Friday, September 4, 2009

The Healthcare Quandary

I am as conflicted and confused as ever over the healthcare issue.

I have been reading just about everything I can get my hands on, including some great thoughts from my fellow bloggers, to try to be as informed as possible. I have asked the opinions of people I respect. I have talked to doctors.

I have listened to conservatives tell me how this is the beginning of socialized medicine; how, if the “public option” happens, the private insurers will be driven out of business and the government will become bigger and bigger; and how we will eventually have to wait weeks/months/years to obtain medical treatment we might need. I have also been told the proposed healthcare legislation has provisions that encourage euthanasia for older patients (this is not true).

Those more to the left allow as to how we are the only industrialized nation that does not assure healthcare for its citizens; how we have allowed the insurance companies to take over and run healthcare and, in so doing, cut out a major portion of the population via their various denials of coverage (Nancy Pelosi has called the insurance companies “villains”); and how upwards of 45 million are uninsured, which is unacceptable.

I have read authentic stories of patients in Canada and the UK who have, in fact, died while waiting for some procedure due to the government red tape involved. There are also accounts of patients from other countries, who in fact have some form of government insurance, coming to the U.S. to get treatment and paying from their own pockets due to the superiority of care in this country.

I have also read heart-wrenching accounts of hard working middle class Americans going bankrupt because of a catastrophic illness; a father whose Down Syndrome daughter was denied coverage because of her “pre-existing condition” when he changed from one insurance provider to another; and, maybe the most preposterous of all, a happily married couple who, upon recommendation of a hospital social worker, divorced so the husband, who contracted early-onset dementia and could no longer work, could qualify for Medicaid by not having to count his wife’s income.

It is enough to make one scream. And, after all this reading and studying, I am really not any closer to having a firm opinion. Here, however, are my thoughts today:

-- I think the Obama administration, though perhaps well intentioned, has done a horrible job of presenting the healthcare package to the American people. Although regular readers here know that I respect the man a great deal, sometimes I watch and listen to the president speak on this matter and think that he really doesn’t get it. He comes across as arrogant and impatient. I feel like he’s telling me to just get on board and let him work out the details. And that’s not Democracy, folks.

-- President Obama went on a popular national radio show recently to tout healthcare reform. There were callers to whom he spoke. To one of them he said, emphatically, “I guarantee you we will pass healthcare reform.” Really?! Seems a former president and his wife tried to make the same guarantee back in the early 1990s and look where it got them.

-- I am tired of people crying “socialized medicine.” Socialized medicine means the government essentially owns all the hospitals, and the doctors work for the government. A “single payer” system means the pay to the healthcare providers is funneled through the government but the providers are all still independent. They are not the same thing. As I see it, socialized medicine is not even on the table. A single payer plan, of sorts, would happen via the public option, but we would still not have a complete single payer system because private insurers would still exist. This is NOT socialized medicine. Maybe it's coming, but this is not it.

-- Along those lines, Medicare, enacted by the Johnson administration in the early 1960s, is an example of a single payer plan. Seniors who are on Medicare have their bills submitted directly to a government entity that pays them. I am sure it has its flaws but there are many elderly people who are very protective of it and, understandably, don’t want to lose it -- a lot of the same people who are so upset about the public option. A little ironic, it seems.

-- Insurance companies should not be painted as the “villains” in all of this, a la Nancy Pelosi. Some time ago, healthcare costs skyrocketed so that every person now must have health insurance to avoid bankruptcy in the event of a catastrophic illness. It was not always this way. For many years my dad, who was self-employed and the breadwinner for a family of four, did not carry health insurance but, rather, he “self-insured.” Today that would hardly be possible. Because health insurance today is not what it was originally designed to be, the companies have had to make drastic changes. They’re in the business – surprise, surprise – to make money so, just like any business, they are going to design themselves to have as few costs as possible and retain as much cash as possible. Because the cash they dispense goes to pay for our very wellbeing, it’s very personal to us as consumers. But it’s silly to call them “villains.”

-- My friend Steve wrote a great piece in which he questioned the whole matter of how healthcare today is so tied to our jobs. Getting health insurance is pretty much expected in this country when one applies for work. Steve hits the nail on the head, saying, “the fact that our healthcare is tied to employment is one of the reasons we are in this mess.” Wow, I could not agree more on that one. Why in the world should it be so? Would-be entrepreneurs are constrained from following their dreams because they need a job that provides health insurance.


My heart is heavy when I hear of hard-working American people who are denied coverage for healthcare. I have heard the accusations of laziness, making bad choices, etc. But I am careful not to judge another’s situation. Thank God, I have not been in those shoes. Not yet anyway.

Be that as it may, I still have a big problem with more and bigger government. Yes, we’ve had Social Security and Medicare around for a long time. But that doesn’t give me much comfort. I will be honest: the “public option” really scares me.

Although I am a little more informed than I might have been a few months ago, I am not any closer to a strong feeling either way.

I am prayerfully hopeful that our representatives from both sides will come together and tame this beast that is called healthcare. It is going to take hard work and it is going to take compromise. Arrogance, name calling, yelling and making outrageous exaggerated claims will not get it done.


Kelly said...

This is a thoughtful, well-presented piece, Bob and I agree with very much of what you said.

My husband is self-employed and we currently use an HSA for our insurance. So far, it has worked well for us. I'm reasonably happy with my healthcare. Still... I realize there are plenty of folks out there who aren't (or don't even have healthcare).

I certainly don't have the answers nor do I necessarily think our president does, either.

WhiteStone said...

We have good insurance, too, but I'm well aware there are many who don't. And so I am in a quandary...I'm quite satisfied with the health care system the way it is in regards to myself but it seems we need to do SOMEthing for those who do not have care. I'm just not certain that what is being proposed is affordable (the DEFICIT) and I'm concerned quality of health care may be affected. The economy right now really scares me. If California can go down the tubes, what about the rest of us?

Redlefty said...

All I know is that a hospital employee came right into the delivery room at the hospital yesterday (my wife was in labor) and said, "I'm here to collect thirty-seven hundred dollars."

Huh? It was just so sudden and unexpected. I wanted to respond with "I am the Queen of France!"

You're right -- this is just a massively complicated issue with about 100 potential areas for improvement. And no political party has a monopoly on the good ideas (or the bad ones, either).

Pam said...

That's the problem in a nutshell. There are many good ideas about how to improve the system. I don't understand why some of them couldn't be done on an incremental basis.

Like I've said before, I've heard many good ideas that would be great if they could be woven into the fabric of a good, workable plan.

Sadly, the issues is so divided politically, when this is one problem that should be solved, however it's solved, by all those we elect to represent us.

The solution will affect every American, not just Republicans, not just Democrats. This is an American problem.

I wish it were as simple as: provide a means of insurance for those who have none; do away with pre-existing conditions; make insurance portable; deal with tort reform; simplify medical records keeping; find a way to control the excessive costs of prescriptions and hospitalization and do away with all the waste in the system.

Would that I could wave a wand....

Debby said...

It upsets me that the most vehement opponents are the insured people. They cannot understand things from the point of view of the uninsured. You are absolutely right. 45 million uninsured is unacceptable. There is plenty of blame to go around. Let us start at the door of drug companies, imho.

Headed off to Redlefty's blog to see if there's any baby news.

Bob said...

The 45 million number is according to what the healthcare proponents say. I have seen reports that indicate that is an exaggeration, that part of that number includes students and illegal immigrants, and that the true number is something a good bit less. Still, anything like that in the millions is too many.

Yes, Redlefty is certainly teaasing us with "my wife was in labor" wasn't he?! OK, she was in labor; tell us the real news! :-)

BTW, is it health care of healthcare?!

quid said...

Bob -

What a great piece. I agree with you on every point. Obama, etal, have not done their job, and it is now difficult to "undo" what wasn't done and "do over". The claims of socialism are absurd. We have had a mixed capitalistic-socialistic society since the

I'll tell y'all a little secret about the insurors. I am working for my second insuror, now. One thing they have in common... their employees get healthcare ON DAY ONE. Pre-existing conditions for their employees DO NOT EXIST. If only this was a mantra for all.

I remain unscared of the public option because I feel Tricare works. I honestly wish they would simply expand Tricare to cover the military and those who cannot get coverage. The building blocks are in place. I think a public option would challenge the insurors to be better. Are we/they villains? There is some villainy that has taken place (same with the pharmaceutical companies). More that villainy, they have just made a lot of pigheaded, stupid business moves similar to the American Auto Industry and the banks. Greed and egotism are the root of this. They can change. They have to.

I believe that, including illegal immigrants, the number without healthcare was closer to $70 million (so maybe 45 million is the right number)when the employment debacle and loss of jobs started last fall. Now I believe the number is larger... but the Recovery act did help to keep it somewhat under control by helping to fund COBRA.

I have an excellent medical plan (I should, I'm with an insuror) that costs me $33.00 every two weeks to cover just me. I wish everyone had it. Despite that, I can't get pen loaded insulin (a 2-3 week supply) for less than $175. My friend Allen needs nulasta (sp)shots to keep his white count high while he undergoes chemo. The shots cost $1,000 each. No comment on the stupidity of this. You should know that the insulin probably costs $30-$32 to make and deliver and the shot costs around $90. Part of the bills in both houses address this through the pharmaceutical negotiation. Do they do it the right way, the cheapest way? No. Do they make a dent? Yes.

We need to have some reform this year that makes a dent and covers those who do not have access to healthcare.

If the politicians of this country lose sight of that and allow this chance to slip away, they all deserve to be voted out of office.

Every day of my life is full of compromise. So dammit, we need them to do so, also.

Redlefty said...

Ah, sorry! I really wasn't thinking about it being a tease, because after a few hours of labor everything stopped and we were sent home the next morning.

But that was last Friday. Baby decided to arrive on Saturday. Details to come on the blog when I get a chance!

Again, very sorry about the apparent tease/hijack. I was lost in my own world and forgot that nobody else knew we had gone home after the first labor.

Bob said...

Hey that is just no problem at all Michael and CONGRATULATIONS!!! I can tell you that that third child is really something special.

I am HONORED that we all learned it here first! Hope all the family is doing very well!!!!!

Debby said...

Hey, Bob, I can send those baby pictures to you if you want to send me an e-mail with your e-mail. I'm all set up and ready to go...and then I discovered your blog does not have your email address.

Steve H. said...

Bob...Very good piece. You and I have similar perspectives on a number of areas :) I am in the same quandry you are. I want everyone to be insured...I just am a little nervous how it can be done under our current system!