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Wednesday, March 24, 2010

Dirty Deeds Done Dirt Cheap ("Health Care Bill")

Yeah, that's right, I said it. I am a woman who suffers from several chronic and, well, expensive disorders. In effect, my life is a preexisting condition. I am a registered Libertatrian, for whatever that may be worth to you, dear reader. I am a woman who has lived with a working socialized medicine program. Sorry Canada, but it really can be done. And I was, for a good long while, on the side of the folks attempting to pass some form of health insurance reform in this country.

Why? Because I am privileged in being a graduate student and being forced to pay high premiums for "coverage" that takes my drug bill from nearly $3000/month to just over $150/month. Of course, the fact that my monthly earnings put me a few hundred dollars over the poverty line is pertinent to that math as well. And yet I am very aware of my privilege. I have an education (and almost a PhD), I have life experience many may not ever have the chance to get, and best, I have doctos who care, listen to me, and even when I don't fully agree with their opinions, work with me to make my life livable.

And yet...

I am very aware of the people in this country who don't have these things. I am very aware of the people who die from minor illnesses we have the technology to cure or care for. And I'm aware, on the more fiscally conservative side of my brain of the actual monetary cost of caring for these people as we currently do--via emergency rooms and urgent care centers. Worse, we not only end up paying more for their care than necessary because we force them to wait for acute situations or go to Urgent Care with minor illnesses, we create the situation in which we find many people easily and even cheaply becoming addicted to prescription drugs by depending on UC centers and finding the many available ones so overloaded that they do not have time to worry about much less deal effectively with drug-seeking behavior.

Meanwhile, people with "health insurance" go to the ER with an acute case and then get a statement for "their share" of the bill. Let me tell you about how this played out in one case I am intimately familiar with: a friend went to the ER. When he received his bill, he went over it carefully; something most people don't bother doing. What he found was an inexplicable difference between his costs, the total bill, and the amount the hospital had received. He called to find out why.

As it turns out, he was told that the hospital has a contract with the insurance company through which they can write off the majority of the bill as a loss and the insurance company pays only a minor fraction. In fact, the "insurance company" paid $41. No, there are no missing zeros there. He paid well over $500. The hospital got to write off (read tax break) about $10,000.

Imagine that. I teach writing and work as a freelance editor. This is the equivalent of my charging a client $1,000 per page, but having a contract with said client that allows her to pay me only $5 per page, after which I write off the difference as a loss on my tax statement.

If I did that, I'd be in jail. The IRS would slam me down for tax fraud faster than I could write the receipt. But, then, I'm not an insurance company. If I were, apparently I could commit insurance AND tax fraud and no one would even blink twice at the act.

So, yeah. I thought health care reform was necessary. I don't, however, think the bill that was passed can, in any manner, be considered productive reform. All the new bill does is bring more people into the fraud fold--it opens the market for hospitals to make money off tax losses and insurance companies to make money off insurance fraud at a greater level.

Worse, in the name of "political progress" the party of "change" actively considered passing the bill in a "deem and pass" move which would create deniability. Why? Because they are very well aware that they are not fixing anything. Why? Because none of the Republican ideas would have fixed anything either. In fact, the process has been on the wrong path for decades and will continue to be so until we are prepared to face the real effects and real outcomes of the system we currently have.

Here's what they did instead: They gave themselves 15 minutes to vote. According to CNN, this was so that if they hit the magic number of 216, those democrats who needed deniability for their homebase, could simply not vote. We now openly admit that our system is so messed up that we have to wheedle our way into the legislation that messes it up further. I don't know if that's progress or congress.

Health insurance in this country is neither health nor insurance. Insurance is a system in which one pays into a massive fund against major losses in case of catasrophe, not a system in which people pay into a massive fund so that they can then pay a copay and have their insurance give their doctors a write off opportunity.

With the current system, not insurance, we also have "not health." Why? Because doctors get awarded (monetarily) for performing unnecessary exams (and often in that rush fail to perform necessary ones). Why? Because in order to make money, doctors must see 40-60 patients daily, meaning that they neither spend enough time to give good care, nor have enough mental capacity to pay individual attention to each patient's needs. It's simple: even a doctor's brain is not capable of that kind of multi-tasking.

"Health reform" as it has been enacted is a dirty deed. Deem and Pass (I heard Demon Pass for a while and find it far more appropriate a term), is how one does this dirt cheap. To avoid that label, take as much time to pass as is necessary for Dems facing tough races is, well, just as dirt cheap; it just looks prettier.

Make no mistake: I think the Republican party would have made a greater mess of things had they bothered to fully participate instead of just adding an amendment here and an amendment there.

So what now?

I am quite used to the fact that I will not get what I want and the system will not be fully fixed, but I am also always happy to share what I think are good suggestions. Maybe, if we start talking about this, really talking about this, we can begin.

Here's a way to start looking at things differently: How American Medicine Killed My Father may sound like a whiny "why me" kind of article, but it isn't. It's a real, economically sound, and workable plan.

Discuss.

33 comments:

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趙佳治 said...

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Poverty tries friends.................................................................

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