Healthcare
Jul. 26th, 2009 11:27 am![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
pecuniumI'll admit it, up front, I have a vested interest in single payer (or, failing that sudden outburst of sense, a public option) healthcare.
Why? Because I am, pretty much, uninsurable without it. I have a "pre-existing condition, and if I can get on a policy I will 1: pay more, and 2: have to hope that I don't miss some single event, which is on file somewhere else, and get kicked out of my plan the moment I have some other condition show up; when my policy provider decides to engage in some retroactive recission.
That little trick (which is widespread and has second order effects [the settlement covers, "out of pocket expenses," what it doesn't address is treatment not gotten because the out of pocket expenses were too great for the affected to pay]) is evil.
You buy a policy, and when you go to use it, they cancel it. All of a sudden you are sick, broke, unable to get treatement and you may be on the hook for treatments you got when you were covered.
That doesn't happen in Canada. What also doesn't happen in Canada is the sheer level of expense. We, in the US, pay more, and get less than the Canadians, the British, the Japanese, the French, the Germans, the Dutch, the Swedes, the Swiss, etc.
I think the estimated increase in taxes for single payer is something on the order of 10-12,000 per person, per year. Maia is paying $14,400 a year for her plan.
She doesn't get to choose her own doctor. A bureaucrat decides what treatment she can get (and when they happen). She pays something obscene for drugs (I think it's full-freight for the first $600, and then 20 per scrip thereafter). She has had to go to other doctors to get treatments her provider refuses to give her.
She has to worry that some other bureaucrat will decide that her policy isn't making them enough money, and find a way to cancel it.
So, a 12,000 bite would save her money, and her level of care would go up.
Why? Because the system in the States is defective. It's not about keeping people healthy. It's about making money. Keeping people healthy is a small part of the pie.
My condition requires that I see a rheumatologist on a regular basis. It would be best if I saw a cardiologist once, or twice a year and got an EKG, and a cardio-sonogram. I need to take some drugs, every day. I sometimes have to see a dermatologist; which almost always means more drugs. I need bloodwork. All of those things are money. All of them would be a real hassle if I wasn't able, right now, to use the VA. They aren't, "neccessary." Right now most of them are to make sure things have stayed the same.
When I was first being treated, it turned out I am deathly allergic to the best knockdown drug for when I'm having a real flare-up. Walter Reed, in the first four days of my reaction, performed a spinal tap, 3 sets of x-rays, put me on oxygen, did three punch-biopsies of my skin, put in an IV; gave me IV potassium (twice), had five sets of specialists look at me, assigned an intern to keep track of me, assigned me a private room, checked my temperature every two hours, and did so much bloodwork I started sleeping through the draws, then did a broncocopy; and two pulmonary biopsies.
All to rule out infection, in case it was something other than the drug reaction which seemed the most likely problem.
They kept me in the hospital for another week after the symptoms were abated; in case my reaction had secondary complications.
Kaiser would have sho me full of steroids, right away, and sent me home.
A friend of mine hurt his arm while he was in England. He went to see a doctor (NHS is covered in the fees one pays to enter the country, so he was covered). The doctor palpated it and said, "I don't think it's broken, but lets do a CT scan, just to be sure." My friend said, "What, isn't that expensive?".
"Well, it's no good if we don't use it, so if it's free, let's take a look.". He had a minor fracture, and it was splinted up and he was on his way.
I had a kidney stone. They sent me for a CT scan to see how large it was, where it was, and how many there were. The place was empty. When she was done, the operator took a personal call for about five minutes (at which point I really wished I'd gotten another dose of fentanyl before I went).
The bill... 1,500 bucks.
For my entire stay in the ER getting treated for the kidney stone, about $9,000. It was four hours.
Sara Robinson, at Orcinus has a post up on the subject, Another country heard from with a lot more stories, facts, figures, etc.
Will the transition be trivial? No. At the very least a lot of private bureaucrats are going to be out of work. But the benefits (better health leads to a more productive economy, people being able to find new jobs because they aren't trapped in a sort of health-care peonage, extra money floating about in the system because people aren't spending extra thousands of dollars for plans which aren't keeping them healthy).
But the ad money for private plans will persist. The price will go down. Providers will have to compete, and they won't be competing with some other plan trying to make money, but with a plan trying to make, and keep, people healthy.
We can do this, but it's going to take work. It's going to require sticking your senators', your representatives', your president's feet into the fire, and keeping them there.
It's going to take letters to the editor, calls to the radio, e-mails to NPR, FOX, MSNBC, CBS, NBC, etc.
It's going to take blogging, and speaking out when people start spouting nonsense. It's going to take pushback. I don't have the millions of dollars Aetna, Blue Cross/Blue Shield have. No one is giving me airtime, and column inches to spout the healthcare industry talking points, the way they are giving those things to Michael Steele, and Ben Nelson, and Bachus, and all the rest of the shills for the status quo.
If we are going t beat that advantage, it has to be a drumbeat. This is the best chance we are likely to see for a while. The Republicans think it's their chance to "break" Obama, and smash the move to a more progressive public policy. Like Social Security they are terrified of really fixing heathcare, because it would show that somethings are best done by gov'ts, and that taxes /= wasted money.
We can do this. It will be hard, but we can do this. We have to do this.
Our lives depend on it.
Why? Because I am, pretty much, uninsurable without it. I have a "pre-existing condition, and if I can get on a policy I will 1: pay more, and 2: have to hope that I don't miss some single event, which is on file somewhere else, and get kicked out of my plan the moment I have some other condition show up; when my policy provider decides to engage in some retroactive recission.
That little trick (which is widespread and has second order effects [the settlement covers, "out of pocket expenses," what it doesn't address is treatment not gotten because the out of pocket expenses were too great for the affected to pay]) is evil.
You buy a policy, and when you go to use it, they cancel it. All of a sudden you are sick, broke, unable to get treatement and you may be on the hook for treatments you got when you were covered.
That doesn't happen in Canada. What also doesn't happen in Canada is the sheer level of expense. We, in the US, pay more, and get less than the Canadians, the British, the Japanese, the French, the Germans, the Dutch, the Swedes, the Swiss, etc.
I think the estimated increase in taxes for single payer is something on the order of 10-12,000 per person, per year. Maia is paying $14,400 a year for her plan.
She doesn't get to choose her own doctor. A bureaucrat decides what treatment she can get (and when they happen). She pays something obscene for drugs (I think it's full-freight for the first $600, and then 20 per scrip thereafter). She has had to go to other doctors to get treatments her provider refuses to give her.
She has to worry that some other bureaucrat will decide that her policy isn't making them enough money, and find a way to cancel it.
So, a 12,000 bite would save her money, and her level of care would go up.
Why? Because the system in the States is defective. It's not about keeping people healthy. It's about making money. Keeping people healthy is a small part of the pie.
My condition requires that I see a rheumatologist on a regular basis. It would be best if I saw a cardiologist once, or twice a year and got an EKG, and a cardio-sonogram. I need to take some drugs, every day. I sometimes have to see a dermatologist; which almost always means more drugs. I need bloodwork. All of those things are money. All of them would be a real hassle if I wasn't able, right now, to use the VA. They aren't, "neccessary." Right now most of them are to make sure things have stayed the same.
When I was first being treated, it turned out I am deathly allergic to the best knockdown drug for when I'm having a real flare-up. Walter Reed, in the first four days of my reaction, performed a spinal tap, 3 sets of x-rays, put me on oxygen, did three punch-biopsies of my skin, put in an IV; gave me IV potassium (twice), had five sets of specialists look at me, assigned an intern to keep track of me, assigned me a private room, checked my temperature every two hours, and did so much bloodwork I started sleeping through the draws, then did a broncocopy; and two pulmonary biopsies.
All to rule out infection, in case it was something other than the drug reaction which seemed the most likely problem.
They kept me in the hospital for another week after the symptoms were abated; in case my reaction had secondary complications.
Kaiser would have sho me full of steroids, right away, and sent me home.
A friend of mine hurt his arm while he was in England. He went to see a doctor (NHS is covered in the fees one pays to enter the country, so he was covered). The doctor palpated it and said, "I don't think it's broken, but lets do a CT scan, just to be sure." My friend said, "What, isn't that expensive?".
"Well, it's no good if we don't use it, so if it's free, let's take a look.". He had a minor fracture, and it was splinted up and he was on his way.
I had a kidney stone. They sent me for a CT scan to see how large it was, where it was, and how many there were. The place was empty. When she was done, the operator took a personal call for about five minutes (at which point I really wished I'd gotten another dose of fentanyl before I went).
The bill... 1,500 bucks.
For my entire stay in the ER getting treated for the kidney stone, about $9,000. It was four hours.
Sara Robinson, at Orcinus has a post up on the subject, Another country heard from with a lot more stories, facts, figures, etc.
Will the transition be trivial? No. At the very least a lot of private bureaucrats are going to be out of work. But the benefits (better health leads to a more productive economy, people being able to find new jobs because they aren't trapped in a sort of health-care peonage, extra money floating about in the system because people aren't spending extra thousands of dollars for plans which aren't keeping them healthy).
But the ad money for private plans will persist. The price will go down. Providers will have to compete, and they won't be competing with some other plan trying to make money, but with a plan trying to make, and keep, people healthy.
We can do this, but it's going to take work. It's going to require sticking your senators', your representatives', your president's feet into the fire, and keeping them there.
It's going to take letters to the editor, calls to the radio, e-mails to NPR, FOX, MSNBC, CBS, NBC, etc.
It's going to take blogging, and speaking out when people start spouting nonsense. It's going to take pushback. I don't have the millions of dollars Aetna, Blue Cross/Blue Shield have. No one is giving me airtime, and column inches to spout the healthcare industry talking points, the way they are giving those things to Michael Steele, and Ben Nelson, and Bachus, and all the rest of the shills for the status quo.
If we are going t beat that advantage, it has to be a drumbeat. This is the best chance we are likely to see for a while. The Republicans think it's their chance to "break" Obama, and smash the move to a more progressive public policy. Like Social Security they are terrified of really fixing heathcare, because it would show that somethings are best done by gov'ts, and that taxes /= wasted money.
We can do this. It will be hard, but we can do this. We have to do this.
Our lives depend on it.
![[identity profile]](https://www.dreamwidth.org/img/silk/identity/openid.png){kind=small}
Canadian Health Care
Date: 2009-07-27 12:31 am (UTC)We'd been to a neurologist, a rheumatologist, and had countless GP visits (fully covered) when he went into his GP with suspected food poisoning (when the abdominal pain finally made itself known).
They took a look at him, suspected appendicitis, and shipped him off to the hospital by cabs (not covered) for [note: I was not in town for the next bit, the order of the incidents may be off but all of it happened] an MRI (done within an hour), looked at the results, said 'oh dear', drew some blood, and sent him up for a CT scan (within 45 minutes). Whereupon they noticed that his left kidney appeared to be more like an eggcup than like a kidney, scheduled an ultrasound for the next day, looked at his blood results and general condition, and slapped him into ICU with a load of fluids and Cipro and painkiller running into his arm.
After the ultrasound, they realised they couldn't give him an internal stent [boring details skipped over] so they fitted him with an external nephrostomy setup, got him stable and on a pain control regimen, and - after some discussion - sent him home to wait for surgery.
He could have had surgery immediately if we'd wanted to do it the old-fashioned way and crack his abdomen, but as this is far more major an traumatic surgery than a laproscopic removal entails, we [Ian, me, the doctors, all together] decided to wait it out.
This was February, and at this point we have spent no actual money. The province covered all proceedures, all nephrotomy supplies, and all meds given in hospital, Ian's work plan covered all other meds.
Ian was off work from the beginning of February to the end of August. 66 percent of his wages after the first two weeks were paid by the Canadian Government via Employment Insurance; it was made up to 80 percent by his workplace's Long Term Disability coverage, who also paid out Employment Insurance's aforementioned 66 percent to us direct and recovered it from the government rather than leaving us to deal with the two-week delay and the weekly paperwork.
We had a longer wait than planned: yes, there was a 'waiting list'. Everyone ahead of us had active cancer. Had Ian's condition begun to deteriorate, they would have moved him up if possible or else we would have gone ahead with the conventional abdominal surgery.
While waiting we had five rounds of IV antibiotics, numerous nephrotomy equipment replace/repair visits, a weekly visiting nurse, and six or eight rounds of oral Cipro.
So, eight months of fairly constant medical attention with a hospital admission at the front end and another one - plus surgery - at the end.
Oh, and a year and a bit later he developed an incisional hernia, which required an emergency room visit (covered) and more surgery (covered). No Long Term Disability this time, but the lost wages were about two weeks in total.
So because we had good workplace insurance, we were out of pocket 20 percent of his salary and some cabfares.
Had we had NO insurance we would have been out of pocket 44 percent of his salary plus meds plus some cabfares.
We ran into debt, but were out again by November. With no workplace insurance, we still would have been out of debt within a year at worst.
Without Provincial and Federal coverage, we'd have been bankrupt, at best. At worst, I'd be a bankrupt widow, because we wouldn't have been able to find the money to do the tests to find the problem in time.
We also learned a valuable lesson about "waiting times in Emergency Rooms". You can walk into any emergency room in Canada and go straight to the front of the queue, under certain circumstances. Having lived said circumstances, I can testify to this: You never, ever ever want to be that person. You'd FAR rather have time to read a medium-size novel.
Re: Canadian Health Care
Date: 2009-07-27 04:09 am (UTC)Re: Canadian Health Care
Date: 2009-07-27 04:26 am (UTC)Re: Canadian Health Care
Date: 2009-07-27 05:06 am (UTC)Re: Canadian Health Care
Date: 2009-07-27 07:42 am (UTC)