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}
no subject
Date: 2009-07-27 07:14 pm (UTC)When I went to the ER for my kidney stone, I was billed $9,000, in four hours, because I didn't have healthcare. If I'd had insurance the insurer would have been billed about $2,500. Why the difference? Because they demand a discount, and the only way to give them a discount is to overcharge the uninsured.
So I was subsidisig Blue Cross/Aetna/etc. How much of the corporate budget is spent denying care? A lot. They give bonuses for it. How much is spent on paying nine, and ten, digit salaries to the people who reward other people for denying care? A lot.
Why are drugs so much more expensive here, than in Canada, Mexico, Britain, Germany, etc.?
We don't need to pay the extra freight to make it so profitable a business that it has that much extra money taken from those who use it to make it possible to pay those huge salaries?
One of the ways we pay is that we are dying sooner, and of preventable problems. We have rationed care, but the reason isn't lack of availability, it's greed. Providing care eats into profit. The real customer in our healthcare industry isn't the poor schlubb buying the policy, it's the shareholder, and the only way to give him as much of our money as he wants is to deny care.
And that's happening, even in TriCare, so yes, you are paying someone else, and the cost is frightenly high, when all is said and done.
And we can't do it alone. Shared risk/cost is the whole point of insurance. The larger the pool, the smaller the cost to anyone person. Think of carrying extra saw ammo; if one guy is hauling it all, that's a lot to carry. Spread it around the whole squad and it's a lot lighter. Everyone benefits from having the extra rounds, but no one is too heavily burdened.
Health insurance is the same way. When the next door neighbor's kids don't get measles, your kids are safer.