Obama and Healthcare

Gird your loins, folks, another desperate moment in America is being ushered in by President Obama. What are we on now? Crises number 3 or 4?

I’ve been thinking a lot about this one. What makes us so preoccupied with our health? I have one ongoing condition for which I am required to take medication daily. I take the same amount everyday, year after year, yet my doctor wants me in every three months before a refill. There aren’t any side effects to the medication I’m using. But I’m insured, so he wants me in. The medication would cost me about the same as my co-pay if I ordered from Mexico. But my insurance picks up an additional $100 or so every three months because the money’s there.

And we wonder what’s wrong with healthcare in America?

One of the kids has a recurring condition that occasionally lands the child in the emergency room. When we’re there, all that’s need are IV fluids and a dose of a common medication. We’ve been using the same emergency room for 15 years. Every single time we go in, the ER performs about $1,000 in blood tests to confirm the absence of any other diagnosis plus another $1,000 or so in “services.” WE HAVE INSURANCE so they run up the bill.

(I’ve actually learned to circumvent these outings with a $3 dose of the medication as the situation arises. I have an acquaintance trained as a nurse who has been known to string up her own IV bags she keeps in a closet for a similar situation.)

In general the family is healthy, eats right, gets exercise, doesn’t smoke, etc. What we need is a really good old-fashioned inexpensive major medical policy. Instead we pay is $13,000 a year for a super plan that really never pays back. We’ve been conditioned to fear life without insurance when what we really need to be afraid of is an insurance/doctor/pharmaceutical relationship that’s grown horns.

Who says I should pay someone to profit from my health or the lack of it? Who suddenly decides that I should feel guilty if I don’t have a yearly mammogram even though there’s no family history and I do self exams? Who says I need a colonoscopy if there are no symptoms and no family history?

Just what have we let ourselves be talked conditioned to accept?

I know, one needs insurance for the big what ifs. What if I have a child with a chronic care need. What if I’m in an accident. What if the worst happens and I need constant care. But what if you don’t? Insurance in the purest form is betting for or against something. With my healthcare coverage I should be betting that I won’t need it. Instead we’ve made healthcare insurance a sacred and intimidating experience and trained Americans to run to the doctor for every sneeze. Are we benefiting? I don’t think so. Is someone profiting? You bet.

Healthcare reform, like so many reforms, can best be accomplished by simply dumping the system. There is no logic to a doctors visit that cost me $20, is billed at $120, and is negotiated by my insurance company to be $60 and so they pay the other $40. Bill me the $60 and we won’t have nearly the problem. Let me buy major disaster type coverage and I’ll save money in the end.

Changing the angle of this debate a bit, I’m constantly amazed by the people who demand that nothing gets between them and their doctor, yet they watch pharmeceutical advertising and take those suggestions to the doctors office. They choose doctors who travel to very intensive conferences in order to learn about a drug company’s offerings. (Emphasis on the word intensive there.) They subscribe to insurance companies that negotiate a price they could never pay alone. I’d say a lot is standing between the two of you already.

What would I do? Stop pharmeceutical advertising. Disallow complimentary travel and other marketing by those companies. Stop the access to congress through lobbyists. Wouldn’t happen in a million years, much less my lifetime.

Have you heard our honored president take any of this on? Nope. He just want everybody to have more of the same. All Americans deserve coverage in the most bloated of industries.

Mr. McCain had my heart when he asked at a town hall, “Why is it that every time there are technological improvements in healthcare, costs go up? In every other business the economics demand that technological improvements lower costs.” (paraphrased)

Why do we have dozens of MRI machines in a region, each marketing their product, each sitting idle a good chunk of time, and each charging a boatload when they get a customer? Because the market hasn’t had time to shake it all out yet. In a pure market situation, some of those scan operations should go under. Healthcare, though, isn’t a pure market situation.

First, there are things only my doctor can do that I can’t do. I remember my last mammogram the nurse suggested I start getting a prescription for a diagnostic version. (The first reading always gets this hysterical response that DEMANDS I come in for a more thorough ultrasound/xray anyway. Why? BECAUSE I HAVE INSURANCE.) She explained that a mammogram is one of the few medical imaging tests you can order off the street. Everything else, include the more thorough version she suggested, has to be by prescription. Same goes for that thyroid medication above. The extra step of a gatekeeper keeps the market burdened.

Also, so many of our healthcare facilities have been allowed to operate under not-for-profit tax arrangements. They don’t pay taxes on property. They don’t pay taxes on income. They don’t blink at paying half a million a year on an administrator, though. It keeps the competition uneven for some to be taxed but not others. It changes the market.

Should I be afraid to be without healthcare insurance? Should I be able to visit a doctor for a $60 payment my insurance company negotiates instead of the $120 it would cost me? I don’t pretend to have answers. I’m not sure I’m even asking the right questions. But it’s time to talk about this important issue without being threatened by our president.

Comments

  1. A LOT to discuss there. Deserves a cup of coffee rather than a comment box, don’t ya think?

  2. True. And you’d be coming from the medical side.

    It still chaps my backside that I can ruin my lungs with cigarettes and no one stands in my way, but I can’t get a basic thyroid medication without jumping through all the hoops.