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Killing for Profit: The GOP's Attack on the Health Care Plan [Feb. 6th, 2011|01:56 am]
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Last week another uninsured person died because she could not afford health care.  Melissa Mia Hall, a Texas writer, died of an undiagnosed heart attack.   Why undiagnosed?  Because she didn't go to the doctor.  Why didn't she go to the doctor?  Because she knew she could not afford the fee of either a doctor visit or a trip to the ER.   Going into debt for medical bills could lead to the loss of her home.   I'm sure the GOP thinks this is fine: she's dead; she's not costing taxpayers anything.  

She is not the first.   She will not be the last.   I have another writer friend whose health is bad, who is disabled, now unemployable, uninsured except by Medicaid.  The Texas legislature has chosen to cut education and social services funding--including state funding for Medicaid.   She cannot afford the health care she needs.   She will not get the health care she needs.   When she dies, it will be largely due to lack of medical care.  (But after all, she's an adult woman--the least important group according to the GOP, who thinks the only lives worth making a fuss about are unborn and if women die giving birth, that's just fine.) 

I have dear friends whose grandson has CHARGE syndrome.   The child's parents both have good-paying jobs with good insurance, but even so the grandfather spends several nights a week as the night-nurse for the child (so the parents can work--they do need sleep if they're going to work all day, right?)  because he must be suctioned several times a night.  And the cost of the professional nurse--who must be a pediatric-ICU nurse to be familiar with a 2 yo-size tracheostomy, feeding tube,  IV lines, etc--is huge on top of the copays for doctor visits, hospital visits and the necessary surgeries, and needed therapies that aren't covered.   Last night his grandfather was on duty again--and spotted a sudden fever spike--so D- went in the hospital today.   What will happen when his grandfather is sick...or dies?   One night without nursing care and this kid could--probably would--die when his trach stopped up.  Oh, well, this isn't an unborn child...this is a live child, fighting for a more normal life, so...I suppose the GOP would shrug off his death as the parents' problem.  They should have managed to be born multi-millionaires.

When my husband lost his job in early 2001 (along with so many others)  we lost the health insurance he'd had.  The umbrella policy we carried (a $20,000 deductible) had risen over the years from $2500/year to $6000...then quickly went to $9000.   We could not afford that.  We went bare.  We got our flu shots at grocery store clinics.   We bet on our basic good health...but knew that if one of us had a serious accident or got cancer or had a heart attack, we'd have to choose between no-treatment (and the possibility of death) and the loss of our home after we'd eaten up our retirement savings.  That's not a choice anyone should have to make (except Congresspersons voting against comprehensive health care: they should certainly be faced with the same choices as the rest of us.)  Last year, when we became eligible for Medicare, we found that he had developed both high blood pressure (funny thing, stress...) and a chronic progressive condition, myasthenia gravis.  Neither was new.  We'd known something was wrong, but...we didn't go.  

You sometimes hear a GOP official proclaim that the US has the best health care in the world.  That's a lie.  Our rank in the metrics that matter--life span, maternal and infant mortality, maternal and infant morbidity, for instance,  have dropped steadily relative to the rest of the world; we are below average in important measures of health and access to health care.   No other first-world country does as badly.   Many so-called second-world countries don't do as badly.  

Why is the GOP lying about the real cost of health care?   Why are they scaring people with lies about "socialist medicine" and "death panels" and "rationing health care" and "government taking away your choices?"   Why is the GOP pushing to privatize the existing government programs (except of course their own--so far Congress is unwilling to give up its cushy taxpayer-paid health care.)   There's a simple answer.  They're doing it for profit.  For their profit.  Because a one-payer system that insured everyone--that would let someone like Melissa Mia Hall see a doctor without risking losing her home or ruining her credit rating--that would not have family after family using up their retirement savings to pay bills for the aftermath of an automobile accident, any serious illness, a chronic condition, a child's disability--would not bring them the millions of dollars the for-profit insurance industry pours into the campaign chests of those politicians who  dance to their piping...in other words, they're bought.   They're willing to see people like Melissa, and my other friend, and yet other friends, die...because it is expedient that the poor, those who cannot afford  to pay the inflated costs caused by the insurance industry, should die and get out of the way.

The truth is that medical care in this country is rationed now: by insurance companies that make a profit by raising premiums and cutting "allowed services, "  by excluding individuals considered high risk and pre-existing conditions.   I know of a young woman who could not get insurance at all because she had been in a bad car wreck (hers was hit by a drunk driver) and the insurance companies considered her too high a risk--uninsurable.  That's rationing.   As the parent of a disabled child (now a young man)  who has been online and in parent support groups for years,  I know that insurance companies decide--on the basis of their profits, not a child's needs--what will be paid for and what not.   So many hours of therapy a year, so many visits to the doctor,  so many changes of orthotics and prosthetics (never mind how fast the child grows) and soon (because disabled children have needs that go beyond company profits) the family uses up a lifetime's "allowables"...and of course can't get insurance anywhere else because of a pre-existing condition.  

Choice is taken away
, by insurance companies that limit the physicians their customers can visit, the hospitals where they can be treated, the medications those physicians can prescribe.   Choice is taken away from both the sick and injured--who can't choose the physicians they want, the hospitals they're closest to, the medication that works--and from the doctors who know their patients can't afford to defy the insurance companies--nor can they.   The insurance companies do not care if discharging patients from the hospital too soon leads to complications and death later...and it does.   When I worked in a small rural clinic, I personally saw several cases of required early discharge that led to complications.   With any luck, that emergency will require an out-of-network visit which they won't have to reimburse.  The insurance companies do not care if the only medication they approve for a condition is one that makes some patients sicker. For-profit companies care only about profit--it's what they learned in business school--and they can afford whole law-firms full of lawyers to deal with anyone brash enough to sue them.  (They don't even have to pay for malpractice insurance, as doctors do...because although they have panels of nurses looking for reasons to refuse reimbursement and second-guess doctors, they're not officially practicing medicine, so nothing is their fault.) 

People are dying now--and more will die--to line the pockets of for-profit health insurance companies and the politicians who do their bidding.   One death--Melissa Mia Hall's death for instance--is too many.   I don't want to grieve over any more.

I love someone who is sick but has no health insurance. I support health insurance reform, and I vote!


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[User Picture]From: blackbyrd2
2011-02-06 10:51 am (UTC)
Last year I had 3 stents put in. March.
The bill was 40k. I am paying just under 500 a month for the next five years to finish paying it off.
My meds, which I'll be taking for the rest of my life, run me around $400 a month.
I wonder now, if I could get insurance (doubtful), if I could even afford it. Last time I checked, rates for people my age without a group plan, and without a pre-existing condition, were around 500-600 a month. (I couldn't afford that then, though in retrospect, of course, I should have eaten ramen for another decade or so, and sprung for the insurance.) I'm not even sure it would save me any money on the prescriptions, and a $5k yearly deductible means another almost 500 a month before it even helps much.

That works out to somewhere under 2k a month, with some savings possible. I might get off for a mere 1500. I'm fortunate. It wasn't that long ago that my monthly net pay was not much more than that. I'm doing a little better these days, but still just treading water now.

Gee, it's a good thing that, having had the stents put in, I'm unlikely to ever have any future heart issues, eh? Oh wait.

For an actually relevant comment, hospitals and insurance companies are why things are so expensive, IMO. The hospital bills the insurance company at outrageous rates, the insurance companies pass it all on to their customers, and everybody wins. Except the patient. And yes, insurance companies set rates that they won't exceed. Those rates are based on average costs, which are inflated by the hospitals to make up for the capped rates the insurance company will allow them to charge. And half the doctors, IMO, don't think this is heinous because in most cases, it's the insurance companies paying the bills. They just don't think about how those costs get passed on. That's why the following is so common;

The one thing I have found to be true is that, as a cash customer, I can almost always get at least a 20% discount. Some places it's double that. That doesn't seem like much until you think about a $40,000 bill, where you could shave off $8,000 or more, if only you had that much cash just sitting around. (You can do this too. Just ask. It's so common they often suggest it without being asked.)

Also, shop around. Basic blood test (lipid / liver profile) varied between just two labs from $68.00 to $180.00 Frankly, the cheaper lab has better techs. They only poked one hole in me, instead of half a dozen.

Of course, if you go to the hospital it isn't going to help anyway. Prices are so inflated it is disgusting. Not counting food, a saline IV or meds,(all billed separately,) I paid $1500 for the bed, in a room which I shared with some other person. You may say that the price is so that, in an emergency, they'll be right there to take care of me. It's true I'd be closer and response would be quicker, but don't think they wouldn't charge another 20-50k if I actually needed that assistance. I mean, they charged me $1500 for 'supplies' in the cardiac room, which consisted of bed linens, maybe the catheter, and some bandages. Oh and rubber gloves and paper masks. (There's no actual surgery with stents. They just poke a hole in your leg.)

Meh. I'm just bitching becuase it shouldn't cost so much. On the Turner movie channel, you occasionally see old clips of people like Gregory Peck doing a public service announcement for the Will Rogers Hospital, which was a non-profit, and required donations to function. Nowadays, they're all publicly traded coprorations, and the important goal is the bottom line.
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From: deire
2011-02-06 04:51 pm (UTC)
Just curious. I have pernicious anemia and have been treating with megadose sublingual supplements--which, well, U.S. care. Do UK docs consider that to be inadequate compared to injections? I'm curious because I feel like I'm not getting enough with the megadoses.
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[User Picture]From: jwjohnson
2011-02-06 12:31 pm (UTC)
Why are you one of the few who get it? Whats wrong with people? We just dropped our insurance. It went up again and we couldn't see the point of paying so much for something that didn't pay a dime last year.
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[User Picture]From: e_moon60
2011-02-06 04:57 pm (UTC)
A lot of people get it but don't speak out. One thing Melissa's death did for the writing community is give us a focal point for speaking out, one person a lot of us knew. And in a community with communication skills and some contacts.
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[User Picture]From: kirylyn
2011-02-06 01:07 pm (UTC)
I thank all the gods above and below that I was actually working for a good company when I needed a kidney transplant (and it was before the recession)

if I was on just medicaid? I doubt they would ever "match". but hey, who cares if I would have to go to dialysis three times a week and be disability, that has to be cheaper than getting a new kidney, right??

Jackson Hospital in Miami may get blasted in places but all but one of the nurses *cared* and helped. Granted this was in 97, before the Bush years, I shudder how I'd fare these days.
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From: (Anonymous)
2011-02-06 02:09 pm (UTC)
Myasthenia gravis is a nice science-fictional ailment; it's what Waldo had in Heinlein's story of that name. I suspect this does not make the real thing any more pleasant to cope with, however.

I made the argument last week on a friend's blog that we have had health care rationing for years, conducted in secret by the insurance companies. And that what started the "death panels" rumor was Obama's attempt to bring the discussion of what treatments to fund into the light. I don't know if I'm getting through even to that one friend, though.
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[User Picture]From: dd_b
2011-02-06 02:10 pm (UTC)
Sorry, that was me above. I seem to have fallen off the login wagon somehow.
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[User Picture]From: frostfox
2011-02-06 02:13 pm (UTC)
Clearly and succinctly put.
I just can't understand why the bulk of the American population can't see this.

As another Brit, from a poor, working class background, both my parents lives were saved multiple times by the NHS, my father had his first stroke when I was 14, my mum had her first heart attack when I was 16, he died when I was 21 but I'm 47 now and Mum is still battling along at the ripe old age of 81. My life was saved by the NHS at birth (emergency cesarean) and several times since, just simple things like infections and impacted teeth and cat bites and it has always cost me nothing but the National Insurance and taxes I happily pay.
Serious illness is draining enough, the idea that you might also have to worry about paying for the care, horrifies me.

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[User Picture]From: e_moon60
2011-02-06 04:55 pm (UTC)
They can't see it because they've been lied to for the past fifty years, at least. As the song from South Pacific said about race, "...you've got to be carefully taught..." and the right-wing teachers have been steadily at work, consolidating control of the media. All over the country you can hear spit-flinging talk radio yowling about the horrors of "socialized medicine" and the "nanny state" and how people in other countries can't get the wonderful stuff we can get (the rich can get...) You can see them on television--Rush Limbaugh and the rest--spewing the party line. When and where can you see and hear the contrary? Mostly online. And it's online that we can find (if we know to look for it) people in Canada, NZ, the UK, elsewhere, who can tell us directly about their experiences.

Every system has its horror stories. (You guys let Wakefield go on far too long and now we've got the SOB over here, only fifty miles from me, still spewing his lies about immunizations and autism.) No system is perfect. But a "system" that lets a nation's health stats slide from #1 right down the scale...and that forces people to choose between death and homelessness...is a horror, period.
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[User Picture]From: e_moon60
2011-02-06 05:00 pm (UTC)
Thank you for responding. One of the problems here is that the right-wing control of so many media outlets means people here do not know what the medical situation is like in Canada or the UK or elsewhere that has a rational health care system. Your voice is needed. Our people have been fed a coal-train full of bull for decades...it's time for some truth and light.
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[User Picture]From: wouldyoueva
2011-02-06 02:56 pm (UTC)
At the time my husband, Jack Chalker, died, I was working as a contractor for Medicare. People point to the problems with Medicare but after working there, I am firmly convinced that if it were offered on the open market next to what's out there now, 90% of America would rush to buy it.

A little-known advantage of Medicare is it has a level of appeals a private insurer doesn't: your representative in Congress. Medicare does take seriously those who can control their funding.

Is it perfect? No, but every health insurer I know isn't perfect.

We need to get these stories into the national dialog, not just the horror stories but also the testimony from the Canadians and Brits about how a civilized situation works. I've had folks who were anti-government healthcare tell me, with sincere belief, that folks in Britain and Canada HATE their system. Perhaps there are some that do, but I doubt they're the overwhelming majority.

Finally, the cost issue. When I worked on that Medicare contract, I was employed by Lockheed Martin. Rather than negotiate insurance for all their employees, nation-wide, it was done contract by contract. Our contract, with many middle-aged engineers, had a heavy deductible. Every week I looked at my paycheck and looked at the deduction for Federal taxes--taxes that covered everything the Federal government does--and then looked at my health insurance deduction. The health insurance was always more than taxes. It seems for that kind of money, the insured could get much better care.
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[User Picture]From: mevennen
2011-02-06 03:22 pm (UTC)
We do not hate our system. Neither my right-wing nor my left-wing friends recognised the country (UK) described by American proponents of the private health care system. It bore no resemblance to the place in which I live, or the health care system that saved my partner's life. With a view to spreading the word about this, I've just put up a post about this on my own LJ.
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[User Picture]From: e_moon60
2011-02-09 03:42 am (UTC)
Sorry--the comments have come so fast and thick I apparently missed this. Yes, you may. Or link to it, either one.
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[User Picture]From: la_marquise_de_
2011-02-06 04:41 pm (UTC)
I hate the heartlessness of the US healthcare system, and I am perpetually baffled by the arguments that support it -- and the claims alongside the system that the US is a caring country. Letting someone die just to save money is barbaric.
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[User Picture]From: e_moon60
2011-02-06 04:45 pm (UTC)
Enough lies, spread widely and loudly enough, with a solid dose of fear-mongering, have convinced people that the pittance they get now is the best they could hope for. The right wing has been lying for decades, raising anxiety and fear for decades, and putting up faux emergencies to distract attention. By all means, get people het up about gay marriage and abortion and voter fraud and illegal immigration...and then tie those into the medical discussions, so you can blame the high cost of health care on Certain Segments and whip up more fear and confusion.

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From: deire
2011-02-06 04:44 pm (UTC)
Ah, but poor people are so much easier to control than educated people with options. I don't see this as incidental to their profit and control. I see this as integral to it.
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[User Picture]From: e_moon60
2011-02-06 04:47 pm (UTC)
That the strategy is aimed, at least in part, at turning the mass of citizenry into helpless serfs, I would agree.

But the poor are not the largest voting segment, and the lies are being targeted to the voters.

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[User Picture]From: starshipcat
2011-02-06 05:41 pm (UTC)
Part of the problem is that health care expenses don't follow a bell-curve pattern, where the bulk of the activity is clustered around the median and the outliers are relatively rare. Instead, they follow what's called a power-law pattern, in which a relatively small group of extreme cases consume the most resources.

There's a wonderful articles in a recent issue of the New Yorker called "The Hot-Spotters" which deals with a statistician's effort to improve health care by focusing efforts at keeping that small group of very sick people from getting sicker.

I found out about it from Cory Doctorow's blog Boing Boing, where I noticed that several posters got all exercised about how this sort of program is just ripe for abuse by goldbrickers who pretend to be sicker than they are in order to get gold-plated healthcare. No matter how many times other people tried to show that this is a very unlikely outcome, and the few problem people (hypochondriacs, Munchausen syndrome, etc) can probably be identified and moved into treatment for their real problems, these posters insisted no, no, no, this is a real problem we've got to prevent.

I think the real elephant in the middle of the living room that none of these posters wants to really address is the issue of deservingness. While some of the "hot-spotters" are people who would elicit the sympathy of anyone whose heart isn't made out of stone -- the little boy with CHARGE Syndrome you mentioned, or someone who's in a horrific auto accident that's not their fault -- a lot of the people who are described in the article have situations that hit a whole row of those "not deserving" buttons people have but which it's not politically correct to acknowledge. We're talking about people with major alcohol and substance abuse problems, perpetually indigent and homeless, who are often perceived as having screwed up their lives, so this kind of a program is perceived at some level as "coddling" them or "rewarding" them for their bad life choices. So we keep doling out just the minimum of reactive health care to keep them alive when they get so sick we can't ignore the problem, and then throw them straight back out to repeat the cycle, never mind that in the long run it costs far more to constantly deal with their problems instead of providing the support system that would enable them to get their problems under control.
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[User Picture]From: e_moon60
2011-02-09 03:22 am (UTC)
There certainly is mean-spiritedness involved in this, although I don't think it's the main cause of the problem. You don't find people arguing that we shouldn't build public roads because some people don't deserve to drive.
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[User Picture]From: lillian13
2011-02-06 06:31 pm (UTC)
Hon, if you need a doc and don't mind the drive, come see my brother. Single doctor practice and he works with people on payment.
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[User Picture]From: Alex Piper [fabulaurbanus.com]
2011-02-06 07:40 pm (UTC)
You're so right that many don't seem to understand this.

I had an argument a while ago with someone who said they didn't want public health care because it wasn't fair to make them pay for everyone else's treatment. I asked how they thought current private insurance worked, and they said they had issues with that, too, because it was unfair to people to pay in and then never have to have insurance cover anything. In fact, I was told, people should be able to /withdraw/ money they'd paid into insurance if they didn't need coverage.

Trying to understand this viewpoint, I asked if they meant people should just keep their own savings to pay for medical care. Of course not, I was told. Paying the entire cost of a hospital bill would be ridiculous, that's what you have insurance for! To pay the costs you can't!

So I asked him, if you've paid in $8000, and your hospital bill is $60,000... where does the other $52,000 come from? Well, the insurance companies have lots of money, don't they? That's what they're there for! Well, yes... but that money /comes from the people paying in/. If everyone can withdraw their money like it were a bank, there's no extra.

He couldn't come up with any answer to that, and so turned instead to fuming about how he already has to pay too much to various places in taxes and fees. :/
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[User Picture]From: mrs_redboots
2011-02-06 08:38 pm (UTC)
I live in the UK. My husband was 60 a few months ago; he was instantly contacted to undergo routine checkups for bowel cancer and other nasties (all clear, although his cholesterol is slightly raised), and he no longer has to pay for prescription medications or routine eye tests (we are not sure about dental treatment). I get called regularly for smear tests and mammograms, and we both get called for regular blood-pressure checks.

The NHS has its faults, definitely, but it's really good in emergencies and for routine maintenance. Where it is less good is for non-urgent conditions - but many people take out private medical insurance to be able to have (say) their hips replaced at a time of year that suits them. But for most people, most of the time, the NHS is great!
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