy your car insurance or home insurance through your state or through your job? Of course not.

As it stands, companies get tax credits for health insurance, not individuals. That's wrong.

As well, a huge cost of health care today is malpractice insurance. Doctors order needless tests and pay huge costs for insurance. We need better regulation of poor doctors and less over the top court decisions. We are all already paying for both.

It is a basic principle of macroeconomics that the government is less efficient than a free market (which we don't have now.)

patty said...

Alone in a very red county, drowning in my shiraz, you are a breath of fresh air. Thank you drunken housewife :)