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?


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.

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