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One Child: Why We Must Protect Everyone's Health-care - MoonScape [entries|archive|friends|userinfo]

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One Child: Why We Must Protect Everyone's Health-care [Sep. 12th, 2012|12:05 pm]
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I rarely invite guest posts, but this is a special case...an individual case with national implications.   Please listen to Ellen McLean, who sent me and other family friends this email--which I thought needed much wider distribution.:


So Romney announces he'd keep parts of Obamacare like insuring those with pre-existing conditions with David Gregory on the Sunday morning show and then within hours he is "clarified" by one of his minions.

I am the grandmother of an absolutely adorable little boy named Daniel.  He has CHARGE syndrome which means he spent the first five months of his life in the Neonatal Intensive Care Unit.  He's had eleven operations and has maintained a mostly cheerful attitude the whole time.  He was born with a mess of "pre-existing conditions" including half formed semicircular canals in his ears (causes both deafness and lack of internal balance), breathing difficulties that necessitated a trach along with oxygen at night and various inhalent treatments morning and night.  He's fed thru a tube in his tummy from a backpack he can wear while moving about. 

Any messing with Obamacare is regarded by everyone in our family as a direct attack on this child.  He's already blown thru most insurance companies' lifetime limits.  He is a walking pre-existing condition and we are damned grateful he's learned to walk.  We want him to stay alive and I'm not about to let any politician claim how pro-life they are and cast a vote to hurt or kill Daniel.

Elizabeth here, adding to Ellen's original email.   Daniel's parents knew he would be disabled before he was born: CHARGE syndrome is detectable before birth.   They chose not to terminate the pregnancy, something Romney and the GOP claim is the only moral choice.  But now that Daniel is alive...Romney and the GOP--the Teabaggers, Rush Limbaugh, all the rest--have no interest in helping to keep Daniel alive and thriving.    Both Daniel's parents work at good jobs--something many parents don't have.  Both have insurance....but insurance has limits, as all parents of children with serious disabilities have found out.  To the insurance company, such families are a liability--they cost money and lower profits.  Children like Daniel exceed the limits before they ever reach school age. 

Romney--the The GOP would let them die--and blame the parents.  
Because although they'd force every woman to bear every child conceived in her body, they don't do a damn thing to help with the medical care, or education, or housing, or anything else...never mind if the parents can't get insurance because the child was born that way--never mind if the parents can't get a job, or can't afford the cost of treatment for the child.  They should have been rich. 

Daniel is just as human as he was in his mother's womb.   He didn't become non-human, and thus (as some Republicans have described fellow citizens not in the 1%)  an "animal."   He didn't become any less a human body, a human soul, just because he was born, and costs money.   Failure to cover pre-existing conditions like Daniel's...like my own mother's renal disease...like the aftermath of trauma from being hit by a drunk driver...means condemning real live people--living, breathing, growing, often working--to suffering and death. 

[User Picture]From: blueeowyn
2012-09-12 05:27 pm (UTC)
If you email me the picture, I can post it on my personal website and give you the URL to embed it in LJ.
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[User Picture]From: e_moon60
2012-09-12 05:37 pm (UTC)
I could upload it from here if LJ's uploading weren't screwed. There's a service notice that they're having trouble with uploads. I upload photos from my hard drive all the time (see those socks in the previous post?)

I'm going to post this also on my personal website, where I know the photo will upload just fine.
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[User Picture]From: e_moon60
2012-09-12 06:58 pm (UTC)
And I was able to link from the website photo, into the post itself. FINALLY. (There were complications. Aren't there always?)
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[User Picture]From: blueeowyn
2012-09-12 07:31 pm (UTC)
tagging stuff in html can be so nit-picky, glad you got it to work and a huge SNARL at Romney et al.
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[User Picture]From: la_marquise_de_
2012-09-12 05:39 pm (UTC)
I find the attitude of the Republicans -- and, over here in the UK, our own unloved Conservative party -- utterly heartless and thoroughly selfish. Very, very best wishes to Daniel and his family. He deserves care and help. Any person or party that thinks otherwise has something deeply, morally wrong with them.
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[User Picture]From: pickledginger
2012-09-12 05:54 pm (UTC)
Yes. (Of course, we knew that.)
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From: geekmerc
2012-09-12 06:13 pm (UTC)
I'm not completely sure I can blame the insurance companies and their limits. I'm not even sure if it is right to push insurance companies into situations that might produce a negative profit margin.

My larger concern is the overall healthcare picture. Why are medical bills so expensive? Do we have anti-competitive patents which inflate patented tests and medicine for specific medical issues? Do we have excessively high malpractice insurance prices causing an inflation in hospital and surgical care? Or is the cost of surgery and medicine fair? If the costs themselves are too high, would finding solutions to lowering them extend and relax insurance policies? Are the insurance policies themselves overinflated for what they offer?

There have been several senators who have pushed to look at deeper issues in our tort law, patent law, and the medical profession.

It's my belief that the current Obamacare tries to fix all issues by looking at a single issue (which may not be an issue but a natural result of underlying issues). I'll admit to not knowing enough to know the best option, but the idea I got from the current plan was that everyone will pay more and the rich will get richer. Nothing would truly be changed.

EDIT: Of course, there is the community problem. What is the overall economic status of the community? If it is poor, what can be done to improve the community as a whole? Why is the community not working to take care of its own? This, of course, has been partially a side effect of having instant communications and fast travel. Sense of community and taking care of our own appears to be dying. The benefit, of course, is that we now have technology that can actually keep Daniel alive. It would be better if we could maintain both, though.

Edited at 2012-09-12 06:25 pm (UTC)
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[User Picture]From: e_moon60
2012-09-12 06:40 pm (UTC)
I have direct experience in health care delivery and thus can say with data behind me that in fact for-profit medical insurance is responsible for much (not all) of the higher cost of medical care. Their need to make a profit off of it raises the prices of everything. So yes, I blame them, though I understand why for-profit companies rushed into the opening market.

Those politicians who--well lobbied by the insurance business--look instead at tort law, patent law, the medical profession, and anything but the for-profit insurance companies are missing the biggest puzzle piece. For profit insurance exists to make money, not to provide medical care. This is why they routinely exclude many people--they want only the healthy ones who will pay higher and higher premiums and use little or no services. That's profit. Anything else is less profit.

That profit comes at the expense of actually delivering care, as the insurance companies can squeeze providers and patients both. Working ina rural clinic, I dealt daily with the insurance companies' demands on the provider end and saw how uninsured people (many of whom could not get, or afford, insurance) ended up paying more because--if we did not charge the "full" fee, both government and insurance would cut our already low reimbursement percentages. We were legally forbidden to charge other patients what the insurance company would pay us. I knew people who lost their insurance when their job vanished...who had long wait periods for their insurance to take effect. As an insurance client (we had only high-deductible catastrophe insurance) I saw premiums rise and rise--finally 50% in one year, which is when we dropped it altogether. When I was a kid, my mother could not get insurance at all, not even in her employer's group plan, because she had had kidney infections before.

A one-payer system to which everyone contributes costs less and provides more care for the money taken in. A system that is pay-for-service, rather than pay-by-ZipCode, provides more care for the money spent.

And the US's disgustingly bad health stats are proof that people are not getting the health care they need. They're uninsured...they can't get insurance...they can't afford insurance...their insurance excludes the exact thing (procedure, medication) they need to keep functioning. In my childhood, we had some of the best health stats in the world for life expectancy, maternal and infant mortality/morbidity, etc.--at least for white people and in some cases population wide. Now? We are the worst of the so-called "first world" countries in health stats, ranking below many second-world countries, and it's been falling for decades. How do they deliver better health care for less? One payer.

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[User Picture]From: jcbemis
2012-09-12 07:08 pm (UTC)
and I just hit the limit on my drug coverage for this year, so my expensive med cost $529.65 for enough to get me to next year's allowance
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[User Picture]From: kengr
2012-09-12 08:47 pm (UTC)
Insurance companies in general are getting worse and worse about this, not just the health insurance ones.

Not sure how you'd work the transition, but I feel that we are going to *have* to force all insurance to a non-profit corp model. (Note for readers who aren't familiar with such things: "non-profit" corps are allowed to make profits, heck they sometimes *have* to to carry out their purpose. They just aren't allowed to distribute it to shareholders or owners. Any profits have to be plowed back into the corp or used for purposes consistent with the purpose of the corp)

Alas, I rate this as slightly *less* likely to happen than going to "single payer".

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[User Picture]From: blueeowyn
2012-09-12 07:41 pm (UTC)
My understanding is that SOME of the costs are the result of CYA by some of the doctors/hospitals. If they don't do EVERYTHING to save someone (even someone who is not going to live for more than a few hours and they will be really ugly hours), can be sued for medical malpractice. If someone has symptons that 99% of the time mean X but that 1% is something serious, they have to test for the serious thing to CYA. Some of these tests are really expensive.

Then add in the fact that most people in this country have no real understanding of death and thus will insist in highly expensive and invasive measures that have little chance of doing anything useful (e.g. I know a woman who had that immunocompromised pneumonia due to the meds she was taking to avoid rejecting her kidney; this is the disease that will kill you and it is not a pleasant stay while it does what it is going to do ... but her DH didn't understand that when he asked the doctor "what can you do to keep her alive" that he should have been asking "what are her chances of having any quality of life ever again").

Also, the underinsurance problem means that people are going to the ER for little things that could have been dealt with much more inexpensively in a doctor's office if they could have afforded to go to the doctor. ERs have to treat you regardless of your ability to pay, doctors don't have that. So, a tooth infection leads to sepsis and a multi-day hosptial visit instead of a course of antibiotics or maybe a tooth removal. Or a person with asthma ends up in the ER every time they have a flare up since they can't get the meds to control it because they are poor ... the list goes on.
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From: geekmerc
2012-09-12 07:57 pm (UTC)
I pay between $400-$800/month for medical insurance for my wife and kid. Interestingly, though mine is "free", the same amount would cover all three of us. Doctor visit is generally $100/visit ($25 co-pay with insurance), and the medicine can vary wildly depending on what we need, but can run more than 10 times the doctor's visit.

Generally speaking, I could (and probably should) get insurance a lot cheaper if I only have it cover major medical and pay the smaller doctor visits out of pocket.

I'm a strong believer of making sure people who can't afford a $100 visit are allowed to do so without having to go to an ER. There are many states with programs that support just that. Of course, it varies from state to state.

What really annoys me is the general idea that dentistry is a crock and doesn't get the same level of support; despite the number of illnesses and problems that can be caused by not taking care of tooth problems.

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[User Picture]From: kengr
2012-09-12 08:51 pm (UTC)
I'm on one of those state programs. And it *only* covered emergency dental. Which, since I'm a diabetic is a really *stupid* limitation.

This year, since I finally got SSI, they switched my coverage and I now get regular dental.

They still only cover eye *exams* but not glasses. So if (when) my prescription changes enough or I break my glasses...
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[User Picture]From: pickledginger
2012-09-12 08:58 pm (UTC)
As they are still setting profit records -- and many years, new record lows for the percent of income expended on actual care, I suspect their execs are more concerned about this quarter's bonuses.
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From: geekmerc
2012-09-12 10:35 pm (UTC)
The last I checked, Federal law STILL requires a corporation to put its stockholder's interests above all else. Corporations are not allowed to do what is morally right, only what is financially right for the stock holders.

Of course, we can curve that by mandating laws to restrict companies in other ways, but it only resolves the problem for the companies that the law applies to. In addition, because a company must look after its stockholders' interests, it is the legal duty of the company to try and circumvent the law in any way it can to maximize profitability.

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[User Picture]From: muaddim
2012-09-12 06:36 pm (UTC)
Unfortunately,it's as expensive here to raise an autistic/special child as in US .....
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[User Picture]From: e_moon60
2012-09-12 06:53 pm (UTC)
AHA. Got the picture up by linking to my website post of this. Hurray!
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[User Picture]From: pickledginger
2012-09-12 09:01 pm (UTC)
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[User Picture]From: gifted
2012-09-12 06:56 pm (UTC)
Good post, thanks for sharing this Ellen and Elizabeth.

What a cute kid. My son has curls like that, I just love em. :]
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[User Picture]From: 90sbondgirl
2012-09-25 12:18 am (UTC)
My current experience with healthcare reform: My husband lost his job August 31. Because it was the end of the month, 8 hours after he was unemployed, we were ALL uninsured. Gee, thanks. He got a new job September 12 (yay!!). We don't get insurance until January 1, but I'm just going to hope we all stay healthy. Why? Because COBRA from the last job is $1,200 Per Month for all of us (was $385), and we Just Can't Afford It. That is as much as our mortgage!

The new job does not offer a deductible healthcare plan, which is what we had to keep costs down previously. They only have a copay plan. The premium for family coverage is pretty much exactly DOUBLE what we were paying before, or about $700 Per Month. I now have no health insurance, because we can cover my husband and both children for basically what we were paying before. The only good news is that the dental HMO family coverage is actually affordable, about $30/month instead of $80/month previously, so now we all have dental and vision. Which means, ironically, that now I can get my tooth fixed, but I can't go for my annual Well-Woman exam because I can't afford to pay cash for that. And we make "too much money" for low-cost clinics.

I talked to a business owner yesterday who said she spent literally 2-3 hours reviewing the government documentation about the new healthcare legislation, and she honestly felt, after doing due diligence and research, that it was not the great idea that had been touted. Her insurance costs went up 25% last year, and will probably go up steeply again. She says she's spending over $300,000 per year on insurance. I don't know specifics, how many covered, type of policy, etc., but that is A Lot A Lot Of Money per year, no matter how you slice it.

Please understand. I am all for healthcare reform. I WANT people to get the healthcare they need, including mental healthcare. I honestly believe dental care is quite important, too. And for the record, I want to be clear that I am not a Republican or Democrat. I am not bashing the current administration in any way. I don't have answers, there are no clear paths to me, I simply don't have enough unbiased information. I just don't think this is how healthcare reform should be done.
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