It seems that lawmakers and perhaps large numbers of voters who chose Barack Obama are getting cold feet about the cost of health care reform (a trillion dollars, yikes! But then again, doesn’t the government just print money? Yes, I’m being sarcastic).
Maybe some are rethinking the issue, wondering if we should just not leave well enough alone.
Well to anyone who thinks the present health care system works just fine, I offer this localized version of what is going on (or part of what is going on).
Here where I live at the Northern end of California’s Sacramento Valley we have two major hospitals in town. The biggest is a non-profit (and that has nothing to do with how much patients are charged – it’s still an arm and a leg and more) and a for-profit that changes ownership somewhat frequently, one that was in the national news some time back because two heart surgeons, with the blessing of the management at the time, made quite a business out of performing unneeded surgery. But that does not mean it is not a good hospital, necessarily. Both my wife and I have spent time there and had excellent care, even though there is really no way to make it enjoyable to be in a hospital.
Anyway, that for-profit hospital recently changed hands and is now run by a controversial doctor from Southern California. He began by firing virtually all of the nurses and other staff and allowing them to reapply for jobs. One of the nurses’ unions has been voted out. It couldn’t get anywhere with the new management, so apparently the nurses decided they would be better off fighting their own battles or at least keeping their jobs.
He also cancelled an insurance contract with Blue Cross. As I understand it (and I may not), the hospital says it will still honor Blue Cross and will in fact waive your deductible. I think the catch is that unlike when you have contracted insurance the hospital retains the right to go after you for the part insurance does not pay (beyond the expected deductible). Kind of a double-edged sword there. Blue Cross has advised its customers not to deal with that hospital.
As a result, apparently, the non-profit (Catholic, did I mention?) hospital has been inundated, especially in its emergency room.
Now in my local newspaper I read that the non-profit hospital is being investigated by the feds for what is called “patient dumping”, that is to say they may be releasing patients too soon or denying proper treatment because they lack insurance.
So it occurs to me that not only is the non-profit getting patients steered their way by the insurance company, but could be getting ones without insurance that the for-profit one does not want to handle (although that is not included in the current investigation by the feds as far as I know).
The story indicates that the non-profit was flooded with emergency room patients because of doubts created about the other hospital over the insurance hassle and the fact that Blue Cross sent letters to its customers telling them not to go there.
There is actually a question as to what specifically the non-profit hospital is under suspicion of doing since neither the authorities nor the hospital will say precisely, except for the feds indicating it has something to do with patient dumping.
What I am trying to point out is that private health insurance is not a panacea. The reason the for-profit hospital had a beef with the private insurance is that it does not pay them what they think they should get – and isn’t that the same beef the medical community has with public insurance – too low of payments? (And why do we patients not feel the hospitals are not getting enough money? They demand you buy everything from your pillow to the toothbrush you didn’t ask for at high retail – not even Walmart prices.)
And what is this I hear about public insurance will mean health care rationing? Probably it will, but that is already in place, both through private insurance and public insurance. Private insurance is quite picky over what it will pay for. A doctor may use his or her own best medical judgment with the concern for the patient uppermost in mind, but in the end it all has to be paid for and the insurance bureaucracy is who decides.
Doctors and hospitals have to hire whole staffs of people just to work with the private (and public) insurance bureaucracy – billions of dollars are spent each year not for patient care but instead in an effort to maximize profits for private insurance and for the medical providers to get as much out of the government programs as they can.
Some of the ways private insurance maximizes profits besides denying certain types of procedures include delaying payments by bureaucratically denying them only to later pay, but in the meantime getting more interest on they money they temporarily withhold from you. Also, you might give up and not get your entitled full claim due to the bureaucracy (and I am not making this up; I have personal experience with this routine). I’m sure there are many tricks, such as bureaucratically demanding certain codes be used and requiring forms in triplicate and so on.
I hear and read about public opinion both ways. The public is demanding health care reform and in fact supports a public option. I also hear that there is a strong resistance now in the congress to the cost of a public plan, and one has to assume that they (the congress) are at least in part reflecting the concern of their constituents.
I am holding to the opinion of my most recent blog on the subject, people who have private insurance are reluctant to put it into possible jeopardy by monkeying with the system (and I understand this).
It is often noted that every other industrialized nation in the world has universal, government-sponsored health care.
Okay, forget the rest of the world if we must. But I think that it is only right and it is only practical that all U.S. citizens should have basically equal access to health care. As for illegal aliens, it would seem we only owe them initial emergency care.
Since there does not seem to be overwhelming support, to say the least, for government universal care, then I think that the only thing we can do is say if you can afford (and who decides that, I don’t know) health insurance, you must buy it (because otherwise the taxpayer gets stuck with the bill in the emergency room where it all starts out, and caring for the uninsured also adds to the cost of private insurance). If you can’t afford it, you should have a publicly-supported option. And that public option could be one that is 100 percent taxpayer funded or one that is simply backed by the government but run by a non-profit co-op or even a quasi-private entity.
Forty seven to fifty million seems to be the oft-quoted figures for the number without health insurance. But as has been pointed out, especially by foes of universal care, that figure may be both inaccurate and misleading. A certain percentage of the total uninsured, as much as 10 percent I think I’ve heard, are illegal aliens, and a certain percentage are young people and others who simply can’t be bothered but run to the emergency room when something happens and demand their right to care on the taxpayer dime. And a certain percentage may actually be entitled to some form of public care and don’t realize it.
What we do know is that there are a sizable number of people, and a large percentage of them are children, who for whatever reason are denied health care.
How anyone in good conscience could be comfortable with that continuing is beyond me.
The reason we don’t have universal care (even the kind that has extreme flexibility, allowing the continuance of private insurance) is the lack of guts on the part of so many politicians. Politicians are often people who have apparently convinced themselves that they could not make their living any other way and therefore are scared to death that if they vote against vested interests in the status quo they will lose their job. They fear the money powers who can spread propaganda and deny them campaign funds if they don’t do their bidding.
I say to all the senators and representatives:
“Try voting your conscience for once.”
P.s.
The line now is that any type of public option on health care will run private insurance out of business. Yes, if everyone, to include employers, was offered essentially a free plan versus a paid one, it would. So any public option has to be tightly restricted by actual need, perhaps. And once we get there, I don’t see why we didn’t just expand Medicare.