Improving Health Care in America Means Abandoning the Status Quo
By Michael Pearlman, 6-14-09
With only a week left to train for a 30-k trail race I registered for back in January, I hit the dirt for a run on Saturday. Aerobic exercise activities like running and cycling are critical to my mental well-being; the natural anti-depressant that helps keep me (relatively) sane. Whenever I get discouraged about my level of fitness and endurance on these trail runs, I remind myself how fortunate I am to be able to run at all.
In 2004, I broke two bones in my leg in a spectacular crash during a ski race, shattering my tibia and snapping clean through my fibula at the top of my ski boot. Thanks to the skills of a talented team of orthopedic surgeons in Jackson Hole who performed emergency surgery and through follow-up treatment that included both traditional and holistic healing methods, I made a full recovery. The injury sapped my spirit and left me on crutches for 3 months. These days I run with a titanium rod in my left leg that extends from my ankle to just below my knee. While my hardware can cause me to suffer slight pain during long-distance adventures, it could be worse. A friend who suffered a similar leg injury wound up with one leg longer than the other.
I was also fortunate in other ways-I was covered by health insurance when my accident occurred. Even with insurance, the surgery and physical therapy that helped me recover was financially devastating, leaving me wading through piles of bills, unexpected extra charges and drawn-out negotiations with my insurance company. I learned about “reasonable and acceptable” charges and discovered that insurance companies don’t always agree with doctors about treatments. A bone-growth stimulator that my doctor recommended was apparently an “experimental” treatment that wouldn’t be covered, for example. Only through my doctor’s promises that he would cover the cost of the device was I even willing to use it. Acupuncture treatments using electrical stimulation were effective in accelerating the healing process, but also not covered by insurance. I paid for those treatments out of my own pocket and believe they were worth every penny.
In terms of health care needs, I consider myself one of the lucky ones, so far. I try to eat right and maintain a healthy lifestyle and rarely get sick. I don’t have to see a doctor regularly for treatment of chronic diseases and don’t take any prescription medications. Of course, perfect health can vanish in an instant and there’s millions of Americans who have learned that health care and medication costs can eat up a significant chunk of their monthly budget. Medical bankruptcies are on the rise in this country and will continue to increase under our current health care system.
Over the next few months, the Obama Administration is going to wade headlong into what is sure to be a bitter debate about how to address the spiraling costs of health care in this country. Medical care costs for uninsured Americans are incredibly high and create a burden on providers, so it seems to make sense for the United States to offer universal coverage. The devil, of course, is in the details and there are some people and groups who are certain to fare better than others under any changes made to the current system. While I’d rather not absorb the health care costs of uninsured patients who don’t take care of themselves, but the truth is that we’re already paying for these patients’ care in the form of higher private insurance premiums.
My late father was a surgeon and didn’t believe in socialized medicine, saying that it compromised patient care. That was first and foremost in his mind and is still in the minds of many American doctors whose primary concerns are healing and treatment. American healthcare is buried in bureaucracy already and there seems to be no escape. Insurance companies are often in the driver’s seat in making medical decisions and people are suffering from those decisions. The reality is that any true health care reform will affect the bottom line of drug companies, doctors and insurers. How can we make sure that the money spent on health care reform goes to the right place? If the U.S. can learn from the systems of other countries, why can’t we improve on it? Investing in education and prevention is a good start, but how can we improve the lives and treatment options for those who are already sick?
The arguments are going to continue for months, the lines in the sand divided by political affiliation and by whose campaign is most influenced by contributions from health care lobbyists. The wealthy in the United States already have access to the best medical care in the world. It’s the middle class and those living with minimal savings who have the most to gain from health care reform. Our current system is broken, but will we, as a country, have the courage to make the difficult choices to give the uninsured a fighting chance at better medical care? One size fits all medicine is not the answer and neither is duplicating European and Canadian health care models. But until our country finds a way to provide the economically disadvantaged reasonable medical care, the rest of us, healthy or sick, will bear the cost of their care.
this is an insufferable bit of over-simplified and aggravating fluff journalism. why no mention of the various options being considered??? single payer - why is it shunned??? is creation of health care co-ops a good idea???
you pose a lot of unsubstantive questions in this piece which leads me to suspect you don't know the first thing about the subject. if you want to post about something at least read up on what is going on.
ferrkrissakes. i could go on but why illuminate your blog when i can write my own....
The author brings up another issue which will surely be part of the "socialized healthcare" debate, either now or in the future. And probably should be.
Will the taxpayers be expected to subsidize the higher-than-average healthcare expenses for citizens who engage in high-risk behavior... whether it be ski racing (or other adrenaline pursuits), or high-risk sex, drug use, obesity-inducing behavior, smoking, etc.? Or will we be content to accept the Health Nazis along with socialized healthcare?
(I'm not sure how I would feel about that... just raising what I feel is a valid issue. One of thousands.)
Well, Obama made a speech to the AMA this morning that essentially said: No major tort reform so malpractice rates can be lowered. The president is demanding the medical community sacrifice, but not the trial lawyers, one of the Democrat party's most lucrative donor entities. So, it seems the staus will basically stay. Everybody will get screwed in some way (level of care,etc.), but not the lawyers. Never the lawyers.
Comment By Bill Croke, 6-15-09That's "status quo". Sorry.
Comment By Brad, 6-15-09Recall reading, 60% of healthcare costs occure during the last two months of life, if that is the case, rationing will be a big part of any new system. Canada rations their's...I'veseen it with family members.
Comment By Kitty, 6-15-09Obama's plan is a back door to a single payer plan controlled by the government. He claims we may keep our private insurance. However, what he well knows is that many employers will discontinue workplace coverage because the cost to them has become too much. This will force most employees into the government plan. Single payer health care systems have never worked, and this will fail miserably as well. There is no way you can
Health care is now one fifth of the US economy, which Obama is attempting to co-opt. The guy has no business experience; he's surrounded himself with liars and tax cheats; he protects his supporters from prosecution ( http://www.foxnews.com/politics/elections/2009/05/29/charges-black-panthers-dropped-obama/ ). This is not a person I would ever entrust that much power, especially over my life.
...
[Pay no attention to "There is no way you can" in my comment above.]
Here's a pithy explanation of Obama's plan. Sure, it's posted on a satirical blog, but it's also true:
"Big Guy is pretty excited that we'll be getting to go home to Chicago next week for a speech on his health care reform plan. We'll be speaking at the American Medical Association there.
It might seem like the wrong forum for Big Guy to talk about how under our health care plan we're essentially going to take money out of the pockets of doctors and make them work for free, but that's overlooking two facts. This is Big Guy. And we're doing it in Chicago."
http://baracksteleprompter.blogspot.com/2009/06/sweet-home-chicago.html
...
For a century, the US has had universal access to a public education, even if for a great deal of that century, it was segregated. Separate but equal it was claimed.
And for the last century, there has been a parallel private education path, too, that has been integral to the process. The Sun God started at Occidental, then to Columbia, and Harvard. More and more it is apparent that only those chosen to study law at the top Ivy League schools may participate as leaders in this country at the highest levels. But always through the private schools. One would think hugely important public universities like Michigan, Cal, Texas, Illinois, Penn State, Indiana, and others were capable of putting forth people whose qualifications were those of a national leader.
So when it comes to medicine, those very same institutions produce the heart of our medical education, and very fine doctors. But it will be the Doctors from the prestigious private schools who end up administering the profession in leadership positions.
Public education has done a good job, to a point, and that point is usually about 9th grade when they lose subscribers. They lose kids who struggle to be scholars, and they lose kids who are absolutely bored stiff with the dumbed down lesson plan. The equality of access does in no way guarantee equality in diagnosis or care. That is where money makes the difference, and in a one size fits all free public health care deal God help those who don't fit the Government shoe.
The chance to improve, modify or change any part of the free public single provider education is met with union force and money, all taken from paychecks whether you belong or not, and that very same money is invested in electing liberals to run state legislatures, and Congress. The jaded, uninspired public educators are a large part of the money and votes that elected the Sun God, and they are rewarded by lowered expectations from their institution.
Those no longer interested in the "free" public education now take other avenues to gain education. Home schooling and private non-profit and private for profit schools educate a significant percentage of American kids and young adults.
So, with a national effort for a century, free public education fails many segments of our society. In 100 years, we get it right less and less of the time in the dispensing of free public education. And that education differs in quality depending on the area it serves mostly on a per capita income basis. Thus, a private education system that was here first, and is still here, is stronger than ever. And that is because government cannot be counted on to be fair, equal, caring, interested, and enthused to be the educator to all.
So, the question is, then, why in the hell would anyone think a "free" single payer medical provider would not result in the same experience for its clients? The government will take the money from all at the point of a gun, as only the bailiffs and others in court may have guns, and the guy who shepherds you to jail is armed. Then, they will grease palms of those who have no business being greased, and the unions will call the shots, and those who have the means will avail themselves to a private for profit medical care program, all the while draining the best minds in medicine to their private system. Universal health care will work exactly like universal education.
Please, tell me how you think it ends up any different, with a better result. We know who is to administer it, collect the money, and who the health care providers will be. Mediocre, at best, for the masses, almost non-existent for the poorest, and life as usual for those of means, whether it be here or offshore in a world more connected than ever. All that changes is that the government has more employees, more administrators, and more power. The people have gained nothing, and lost more.
Its unfortunate but the special interest groups like lawyers, doctors, big pig pharma, insurance companies, and anti-government fear mongers who have the money to pay legions of lobbyists to preserve their excessive cut of the health care action are going to try to screw the 20 to 30% of the population that struggle to get by in the best of times and are too poor to make the news or hire lobbyists to defend their interests. These powerful special interest groups have already eliminated single payer from fair consideration and are trying mightily to eliminate the choice of a public option to compete with bloated private insurance companies. Screw them and screw Harry and Louise! Affordable, universal health care for the working poor is long overdue. It should have passed when FDR and then Harry Truman proposed it more than 5O years ago. If we don't achieve universal health care this time around, it should be obvious that the oligarchs and plutocrats still are able to run the country for their own benefit.
Comment By Kitty, 6-16-09My daughter is a nurse who can attest to the fact that poor people, working and not, do get health care.
...
Yeah, right! Many of them stagger into the emergency room when they are about to drop dead and then if they survive, it's on to bankruptcy court. And of course, there's no way in hell they can pay for their medications, buy food and pay the rent. There is basically about 50 million people in America who can't afford health insurance and really can't afford to see a physician except under dire circumstances.
Comment By Kitty, 6-16-09Obviously, you don't work in the medical profession, let alone an ER.
The figure most often quoted is 47 million. Of that, 27% aren't even citizens, and another 20% lack insurance for a short period of time. A certain percentage opt not to have insurance, such as young people just starting out and upper income people.
...
And just as obviously, you haven't spent a great amount of time in an urban ER that is overwhelmed by the needs of the poor and destitute. Its easy to wrap yourself in your middle class cocoon and assume that only lazy bums, misfits, drug addicts and illegal immigrants are having a hard time and that they probably deserve what they don't get. Your point of view is on of the big reasons we have to fight for universal coverage every inch of the way.
Comment By Michael Pearlman, 6-16-09It's easy to say that leaving health care in the hands of big government is a bad idea. It's much harder to come up with an alternative as to how our country can enact true health care reform. Free market theory has also led to a very bloated health care system at many levels.
I can't offer a solution, but I do agree with Mickey's assessment that "Affordable, universal health care for the working poor is long overdue. "How are we as a country going to get there?
My daughter is a nurse who works 12-hr shifts in an urban ER where it's chaos 24/7. So I have a decent understanding of the situation.
You assume things you have no idea about, which makes any kind of intelligent discussion on this topic impossible.
...
Here's a timely article:
How Obamacare Will Change Your Life
"Much of what you have long taken for granted about health care and the way it should be delivered is about to change in ways that you definitely will not like. Your discomfiture will be particularly poignant if you happen to agree with the rest of the electorate about what exactly is wrong with U.S. health care. Public opinion surveys have consistently shown that most Americans consider access and cost to be the most important problems facing the system. Perversely, the primary changes Obamacare will bring to you and your family will be reduced access to care and significant increases in its cost.
...
[I]f you're one of the millions of people who get health insurance through their jobs, your federal income taxes are about to go up."
http://spectator.org/archives/2009/06/17/how-obamacare-will-change-your
...
Well, Kitty, If you think you're surrounded by socialist idiots, just talk to your oh so intelligent self and you can scare yourself to death about "Big Government" while Big Business is screwing the rest of us out of a sane, affordable and sensible health care system.
Comment By Kitty, 6-17-09I repeat: Any kind of intelligent discussion on this topic impossible with you.
So I'll end my input by saying that your dream of socialized health care will most likely come true.
...
In the great universal health care issue, and the ER, the only person I know right now, working ER, is a PA in his last weeks of training. He says lifestyle and choices are what brings most people to the ER. Bad choices. No personal sense of responsibility. And people looking for someone to talk to. Lonely old people. Confused old people. Alcohol and drugs being a huge part of the problem in all age groups. That, and end of life emergencies, one after another. Rest home to ER and back, in a circle than ends only with death, and lots of money spent on delaying the inevitable for perhaps weeks, if not days.
My brother has been a surgeon and OB/GYN guy for 25 years. Insurance is a good idea, but whose practical purpose is to deny coverage. Having that universal will make not difference. Much of your premium is spent on book keeping exercises to satisfy regulators. Dr. Brother says he spends 25% of his time in the record keeping for government business, and has a person full time doing the same in his office. He is old enough he thought it would be a good idea to end his surgical career, and just see patients as a GP kind of Doctor, and refer them to procedures if he feels they are needed. The problem is that he is seeing too many CalMed cases, which pays about $15 a visit. So to examine a person every 15 minutes will garner him $65 an hour, if they are all on "universal health care." It costs him $85 an hour for his help. He is done practicing medicine. Government health care does not pay enough, or on time, and adds a book keeping layer and an audit layer that takes additional resources you can only get by charging someone else too much. It is a crooked system run by crooked legislators, and crooked state administrators, for political benefit. There is no ideology that needs that much money, so there must be considerable funds that leak out the side to special interests or political pockets. But it ain't doctors who are benefitting.
In a look back on his life, Doctor Brother feels his life has been mostly an exercise in futility, and helping the poor does not come with a sense of having done good. Instead, you have been a target, with someone demanding you defend yourself on a daily basis. Ambulance chasing lawyers, sleaze ball pharma salesmen, grubbing and conniving bureaucrats questioning your every diagnosis and bill. A wasted life. No respect but lots of demands. Better, he says, he had spent it teaching science in a community college. More money in retirement, no bureaucrats looking to destroy your career because they can, no ambulance chasing litigators looking to loot the doctor's bank account. You would have been home more often to be with kids and the now divorced wife, instead of looking some dilated vagina at zero o'clock in the morning, called in because the woman is there, at the hospital, in labor, and you cannot deny her care. So you don't sleep, you don't get time with family, and you don't get paid, although the patient has a cadre of legal aid lawyers to sue you if anything is amiss. So it is the Doctor's fault for no pre natal care, or her drug addiction, her three STDs, the malnutrition. And a compromised baby is born, who will be a potential lawsuit on your docket until it turns 18, so you must have a tail on your malpractice insurance to cover you or your estate for almost two decades after you deliver the last baby. All that in a system that having universal health care provided by the very same government that seemingly gets nothing right. Oh, whoopppeeee!!!!
Sorry. I don't share the enthusiasm. Or the faith in government to do the right thing. If you need someone to piss away a huge amount of money, call me. I would like a shot at it.
I know we are supposed to be polite on these posts but, Kitty, you are a fool. You are right-wing conspiracy nut which automatically makes you a liar as well. I've read your other postings and hope you are not an elected official or have nay responsibility where other people's children are concerned.
Comment By Todd, 6-17-09Kitty and bearbait have pretty well described the reality of the situation. Have none of the rest of you heard of Title 19, or Medicaid, or SCHIP, those are programs for the poor. Since the requirements are well above the poverty level, they take in a lot of people. Then of course there are those who are eligible for VA or Medicare or IHS.
Just why folks want government medical care for the rest of us is totally beyond me.
I saw comments about the dotors as well as others wanting too big a cut. Can someone explain why a 6 figure income for a doctor working 80-100 hours per week saving lives or fixing the broken is terrible, but 7 and 8 figure incomes for game players or entertainers (formerly court jesters) is wonderful?
Sure insurance for medical care takes a big chunk of income, I could afford a much fancier house or bigger car, etc if I didn't have to pay for health care, but I consider health care mroe important.
Richest country in the world should have health care for all. We pay for it by reducing spending in other areas that aren't so critically day to day important as medical treatment.
Comment By problembear, 6-19-09pretty obvious that the private insurance lobby pays bearbait by the word....
Comment By Kitty, 6-20-09There is hope after all:
Democrats fear Obama health care plan 'on the rocks'
"The Congressional Budget Office's estimate for the Kennedy bill -- that it will cost $1 trillion and yet leave millions of Americans without health insurance -- has given Republicans strong political ammunition to charge reform may be too expensive at a time of massive federal deficits."
http://www.cnn.com/2009/POLITICS/06/19/health.care/index.html
...
Oh, good grief, I thought her lat posting said she was going to end her input here and now we have more Kitty litter. The truth is that, looking only at the cost side and not counting any indirect economic benefits of cleaning up the current health care mess, the health care reform proposal on the table is predicted to cost a bit more than $100 billion annually, which would be a tiny fraction of the total annual budget and about one quarter of the annual defense budget alone. If you are honest enough to put in the context of what the current health care mess is costing the overall economy, this proposal is a bargain; but, then again, I said honest, so you won't hear that from Kitty or any of her RIGHTWING REPUBLICAN (hello, Jill) cohorts.
Comment By Mickey Garcia, 6-20-09That's 1 trillion dollars over the next 10 years, which is peanuts compared to the 16%-18% of GDP that the U.S. is spending annually on health care, and the almost 1 trillion annually the U.S. is sending overseas to buy petroleum. Meanwhile, the Canadian health care system, a single payer system, spends about 10% of GDP and gets better results. Life expectancy in Canada is 81 years, versus 78 in the U.S. American car companies have moved so many jobs to Canada to take advantage of lower health-care costs that since 2004, Ontario and not Michigan has been North America's largest car-producing region.
Comment By Todd, 6-20-09To those of you in favor of single payer insurance, how much are you willing to pay each month for your insurance? You do realize the government is going to decide how much you can afford don't you, you will have no say.
Comment By the real mike, 6-20-09Get real, Toad. The dairies get to decide how much you can afford to pay for milk AND how much you get to pay for the subsidy; the car companies get to decide how much you pay for their crap; Albertson's dictates the price of your beef; and, right now, the same kind of guys who brought us Lehman Brothers and AIG are sitting in health insurance company offices and deciding how much you pay for health care. Don't kid yourself and don't try to fly a false flag and kid us. Compared to the current system, having the government decide on our premiums would be a tremendous improvement in equity AND value. By the way, I think you're creepy.
This article was printed from www.newwest.net at the following URL: http://www.newwest.net/topic/article/improving_american_health_care_means_abandoning_the_status_quo/C564/L564/