I definitely don’t want to harsh on anyone’s mellow about Obamacare, but this is the part that worries me: the bad debt that hospitals are going to take on. This issue is going to have to be reconciled somehow.
Then again, maybe not.
Obamacare — it’s working!
I’m thinking about how my tax dollars are going to buy proton pump inhibitors for people who not only don’t have ulcers, don’t have raging gastric reflux– but people who tell me their stomachs are just fine!
I’m outraged. My religion, which I re-name weekly, forbids over-prescription of drugs of dubious benefit to people who don’t actually have a disease. My philosophy is called ‘evidence based’. It’s a minority religion, I’ll admit, but reality does have a way of sticking around whether it fits our narrative or not.
I demand that insurance companies stop funding proton-pump inhibitors for people who would do just fine with an occasional Tums. I demand that the secular authorities bow down to my authority as High Priestess (self-ordained) and re-arrange everyone’s insurance immediately.
Don’t whine to me that your stomach hurts. I have conscience, and I’m exercising it on you.
AARP released a statement about the newly passed legislation on the debt ceiling. While in the first two paragraphs, it’s clear they are trying to be nice, by the third paragraph, they are getting down to business about what is wrong with this legislation. From the statement:
“We are relieved that Congress has acted on a bipartisan agreement to address the debt ceiling and prevent default to ensure that seniors will continue to receive their Social Security checks and have access to health care. We are also gratified that after hearing from millions of AARP members, the President and Congress did not cut Social Security, Medicare and long-term care in the first round of deficit reduction.
“Going forward, we are pleased that Social Security, Medicaid and Medicare benefits are protected if the so-called “super committee” fails to reach an agreement later this fall, but we will remain vigilant in our efforts to protect the health and retirement security of seniors and future retirees. We are concerned that a fast-track committee process will deny Americans a voice in the discussion about critical tax, health and retirement issues. We also are concerned about the potential use of a trigger that would arbitrarily cut provider payments under Medicare, which could unfairly shift costs to seniors.
“Seniors have worked their entire lives to achieve a level of health and economic security in retirement. As the deficit debate continues, AARP will continue to impress upon Congress the need to protect Medicare and Social Security from harmful cuts. With the compounded effect of loss of retirement savings and home equity, high unemployment and rising health care costs, cuts to the benefits seniors have earned could undermine the standard of living of not just those with limited incomes, but middle class seniors who have median incomes of only $18,500.
“AARP will continue to raise the voices of millions of Americans who rely on their Social Security and Medicare benefits and oppose benefit cuts for deficit reduction. Americans want a broader conversation around health and economic security, not one focused solely on deficit reduction.
“AARP believes that the American public deserves a seat at the table in any forum, including the newly created super committee, that discusses potential changes to these critical programs. We believe that our nation’s leaders should work together to strengthen health and retirement security for current and future generations.”
Who is going to be on this “Super Committee”? Is this “Super Committee” going to supplant Congress? How many seats on the Super Committee are going to be reserved for the already-super-influential corporations?
As the public debate over health care reform rages on, the private battles with health insurers for essential coverage continue on, as well. While some fight for political advantage, others fight for their lives. The triviality of the former should be obvious to even the most insensate, particularly when contrasted with the high stakes of the latter. Individually, each tale of medical hardship rends the heart and evokes sorrow and sympathy. Collectively, the tales make a compelling case for the desperate necessity of reform. Consider the following two stories:
Houston Tracy, a 12-day-old boy, has already survived a rare birth defect, a feeding tube and open heart surgery. Now his family is waiting to see how the battle with an insurance company will fare.
Last week, Houston’s parents found out that the term “pre-existing condition” can apply the moment someone is born.
“When he came out, he made one little cry and he didn’t really cry much,” said Houston’s father, Doug Tracy, 39, of Crowley, Texas.
Tracy cut the umbilical cord and watched the hospital staff clean his son. But before his wife Kim Tracy, 36, could touch their son doctors got worried. “We could tell there was something wrong by the way they [the doctors] were acting,” Doug Tracy said.
Houston’s skin wasn’t turning a shade of pink like most newborns because, somehow, his blood wasn’t getting enough oxygen. Doctors rushed Houston, with Tracy riding by his side, in an ambulance to Cook Children’s Medical Center in Fort Worth, Texas.
Within hours the Tracy family would learn their son was born with a heart condition called d-transposition of the great arteries, meaning the aorta and pulmonary artery are transposed where they should meet the heart. Doctors wanted to operate within days to save his life….
Houston was born on Monday, March 15. By Friday that week, doctors operated successfully….But by March 24, the Tracy family formally heard their son was denied health insurance.
“We don’t have health coverage on ourselves because it’s too expensive these days and because of the economy,” Doug Tracy said. The couple are small business owners and would have to buy individual policies, which they have for their other children Cooper, 4, and Jewel, 11.
Doug Tracy said the family had no idea there was something wrong with Houston before he was born.
“Prenatal, every doctor visit was perfect, his heart beat was fine,” he said. But Tracy said he called Blue Cross and Blue Shield of Texas twice in preparation of Houston’s birth, and he asked if they could get a policy on his son before he was born.
“They said we can’t do that because he wasn’t born yet, but as soon as the baby’s born go online and fill an application out,” he said. Doug Tracy applied for Houston’s insurance March 18, and the first month’s premium of $267 was charged to his credit card, he said.
“Wednesday, the 24, is when I got a letter of decline — they declined it the day after the [health insurance] bill was signed,” Doug Tracy said. [full article]
And about 1,000 miles away in Wisconsin:
For nearly a decade, Paula Oertel’s brain tumor was kept at bay by a drug that was not approved to treat her condition.
Then Oertel did something she never imagined would jeopardize her good health. She moved. Less than 30 miles – from one county in Wisconsin to another.
The move triggered a review of her health insurance from Medicare, which eventually led to a loss of coverage, including the drug. And the tumor returned within four months.
What happened to Oertel stunned her doctor, Mark Malkin. Nothing he learned in medical school prepared him for what now is too often a sad and frustrating part of his job as a cancer specialist: fighting Medicare and private insurance companies over life-or-death decisions.
Doctors aren’t supposed to get emotionally involved in the cases of their patients, but tears well up in Malkin’s eyes when he talks about Oertel, the 40-year-old Oshkosh woman he has been treating for several years.
“I wish Paula would have a second chance,” he said, choking up.
Oertel and Malkin are facing an ailment no drug can cure: a complex health insurance system that can overwhelm a seriously ill patient unequipped to deal with its complicated rules.
As America debates health care reform, cases such as Oertel’s illustrate how important decisions made between doctors and patients can be overruled, leaving patients with no options and the likelihood of dying in a matter of months. [full article]
Meanwhile, those who profit from a system that denies or restricts coverage are digging in their heels. The New York Times reports that, “just days after President Obama signed the new health care law, insurance companies are already arguing that, at least for now, they do not have to provide one of the benefits that the president calls a centerpiece of the law: coverage for certain children with pre-existing conditions.” Their stance is clear. They will resist change, to the detriment of us all. It’s sickening.
For those who are concerned about health care, health care costs, and health care reform, I highly recommend Atul Gawande’s report from McAllen, Texas, where Medicare spending is twice the national average. From The New Yorker:
It is spring in McAllen, Texas. The morning sun is warm. The streets are lined with palm trees and pickup trucks. McAllen is in Hidalgo County, which has the lowest household income in the country, but it’s a border town, and a thriving foreign-trade zone has kept the unemployment rate below ten per cent. McAllen calls itself the Square Dance Capital of the World. “Lonesome Dove” was set around here.
McAllen has another distinction, too: it is one of the most expensive health-care markets in the country. Only Miami—which has much higher labor and living costs—spends more per person on health care. In 2006, Medicare spent fifteen thousand dollars per enrollee here, almost twice the national average. The income per capita is twelve thousand dollars. In other words, Medicare spends three thousand dollars more per person here than the average person earns.
The explosive trend in American medical costs seems to have occurred here in an especially intense form. Our country’s health care is by far the most expensive in the world. In Washington, the aim of health-care reform is not just to extend medical coverage to everybody but also to bring costs under control. Spending on doctors, hospitals, drugs, and the like now consumes more than one of every six dollars we earn. The financial burden has damaged the global competitiveness of American businesses and bankrupted millions of families, even those with insurance. It’s also devouring our government. “The greatest threat to America’s fiscal health is not Social Security,” President Barack Obama said in a March speech at the White House. “It’s not the investments that we’ve made to rescue our economy during this crisis. By a wide margin, the biggest threat to our nation’s balance sheet is the skyrocketing cost of health care. It’s not even close.” [full text]