But what if private health insurance refuses to pay up????

(Blogger’s note: I’m still trying to fix the small type size problem in this blog, but until I do, remember you should be able to enlarge it on your own screen by using your View option.)

For all of you who don’t want the government to get involved in health insurance reform, here is a reason we need it:

Sure it is good and right that we all take responsibility for providing ourselves with health insurance.

But what happens when you don’t get what you pay for?

A reader submitted an article to my local newspaper in which he described what happened to him and his wife who are self employed and have private insurance.

She got bit by a wasp and suffered an allergic reaction. He took her to the nearest hospital emergency room.

She got treated, but later they found their insurance, Anthem Blue Cross, would not pay any of the cost because it did not have an agreement with the hospital.

When you have an emergency, in particular, and anytime, I would say, you are dealing with a hospital, you are not in a position to shop around. And besides all of that, my wife and I found out recently that private insurance is damn near impossible to get — there is little to choose from and the cost is prohibitive. I was lucky enough to get on a company plan recently — I guess — but you know, it was Anthem, and now I am told that the company is changing plans because the cost has gone up and it is “no longer a value”, the lady at my company who handles this said.

As far as I can see it, more and more people are being priced out of the market, even in employer-sponsored plans.

Those who have insurance and do not have any problems are not eager to change things. And those on the government dole probably don’t see a problem, but there are millions who do have a problem and perhaps millions more who soon will.

Maybe private enterprise can provide health care for us all, but there has to be some government oversight.

Many have been sold on the idea that government is the enemy.

I don’t know.

Who is looking out for me? The government? Private enterprise? Well, no to either one maybe. We all have to look out for ourselves. But I thought in our system of government where the people are supposed to have control over the government in this representative democracy that we look out for ourselves via government in many instances, especially in matters that are too big for us to handle on an individual basis.

There are extremes. On the one hand, the ultra liberal wing (sometimes called the far left) of the Democratic Party likes to see controls over such things as business, the environment, and social issues. And on the other hand, the ultra conservative Republicans (often called the far right) seem to want to see government control over personal behavior.

As I have blogged before (my favorite expression), there is just as much totalitarianism, dictatorship, lack of democracy, in the workings of the far left and far right.

Having to worry whether you can pay for health care and having to worry whether a medical condition can wipe you out financially greatly subtracts from the quality of life.

Personally I have no great objection to government-sponsored health care. After all it would be paid for out of taxes. It would not be free. Private insurance is not free. But at least in theory we would have more control over government health care through our representative democracy than private health insurance.

As many have noted, some of the most vehement critics of government-sponsored health care clutch on to their Medicare cards.

The political winds, though, do seem to  blow in favor of the retention of private health insurance.

So maybe that is fine. But there has to be some way to make sure affordable plans will be available to all, to include, perhaps, government subsidized plans for those who cannot afford insurance.

And no company should be able to sell insurance and then refuse to pay up when the claims come in.

And the idea that someone facing an emergency is in a position to shop around is absurd.

Promise for health care reform elusive…

　

Still riding on the excuse that I’ve been away from immediate access to news for the past several months, kind of like when I began truck driving I just used the excuse I’m just a beginner, but after some 15 years that has kind of worn out, but you’ll have to give me a break on the new one about being behind on the news — somewhat.

But I thought health care reform held some promise. From an early age I had seen the need for some type of comprehensive health care system. Although my family was blessed with good health I know my father, and mother, were always concerned about the cost of health care and what a real medical emergency or major illness could do to a family’s resources.

Back then not everyone had health insurance through their work — and not everyone does now, of course (not everyone has work).

I honestly don’t know whether my folks ever had health insurance while I was growing up or not — I think not, except possibly when I was a teenager, although I’m not sure whether they had it even then.

Fortunately, when my wife and I raised our two girls, most of the time we had health insurance through work. For years it did not seem terribly expensive, even though at our jobs we had to pay part of the premium cost, unlike for some who did not even have to pay that. In later years the share we paid began to rise.

Years after my children had grown up I got a job where the company paid 100 percent of my health insurance premium and the insurance was good — it paid for a lot of my cancer treatment.

Well due to being out with cancer too long I no longer have that job. I am back at a previous job that has insurance, but it has (had) a higher deductible than before — that is the trend nowadays — it does make some economic sense. But no sooner had I got on the plan than I was told the company is going to a new plan because the old one’s premiums had gone up too high for the new year and was no longer a good value. I have not looked at the new plan options yet and I never really understand the insurance gobbledygook anyway. I don’t feel bad about saying that either. I have heard a lot of otherwise intelligent folks, much more so than I, admit they don’t get it either. Actually that is why our President Obama and all the others on Capitol Hill find themselves deferring to the industry on this health care reform thing. Well that is one big reason. Some of them, such as Sen. Joe Lieberman of Connecticut, are in their back pockets because of campaign donations and such (and I suppose a lot of his constituents work for the health care industry). Having the health care industry help do health care reform is akin to having the fox guard the hen house.

And let me stray from the central point here — the promise of health care reform — and note that the term health care insurance or the concept of health care insurance has always been somewhat of a puzzle to me. I understand the basic principles of insurance. The insurance company takes on a risk, that is betting that it can collect more money in premiums than it will have to pay out. If ever there was a riskier pool for insurance, it would seem health care would be one of them. Almost everyone gets sick. So many of us suffer terrible diseases, such as cancer, and unless we get get run over by a freight train (or truck) most of us are sure to get old and probably get some unfortunate medical condition related to age.

And I totally do not understand the concept of being able to get insurance once you are already sick or suffering from whatever you would want insurance for. Maybe I should be hired to make the arguments for the insurance industry.

But it is probably more of a problem of semantics or terminology. Not all health coverage, possibly, should be called “insurance”, really it’s just coverage, help for when you have medical expenses you otherwise could not afford.

Medicare, for example, is not really insurance in my way of understanding. No one who is otherwise eligible for it can be turned down because of pre-existing conditions, and most of its clientele are elderly — a risky group for health insurance indeed.

But back to the central point about the promise of health care reform. So for decades, long after doctors quit making house calls and quit taking chickens for payment, and long after medical technology had exploded and the costs along with it and long after medical professionals realized that this could be big business indeed, millions of folks went without any kind of health coverage because it was not offered through their work or because they did not have steady work or even because they did not have the foresight to realize that a medical emergency could devastate them financially. And buying medical insurance on the open market has always been prohibitive in cost for most.

But over time, more and more jobs offered insurance. At the same time, thanks to president Lyndon Johnson and others, a safety net of sorts was created for the elderly and the disabled and the chronically poor. It was not without holes, especially for the chronically poor and even the newly poor, but it was there.

And over time folks became somewhat comfortable in thinking, “well I have a job and I have insurance, and for those who do not the government will help them”.

But then the costs of even job-related insurance began to climb and due to economic crises, the current one in particular, people lost jobs and their insurance with it.

So, some called for the government to step in and make things right. Some may have envisioned a turn toward what used to be called “socialized medicine” but maybe called it “single payer” or “the public option” (yes, I know on that last one it is not really the same thing necessarily, but it is government involvement and really no one ever clearly defined the “public option”.

Others, perhaps, just thought something could be done to lower costs, say by offering more competition in the marketplace — trouble is some apparently really have the ulterior motive of reducing standards health insurers must abide by to create this competition.

Still others , Obama included, thought there could be some type of compromise, with a blend of public and private.

I was in a hospital bed when Obama was campaigning. So the need for health care coverage came home to me.

One of the most absurd things I witnessed while suffering from the effects of my cancer, which included uncontrolled tongue bleeding, was the fact that the emergency rooms are crowded with people who use them as their family doctor offices because they apparently cannot afford doctors and the law demands that they must be seen. I’m bleeding to death (almost literally, but I didn’t die) and someone ahead of me is being treated for the common cold or the effects of a drug or alcohol overdose.

I want to say here and now that I would not have made it through the last couple of years were it not for the help of family — and that may be the one insurance we should all think about.

And here is something I do not understand. I was in a cancer support group meeting and a woman beside me expressed gratitude that her husband was treated for his cancer free of charge by the hospital because they had no insurance — they ran some type of car repair business, I think she said. He was “self employed.”

Well I do not begrudge him getting help. And I hope that he has survived and is well or at least better off.

But for some reason, everyone who treated me wanted money. Again, if it were not for the help of family and the fact that I did have some job-related insurance, which eventually ran out after I lost that previous job, I would have been out of luck.

Because many use emergency rooms as their family doctor offices and because people without insurance are sometimes, certainly not always, given a lucky break, thanks to various programs and the good will of providers, the paying public has to pay that much larger premiums to make up for the lost revenue. And of course so many things add to the cost: the expectation that we can live on and on and that no treatment is too costly when it comes to saving ourselves or our loved ones, the fact that doctors expect to be paid well — after all that is a big draw to get into the profession in the first place — and the ever-expanding medical technology and the expansion in costs that go along with it.

The cost of medical malpractice lawsuits is also a factor, but would we want to prohibit people from seeking relief through the courts from terrible injustices and encourage the careless practice in medicine in the name of cutting costs? Undoubtedly reform is needed. I would think some control of punitive damages and better judgment by the courts as to whether to even accept many suits could go a long way towards reform.

Oh, and as I have blogged previously and more than once — the medical insurance bureaucracy and all the time it spends trying to figure out how NOT TO PAY CLAIMS is part of the problem.

Even so, I must give credit to the fact that medical insurance has paid an astounding amount of money to keep me and my wife alive and healthy.

One of my brothers told me one of the favorite sayings he has heard is “everyone wants to go to Heaven but no one wants to die”.

I don’t know if that applies here, but I think it does if I even understand that saying. While many people complain about the cost and availability of health care, they decry any form of government control. They are afraid it will cost too much and bureaucrats will be making health care decisions doctors should make.

Well, private insurance company bureaucrats already are doing that on that last point, and as far as cost, no matter what you do it will cost. What many seem to want is a free ride.

And then there are the people who would deny others government help while they clutch onto their Medicare cards. I do not understand that one, and it’s probably not worth much comment. But I have a feeling that many health care reform or government option detractors would be the first in line to get in on any government help if and when they might be in need.

At any rate, at the top of this blog I pleaded that I was behind on the news. I have not followed the health care reform thing closely — mostly have heard the sound bites and caught some headlines and abbreviated accounts.

But from what I have gleaned so far, proposed legislation does not promise to do much for anyone soon, if ever, except Arianna Huffington and others say it is a boon for the insurance industry.

As I have wondered before, why didn’t Obama just seek to cover those who cannot get coverage now?

p.s.

Having some trouble getting type big enough to read on this blog — but of course you can use the “view” option on your computer and enlarge the type size — I’ll try to work this out.

Health care reform could be more simple; Afghanistan tar baby…

I was off the internet for a long time due to my old computer crashing and the fact that I have been out on the  road driving a big truck and have felt out of touch with the news. I buy a newspaper from time to time, but there is little to read or at least little I want to read in them these days. But I did catch some radio and TV news and I did glean some things out of the papers.

From what I gather I am disappointed in health care reform. It sounds as if it is too little too late or too much too late or too complicated. I had previously blogged that I thought they (pushers of reform) were perhaps making things too complicated (and probably too expensive in the process).

It seems to me that the primary focus should be to offer coverage to those who do not now have it for whatever reason. It seems to me that this could have been done, and still could be done, by simply expanding Medicare, and in fact there was some talk of doing just that.

Even the most reactionary conservatives, people who may not know what those terms mean (reactionary, conservative), support Medicare, almost as a God-given right. These are folks who swear that they do not believe in any kind of socialism (read “communism”), but stand by their right to receive Medicare and Social Security (“I paid into it”, they proclaim).

This nation, the USA, has a built-in resistance to government-sponsored, single payer health care for all, but over the years it has seen the development of a defacto version of a health care system — basically insurance through your job, Medicare or some form of it (Medicaid and so on) for the elderly and disabled, or just plain private insurance.

But in this process millions of people get left out for a variety of reasons, but mainly cost and unemployment.

So why could we have not simply expanded Medicare to pick up those who could not get health insurance any other way?

In our system, such as it is, those who can afford to pay for their insurance should, even those who might be offered the expanded Medicare.

There would have to be some system or rules to figure out eligibility and a sliding scale to determine who would have to pay and how much. In the process, there would be some inequity. There always is. No system is perfect.

But with tight restrictions, we could have, and still could, offer some type of coverage to all at a much lower cost, saving the massive indebtedness we are headed for.

And while I am on the subject, I want to comment that I had always wondered why there was resistance to allowing insurance companies from operating across state lines, as the Republicans call for. Now I find out from reading the news that one problem is that if allowed to do so, companies would choose to operate out of states that do not have a lot of consumer protection rules. In other words consumer protection rules, such as in California, where I live, could be bypassed. Seems to me that could be fixed. Competition is needed.

WAR, WHAT IS IT GOOD FOR? ABSOLUTELY NOTHING — as the old song says.

It seems as if President Obama has got himself stuck in a similar way as the late president Lyndon Johnson did to the Vietnam tar baby. Call it the Afghanistan tar baby. At least Obama did not claim in his campaign for office that he would do otherwise.

But I think we as a nation are either indifferent to that war or have lost sight of what we are trying to accomplish.

I for one have no interest in nation building. True nations are built as an almost natural process by those who live in them.

We originally went into Afghanistan under Bush man junior to go after Osama Bin Laden and Co. and those who aided and abetted him, the Taliban and Al Qaeda or whomever. But Bush lost interest and went to nation building in Iraq. Perhaps Bush or Shrub, as the late Molly Ivans called him, is smarter than I give him credit for. Maybe he realized that Afghanistan was hopeless and thought he could grab som glory in Iraq.

Maybe sometimes the best defense is a good offense. But it seems to me that we should limit our offense to going after those who did or would attack us and not try to re-build the world in our image — we can leave the latter to God.

Should we go back to the old sailing ship days in health care???

ADD 1:

Sometimes I post a blog and then think: “what I should have said is this…”

That’s the case here. What I should have said is the fact that some seem not to care if other folks can get health care reminds me of reading both fiction novels and true accounts of the old sailing ship days when hearty sailors were out to sea for years at a time. Back then if you were an able bodied seaman and you were injured you were no longer worth anything to the ship’s captain and its owners. You lost your pay and had to depend upon the pity of your fellow sailors, even for a scrap of food (a good reason to get along with your fellow employees for sure). Seems like a hard core and hard-hearted way of doing things to me. But I suppose some would prefer that method for today’s society, maybe on the grounds that too many take advantage of the generosity and compassion of others while failing to do what they can for themselves. But somehow I have to think many of the so-called tea party protesters either do or will at some point find themselves in need of help from public programs and will think nothing of signing up. And of course I know what they will say in their own rationalizations: “I paid for it.” Yes, and so do we all. You’re welcome. 

————-

I wish the health care reform issue was over. From the news reports it appears as the most contentious issue ever to face the public in my lifetime (60 years).

Nearly everyone wants excellent health care, but people just don’t agree on how it should be paid for and what their own responsibility, if any, should be outside of themselves and their family members. And most agree that the cost of health care is a problem but there seems to be no consensus on what to do to control costs.

While I am not one of those who thinks the so-called “free market” solves all problems, it is kind of hard to tell because we seldom have a “free market” in anything, due to government regulation on business, much of which is, truth be told, promoted by business to get advantage in the marketplace. It occurs to me that the black market may be the only free market (because there is no government control).

While I do not know if government-sponsored health care is always the best way to go, I kind of think it would have been better had this nation (the United States) done so a long time ago. We did not, totally, anyway. We do have Medicare and Medicaid and military insurance and so on, though, and it seems to work for those involved – yes I know, Medicare is running out of money. But I think anytime one says Medicare or Social Security has a funding problem, it is more an issue of priorities than anything else. It is no secret, for instance, that Social Security funds have been robbed over the years for all types of things other than the intended purpose.

And as in the private sector, the public sector has depended too much on borrowing as if the day would never come when it had to be paid back or when revenues dropped too far down to pay the cost of interest on all that borrowing.

Maybe what we need for health care is indeed a free market. But there would have to be government oversight. I mean what good does it do if you are asked to pay health care premiums but can have your coverage denied or dropped because of pre-exiting conditions? And how can you say there is a free market when you can’t buy private health insurance across state lines – and who put that provision in the law in the first place?

As I have stated several times before on the subject, I think President Obama would have done better to simply put forward a program in which two things would happen – health care coverage would be made available to all with consumers expected to pay the cost of premiums, and in cases where people truly could not afford coverage (and that is sometimes subjective, but there has to be a legal cutoff point) the government (yes, the taxpayers) would step in. In some sense that is what we already have, but the problem is that there are cracks people fall through or loopholes. People often have to end up liquidating their own hard-earned assets to pay for health care and/or to qualify for assistance.

And there really needs to be a law that health insurance is mandatory. Why? Because so many people without health coverage flood the emergency rooms and the law does require that they be attended to (a hospital in my town has been under fire by the government for supposedly failing to meet that obligation to the full extent to the law). To cover the cost of the uninsured, hospitals and other medical providers have to charge those who do pay at a higher rate to offeset the costs of those who don’t, and the government of course has to raise taxes to cover the cost too.

I get the impression now that health care reform or at least some type of adjustment is coming. It will be watered down from what ultra liberals want and it may be too restrictive for conservatives, but if it at least meets the goal of offering – and mandating – coverage for all, I think that would be an improvement.

A truly free market in health care coverage would have the advantage of allowing people to decide just how much they want to be covered. Do they want to pay extra for a plan that pays nearly all costs or do they want to be more economical by simply protecting themselves from catastrophic incidents? I know if I or my family members had to pay for the full cost of my own bout with cancer none of us could meet it.

And a free market where consumers decided about and had the responsibility to pay for coverage would free employers of the burden of offering health care coverage and would allow small employers to feel free to take on more employees, not having to consider that if they do they might fall within one of those proposed mandates that employers of a certain size provide coverage.

In fact, the system in which so many have or had generous coverage is a large part of what led to so much inflation in health care costs in the first place. When those who offered services – hospitals and doctors and others – knew that consumers did not directly deal with or even see the costs, they tended to inflate the bills.

And one more thing: while the president may be to the left of many, his willingness to compromise but at the same time his insistence to get something done plays just right with me. To those who feel he is ramming something down their throats (so to speak), I say elections have consequences. Your guy won last time, the other guy won this time.

P.s.

In my previous post I wondered if Obama would present a little more clarity to his proposals. I think he did. That is he presented a clear outline of what he wants. It apparently is still a work in progress, and even though congress often does not read all the details of what it votes on – who would? And to the tea party protesters: if you are sincere and if there are enough of you – and it’s not just charade orchestrated by the ditto head Rush Limburger or Glen Heck or Hannity Insanity (not their real names) blowhards — you may well have an effect. Public pressure – even outside of actual elections — also has its consequences.

It’s a great life if you don’t weaken, and is democracy workable?

Once when I worked as a newspaper reporter/photographer I was doing a photo-story about an old rancher who still drove his cattle through the mountains between winter and summer ranges decades after nearly everyone else had turned to using trucks.

As the bawling herd of cattle broke out of a stand of trees into a clearing and the dust flew, he came riding right past me, turned his horse toward me and grinned, and said: “it’s a great life if you don’t weaken.”

That was more than 30 years ago, but I finally think I can appreciate what he was saying.

After being laid low by cancer and losing my ability to make a living and now, at least for the time being, being able to go back to work at my occupation of the past decade and more, truck driving, I can say with understanding that it is indeed a great life if you don’t weaken, and it’s a great life if you do weaken but get back your strength.

Related to all of this and the blog I am doing right now, my sister called last night and said she had not been able to get a hold of me (she did not have my cell number, but she did manage to find my wife’s finally) and noted since I no longer was doing my blog she did not know what I was up to.

I reluctantly had to drop my blog postings for the most part for the past several weeks because I have returned to work and have not had the time nor the energy nor the capability to blog each day as I had been doing. As I have noted previously I am trying to get my blogging system mobile so I might be able to resume more regular blogging.

Because the truck I am currently driving does not have an operable radio (the head mechanic tells me he is ordering one) and because newspapers do not seem to be a readily available or even affordable and because of time constraints I have been in a near news blackout for the past few weeks but have caught up a little since returning home for a day or two.

The last time I blogged I addressed the continuing health care debate. I don’t want to say much more about that other than I now think President Obama would do well to just push through a package that would ensure that no one is not covered, and some might argue that such is already the case. I would not argue that, but the issue is so divisive, that I think he would do better to move on and work harder on the economy and resolving just what our strategy should be in Afghanistan.

And I now read that so-called conservative columnist and TV pundit George Will has come out against our continued involvement in Afghanistan (I read his column). Could this be the equivalent of the Walter Cronkite moment in Vietnam? When Uncle Walter went there and suggested it was hopeless that seemed to doom the whole project.

Will uses big and often obscure words and phrases and analogies and seems a little more intellectual than your down-home ordinary reactionary type conservative and not quite as devious as your ordinary neocon who uses his or her education to excite and stir up the more ignorant or not so informed masses, but he is conservative and his position could give the right the tools or ammunition to back out of what might be a losing proposition. And wouldn’t it be weird if the right turned out to be anti-war and the left pro.

Actually, I think that in mainstream or at least Main Street America, except for those who have family members directly involved, the attitude is more one of indifference to the war, except that it is assumed that you either support Team America or you don’t.

And personally, even though I think our wars since WW II, the big one, wrapped up a few years before I was born, have been folly, I do think that if the nation decides to go to war (and we have) then the only object can be to win, and winning means complete defeat of the enemy and unfortunately at least temporary occupation of the conquered lands. If we cannot or do not want to do that, then we should not be engaging in war.

And then the issue of the Obama back-to-school speech where many parents reportedly want to forbid their children from listening and many schools are going along. So we are teaching our children to only listen to things you or your parents agree with. So much for democracy, critical thinking and open debate. And besides, it is my understanding that the president was only going to urge children to study hard and get good grades. And I guess originally he was going to ask the children what they could do to help him. And that seemed political. We need to protect our children from politics.

Sometimes I wonder how practical democracy for the masses is. Maybe that phrase I heard attributed to some college professor years ago was accurate: “the masses of asses”.

Health care reform under protest — I give up

I don’t know whether to be proud of all those citizens showing up at the town hall meetings, many to voice their protest over proposed health care laws, or whether to be disgusted with all the demagoguery going on, such as that from those Republican lawmakers who voted for a provision in 2003 they now claim to be against and further claim is a measure promoting euthanasia.

I know there is legitimate concern over proposed revisions to our health care laws but there is so much lying on all sides concerned that it is depressing.

Facing my own health care insurance problems, I feel nearly helpless and hopeless – although not quite.

But I know I am not in a unique position, and that only further confuses me. Surely so many others must be facing the bewildering position of being between insurances and knowing that if you let one lapse a new plan may not accept pre-existing conditions. I might be going on Medicare if due to my medical condition (cancer) I cannot work, but that would put me into poverty,that is not being able to work,  but without help I can’t possibly pay private insurance on my own. And reading over all of the terms and restrictions of private insurance is bewildering. One would have to be the proverbial Philadelphia lawyer to understand it all, and even that would not help, unless one specialized in health care law.

While I fully appreciate anyone taking part in the protests if they know what they are talking about or at least have legitimate concerns based on some semblance of fact, I have nothing but contempt for the know-nothings who simply spout off FOX News or right-wing Republican talking (propaganda) points.

And I am not afraid to say something else about all of this: there is a lot of greed among the health care providers, to include doctors, and insurance companies.

It’s hard for me to criticize doctors because I have needed them so much and I know that taken as a group they do so much good for society and I know that to be a good doctor is a rare enough skill and talent that it has to be or should be well rewarded. But it also seems to me that doctors are the ones who could do more than most to help straighten out the health care crisis. But the doctors whom I have spoken with seem to feel they are too busy and someone else needs to handle reform and that in so doing whatever way it comes out they have to be compensated at the level to which they are accustomed. I have not had long and detailed discussions with doctors, but I have mentioned my concerns. And although they indicate concern and sympathy they also convey the attitude that they must be rather well compensated otherwise it is just not doable or worth the bother.

As to the issue of abuse in malpractice litigation adding to high medical costs, while I am sure there needs to be reform there, I imagine it is more of a red herring used by opponets of health care reform who prefer the status quo.

But at some point on an individual basis one has to face reality and go along with the program, such as it is.

And one more thing: I think a vast majority of the public wants FREE health care or at least health care that seems free, such as employer-provided. They do not want to think that they have to pay for it and they for sure do not want to be taxed for it. A big concern among many – and perhaps somewhat legitimate – is that their tax dollars will go to health care for others and not themselves.

It is true, I believe, that there is a class of people in our society who take public assistance for granted. They along with greedy drug companies and others in the health care industry are adding to the poison in the atmosphere against health care reform. Many are concerned that too much government involvement will throw us all into the government free clinic zoo. Many working people work simply to not have to live in that nether world of the “sick”, “lame” and lazy. They fear that Obamacare (and actually there is no identifiable program) would throw them into the community clinic.

And there most likely would have to be some type of health care rationing under a government program — how else to control the costs? There already is rationing in the private system anyway — it’s called cost, availability, exclusions and so on.

While President Obama may believe what he says, that he does not want to take away anyone’s insurance, I have to admit it does seem that a so-called government option would overpower what the marketplace could offer and would offer employers a way out of providing for their employees. And actually employer provided insurance is probably where we went wrong in the first place. When it really was free (to the patient) the medical community had a bonanza, they could and did, and heck, still do, charge anything they want. And they want a lot.

I give up already – I’ll go along with the program to the extent I can.

Health care reform: Probably best to cover those who can’t get insurance on their own and leave it at that…

Since people who have no health insurance crowd emergency rooms putting a tremendous burden on the health care system and upping the costs for those who do have health insurance and pay premiums, I am not at all against the idea that  everyone should be required to have some type of insurance plan.

Right here in the city of my residence, the Catholic-run, non-profit hospital is in hot water, being accused of “patient dumping”. The authorities claim that patients come to the emergency room and suffer long waits, many hours, and often leave on their own before being called. And they also allege that even patients that are seen are released without proper treatment.

It is not generally known what is really happening or why it is happening, other than the emergency room is extremely crowded most of the time.

One factor in all of this, though, is that the cross-town private-for-profit hospital has been taken over by an outfit run by a doctor who runs other hospitals and whose modus operandi is to cancel existing insurance contracts with the come-on to patients that the hospital will nonetheless accept insurance and waive the deductibles. Problem is, the hospital will also go after the patients for that part over and above what the insurance companies have agreed to pay.

Blue Cross has told its customers not to do business with that hospital. That may have sent a lot of people to the other hospital. But I suspect the overcrowding is really from those with no insurance. Many of them have probably got the impression that the private hospital is not the place to go. For that hospital also fired virtually all of its nurses, busted the nurses’ union, and then hired back some nurses. It was the ones hired back that voted the union out. They apparently decided they needed work more than a union.

But I got off the track a little here, as I am wont to do. This using the emergency room as the all-purpose clinic because you have no insurance and can’t see a regular doctor or go to one of those private clinics that have sprouted up all over is out of hand.

Having had to use the emergency rooms at both local hospitals in the recent past due to a bout of uncontrolled bleeding and other symptoms as the result of cancer, I have seen the emergency room zoo. People use them for everything from ingrown toenails to serious injury. Okay, I don’t exactly recall anyone being there with an ingrown toenail (although I don’t discount the possibility at all), but it was obvious that people who had normal discomfort from having the common cold or some other malady freely used the emergency room when many others would have just stayed in bed and maybe made an appointment with the family doctor.

And using emergency room doctors who don’t have a good handle on your personal medical history is dangerous. I fell into that situation on one visit because it was over the holidays and my own doctors were not available. Later when they saw me they shook their heads at what the emergency room doctor did and said he prescribed the wrong medicine (I’m not talking malpractice here – just confusion).

And now to President Barack Obama’s health care proposals. I really have lost track of it all and have had a hard time thinking about it because I have gone back out on the road on an eighteen wheeler and have been kind of busy. And yet I have heard about it out there. It seems that all the truck stops are partial to FOX News, which spews out anti-Obama propaganda 24-7.

As much as a political junkie as I am, out on the road I refrain from political talk for the most part because the crowd I am around always seem to be right-wing reactionary, even though many of them probably do not know or even care what the terms “right wing” and “reactionary” signify.

I have blogged on the subject of health care reform many times, but without getting into the nuts and bolts of the whole thing again, I maintain that the problem in this issue is that it is too confusing and I also fear that Obama and other proponents of reform have taken on too much.

Personally, while I do not prefer the term “socialized medicine”, I would not at all be against some form of government-sponsored health care, such as used by other industrialized nations. But this is America, and we do things differently here. We have developed a system in which many are covered through their employers by private insurance and many who do not or cannot work are covered by some type of government insurance. The major problem we are facing is cost. At one time, many (not all) employers paid the whole premium for health insurance (in fact my last employer did). But health insurance has become so expensive that employees have had to take on a major share of the cost, even when their wages do not go up. Some employers have dropped insurance altogether or have put people on less than full time, taking them off of insurance coverage. And of course hundreds of thousands of workers have lost their jobs and the insurance that went along with it.

And please don’t think that just because you are out of work and can’t afford health insurance that you can automatically get on a government plan. There are waiting periods and income restrictions – if you were prudent enough to save money or make investments, you are penalized.

I have read of angry mobs or at least belligerent audiences Democratic proponents of health care reform have faced in town hall meetings (even death threats). We all know that Republican operatives are spreading rumors, such as old people will be forced into assisted suicide, and putting people up to crashing the meetings. I suspect, though, that many people are truly concerned and puzzled as to what their government has in mind.

I think Obama has made the same mistake as Hillary Clinton did back in the 90s. Both made things too complicated.

I guess I have a simple solution for most everything, but even though I have blogged this before, I continue to maintain this:

It is every individual’s responsibility to pay his or her share of the costs of medical care. Therefore everyone should have some type of insurance. But for those who truly cannot afford it, either due to disability or job loss, there should be a government-sponsored plan.

The figure on the uninsured that I always here is something under 50 million. This nation has a population of something to the tune of 306 million. Many of those classified as uninsured are eligible for insurance but have not taken it out and many are illegal aliens.

If Obama had just sought to cover those who could not get insurance any other way and left everyone else alone, he could have moved onto other matters, such as improving the economy, not saddling it with more massive debt, such as the trillion dollars (over a decade) his reform package is said to cost.

I also know from my own personal experience it is helpful to have the resources of family. Not everyone has that available, though.

But we all do have a responsibility to ourselves and our loved ones.

Although many of our government policies are socialist in nature, we are not a socialist nation. Yes it is ironic that the most vocal critics of “socialized medicine” would not think of letting you monkey with their “Social Security”, but that’s the United States of America. We have a unique perspective on things.

Hard to support a health care plan that is a “work in progress”…

Seems to me all this polling about how many voters support health care reform and how many don’t is skewed in that there is no coherent or identifiable plan out there.

I guess that’s called “transparency” ; you can see through it all because it’s not there.

Health and Human Services Secretary Kathleen Selbelius just said in a short interview on FOX News that there is no “it” (meaning plan), that it is a “work in progress”.

Kind of hard to answer the question whether you support a plan that is still in progress.

Nonetheless Fox glibly reads off the numbers – 50 percent approve of the Democrats’ or president’s plan and 40 disapprove (I guess 10 percent have no opinion – wise people since there is no one plan to have an opinion on). And maybe I got the numbers reversed, because in double checking what I thought I heard,  I found that on the Gallup Poll site for today it says 50 percent of those polled dissapprove of the president’s handling of the health care issue and 44 percent approve. And I suppose if you do not even know any details, you probably would be forced to be dubious of the whole thing.

I like how FOX News likes to play the devil’s advocate with its chums on the right. When a Republican congressman was lambasting the liberal Democrats for bloating the budget, the FOX host pretended to corner him by asking: “where were you when Bush passed all those spending bills and ran up the deficit?” (okay, not really the exact quote, but a good paraphrase).

I fell for it. I thought “ah hah!, got you there Mr. Two Face”. But the seemingly hard question was just a set up. The congressman answered that he voted no all the time and warned Bush that he was running up the deficit. Well some Republicans must have voted yes, especially for those many years that Bush had the majority in both houses.

(Despite its tag line, FOX is neither fair nor balanced in its coverage, but it is entertaining at times and it does in a way serve as a check on, say, CNN or MSNBC, but while the latter may at times seem to lean one way, the former is just one way. The problem is most of the news on cable is mixed with opinion, so you seldom if ever get the straight story.) 

Not much of a segue here – but even though some think partisan politics is a bad thing, at least if practiced correctly it might get something done. I thought the purpose of political parties was to form ideas around a set of beliefs and coalesce everything into proposed legislation.

But in American politics with our separation of powers, particularly between the legislative branch and the executive, and our emphasis on individual candidates and personalities and the power of special interests (via lobbyists and their money donations), parties are not effective as they are in nations that have a parliamentary form of government.

And that is why President Obama is apparently having such a hard time passing health care reform legislation. Even though he has a super majority in the congress, not everyone in his party is behind him and to make matters worse he does not even have his own plan that can be identified and studied.

I almost think he would have had a better chance of just pushing his own plan and calling it “socialized medicine” and proclaiming that it is the only way to guarantee health coverage to all and at the same time get a handle on costs.

Social Security is a sacred cow, so why couldn’t he just call it Social Health Security?

And now I hear one pundit say something to the effect that if we try to cover everyone the doctors will not be able to handle it so therefore we will have rationing. So I take it that he would prefer we not offer health care to everyone. (ADD 1: I realize now that was the creepy, but ever political insightful, Dick Morris.)

President Obama seems to be on the ropes with his health care reform initiative, but for all I know he knows what he is doing and will prevail. But from what I can gather it seems more likely that some type of Band Aid measure may make it through and although it will not really help, Obama will be forced to declare victory and move on.

I just happened to be listening to cable news gabbing when I should have been doing something more productive and felt compelled to get some observations down.

P.s.

I heard more on this current story of a woman in Canada who said through the government health care there she was put on hold for a life-saving procedure and wound up coming to the United States. She had to mortgage her house, I understand, but at least she got treated. She said that after getting some info from the U.S. she tried to go back to Canada on the U.S. doctors’ advice to get what she needed done via the system there because it would be cheaper. But she still ran into a brick wall there and got her procedure done in the U.S. after all. She also claimed that Canadians often do not admit that they get a lot of health care in the U.S. while claiming they have such a good health care system at home. I personally have no idea if this is all true or whether she is leaving something out. The bottom line is if you have the money, you can get medical care somewhere. The problem is so many of us do not have the fortune required to get medical care that we need. Sometimes I think not enough is said as to why medical care costs so much. I understand the cost of advanced technology and the fact that professionals will always demand high remuneration and the cost of research for drugs. Even so, are there not limits?

Health care: entrenched system hangs tough against change…

Soaking the rich for universal health care won’t fly. And it should not. Taxing existing health care plans via the employer deduction or through the employees’ individual income is counter productive and unfair, and borrowing more dollars from China is not wise, to say the least.

I’m not sure where that leaves things. But it seems that the cost of health care needs to be a shared thing, not left on the shoulders of just one group, because for one thing they will resist and for another they will get out of it, and soaking the rich is not really right anyway. If health care is to be provided universally then it should be paid for that way. Of course not everyone has equal means to pay.

And I should note here that there is a practical question as to whether there can be a system in which everyone gets identical care, that is everyone has the same level of care available. I personally have always assumed that those with means are going to have an advantage. They can pay cash and/or have better, more expensive, health plans.

And how much is too much to pay for health care? When it comes to your own life or that of a loved one, you can’t come to that ultimate figure, except by what you have available or can raise. But what if someone else is in dire need but has to get help from you through your taxes? As big a heart as you may or may not have, that is where one is liable to think a little more rationally (and ration, as in rationing, is part of that word).

This question becomes especially troublesome when we are only prolonging life for a limited amount of time.

And here’s a problem on a personal level. I’m weighing my options (if I have any) as to whether I can go back to work after being out on disability with cancer (that is not cured and cannot be). My COBRA plan (the federally-mandated program that allows one to keep group health insurance from a job by paying the full premium) is due to run out three or four months before I would be eligible for Medicare. I can extend my insurance beyond COBRA but it will not cover as much and it will cost more, my insurance carrier has told me (what a deal offered by private enterprise).

If I am able to go back to work, I can have a company-sponsored plan (not entirely free for me as in my last job that is no longer available) that will cost me less, but will my employer continue to offer the now tax deducible plan if my employer would have to pay taxes on it as some are proposing? Not likely, especially in this bad business climate. Will the government cover me then? And what hoops and how much waiting is involved in getting on a government plan? It’s two years for Medicare. Taxing health plans as one current Democratic plan seems to be calling for contradicts President Barack Obama’s campaign promise not to mess with anyone’s existing insurance plan while offering some type of government option.

I keep thinking that the point of this whole thing has to be availability and then cost, which sometimes amount to the same thing.

As much as I distrust and even resent at times the health care industry, I think messing up the current system where the majority of people have private or so-called group plans through their work is not the way to provide universal care, if for no other reason than the offering of a universally available plan from the government would probably wipe out private plans, especially if the government plan was free or at a much-reduced price to the consumer, even if it was more bureaucratic and not as good as private coverage (and I don’t mean private coverage is not bureaucratic – it is). Employers are not likely to offer health plans if they know everyone can be covered by the government.

The way to provide universal care – and here I go again – is to cover people who are not able (not just don’t want to bother) to buy their own insurance. While I would not be against in concept, say, a single-payer, government health care system, that seems unlikely when a different system is so entrenched and accepted by the majority.

Yes, Medicare is said to being going broke. But, it would seem the most cost effective and quickest way to extend coverage would be through Medicare, a system already in place.

And now we are being bombarded with the story that people in Canada, Great Britain, and Sweden and other places that have what is often called “socialized medicine” (provided through the government) have to wait for critical care or procedures for months or years or are flat out denied and sometimes resort to going to the U.S. to get care. That’s interesting. You still have to have the money to pay and if you have the money to pay, what’s the problem? The whole problem is people cannot afford medical care without health plans and health plans, whether they be privately run or run by the government, have to have some means of cost control or they would go broke. Waiting can be part of that cost control, as well as outright denial. I am not sure why just because some other country might have a plan that is not consumer friendly why the U.S. cannot improve upon that plan, but still offer universal coverage.

Medicare needs to be improved, to include offering broader coverage (vision, dental), and it needs more funding. Of course that will put a larger strain on the budget. But doing any improvement will necessitate spending more money. Improving an existing and quite workable program would seem to offer the most cost effective solution. 

We face two major needs: one is for everyone to be secure that he or she has health coverage. The other is for everyone to realize that he or she has a responsibility to help fund that coverage to his or her ability. As it is now, we who pay for health insurance share in the cost of health care for all in that we pay higher premiums to help medical providers help defray their mandated care of the indigent and others who do not pay and we are taxed for Medicare and the other public health programs. We need a simpler and more efficient and more equitable way to do all of this.

It’s estimated that current legislation on health care change going through congress could cost $1 trillion over a decade. Strange that it matches with the projected cost of the Iraq War. That war has been rightly called, I think, a war of choice. One wonders why the health of our citizenry was not considered the better choice. Our health care system is pricing people out of the market and people are losing coverage each day due to the current economic catastrophe. It’s estimated that as many as 14,000 people a day lose their insurance due to job cuts (from and article out of the Wall Street Journal online).

An oft cited figure for the uninsured is about 50,000, but a significant part of that is young people who earn enough money but don’t want to pay for insurance, figuring, I guess, that they are healthy. So when something bad happens the rest of us have to pay. We also pay for people who are in this country illegally. One study estimated that insurance ratepayers fork over some $1,000 extra per year to cover the expenses of the uninsured (from an article in the Wall Street Journal online).

Stories like the one I heard today on CNN do not help support the public option. It was revealed that Medicare pays at least one private company a thousand dollars to rent a wheel chair for a year when the same model can be bought for $300 or less from that same private company. That’s because when congress made the deal it was lobbied by the industry on price schedules and bidding procedures. So the same private industry that rails against public health care realizes when it is inevitable and profits from it.

I appreciate the president’s even handedness and willingness to negotiate, but sometimes leadership calls for putting together a workable plan and not letting it be diluted or emasculated by allowing the opposition (which likes the status quo) to get its hands on it, and then sticking to your guns to support your own plan (you have to have your own plan too).

One problem in all of this is that no one seems to identify exactly what the proposed plans supposedly being debated in congress would look like. And most people, quite understandably, do not want to lose what they have if they have it. Another problem that I see is that the president does not seem to offer an identifiable plan, other than in broad generalities, and his own party, the Democrats, have various plans afloat. The Republicans, as far as I can tell, are mostly pretending to be concerned or to want health care reform, but are primarily interested in carrying the water for the health insurance industry (to be fair, sadly many Democrats seem to be in the pocket of the health care industry lobbyists too).

Health care is such big business. There is so much money to be made. It is hard to fight the establishment, even for the yes we can man.

P.s.

Have you noticed that the Harry and Louise ads on health care from the 90s are back but this time that concerned upper middle class couple wants change? (Things have deteriorated somewhat in their formerly protected world, apparently.)