Sunday, August 9, 2009

Need

What's stalling progress in health care, in my opinion, is any sense of "need." I read a recent Rasmussen poll that said 68% of voters considered their health insurance coverage "good" or "excellent." It's difficult to achieve change for only 32% of voters (I think we can safely ignore non-voters when discussing achieving political change). And it's VERY difficult to achieve change for a minority when it may cost the majority something.

I want health care reform because health care is rationed here in U.S. and I believe we can be more equitable in our rationing. Personally, I'm happy with my health insurance coverage. I consider it expensive and the costs have risen every year the past 10 years, but I am able to adjust finances and I have been fortunate enough to avoid all major illnesses. But I also understand that our health care is rationed here in the U.S., I just happen to be at the head of the ration line. Because I can afford my premium, deductible, co-pay, and co-insured payment, I can afford most health care I will need. When we needed help for Casey's migraines beyond what was covered by our health insurance, we were able to pay the bill from our own pocket and she was able to gain some relief. I can afford preventative medicine with my son's asthma. Others may have emergency care available for free when an asthma attack hits, but because I'm at the head of the ration line I can obtain preventative care. The health care system rations care and gives it to me and my family because I can afford it.

I want health care reform because I am already subsidizing the care the system gives to people with no health insurance coverage at all. The hospital charges me more to make up for the care it gives to people who receive care even when they can't afford it. The ambulance service costs me more because it's cheaper for some people to call 911 and get emergency care (for non-emergencies) than it is to go visit a doctor. Doctors and hospitals have to charge me more because people who could not afford care neglected to see a doctor for problems that have now gotten much more serious, but their ability to pay hasn't changed. Since I'm already paying an extra cost for this broken style of care, I'd rather see these same people get preventative care.

I want health care reform because getting sick shouldn't cause bankruptcy. A recent Harvard study showed that 62% of all personal bankruptcies in the U.S. in 2007 were caused by medical debts. The study found: "Most medical debtors were well educated, owned homes, and had middle-class occupations. Three quarters had health insurance." It makes me wonder if very many of the 68% who think their coverage is good or excellent have yet weathered a serious illness. How many times have we seen collection cans on the gas station counter to help pay for the out-of-pocket costs of some hard-working family hit by illness or tragedy? Just last week a guy in this area saved a toddler from certain death and suffered severe injuries in his efforts. Of course, a fund raiser was immediately scheduled to help him pay for his medical care not covered by health insurance.

I do not believe that tweeks will resolve my concerns. I believe we need serious change.

Yes, I'm concerned about what the financial costs of health care reform may be. But when I can progress beyond my desire to protect what's mine, I realize something MUST be done. The status quo is not an option. If I approach the current legislative proposals with an understanding of need and desire for serious change, I am much better able to ignore the lies and distortions about what the proposed reform is (and is not).

6 comments:

Erick said...

Very interesting post. I may comment more later, but one thing of note to me is also, when you realize that 62% of the population is happy with their health coverage, that necessarily leaves out the percentage of the population without health coverage. I've seen that number anywhere from 18% to upwards of 30%. Maybe this is why all the polls now show a pretty even split in public opinion on the issue.

Anna Casey said...

Thanks for this perspective. Most times these type of thoughts seem lost in the chaos of the debate.

Anna Casey said...

Thanks for this perspective. Most times these type of thoughts seem lost in the chaos of the debate.

JayEnEff said...

It is unfortunate that the US, the wealthiest nation, does not have healthcare provided universally. (College education too.) I can't help but think that the whole nation would benefit greatly if it's people were healthy and well educated. It's hard to see how even the financial benefits to that country would not outpace the costs of doing so.

Anonymous said...

Hey, awesome blog entry.

Thanks to anyone taking the time to read my comments. Some notes:

The standards used by the Harvard study are noteworthy. For example, if a person in their study lost just two weeks of income due to illness, the Harvard group would categorize that as a medical cause for bankruptcy.

Is it more accurate to reference medical expenses as the "cause" to a bankruptcy as opposed to a "contributing factor?"

I am fortunate to work for an employer that provides outstanding health care options to all its employees. As good as my employers plan is, I am appalled at the overweight and obese people in my building. They have outstanding health coverage, yet they're not taking advantage of it.

I am even more fortunate that due to my current positioning in the organizational chart, I get additional preventative health care at no cost to me. Is that wrong for my employer to not offer it to everyone? Is it rationing that they only provide that level for me?

According to http://tinyurl.com/qcjxzo the annual cost of obesity has doubled in the last 10 years. An annual price tag of $147 billion. My co-workers have the coverage and the education, but oh so many are not participating in the prevention.

Our public schools that we fund with our tax dollars educate the children on health and nutrition, yet childhood obesity is at an all time high.

If John Doe is an illegal immigrant and we pass a universal health care law providing him coverage, will he be more likely to get regular checkups? Or will he be more likely to prefer the anonymity of the current practices of the free clinics than to have to put his name and other details on the dotted line to get the federal government coverage?

Sorry to vent on your blog, thanks for reading if you've gotten this far. Everyone have a good day!

Richard

DVD said...

Thanks for the comments, everyone. I agree with JayEnEff and wish the national conversation was "how can we make this work, let's find the resources to get this done."

The Harvard Study is fascinating, I wish the details were more widely known, I appreciate Richard taking the time to look at it. I was just talking last night, again, that this health care issue is much more a middle class issue than the middle class "seems" to appreciate (but I was also told last night that the town hall angry people are a small minority, so who knows what the real middle class opinion is). It's the people with assets and income that MUST pay their bills, or face losing their assets and having their income garnished. If you have no assets and very little income, I have little financial incentive to worry about how much I owe the hospital.

Everyone's comments are good and stand on their own. Because I like to discuss words I will offer my thoughts about the question of "cause" and "contributing factor." The study uses the term "cause" and under a "but for" test the term is acceptable. If the bankruptcy wouldn't have happened but for the medical expenses, then the expenses caused the bankruptcy. Of course, probably all of the debtors had other debts too, so it also seems acceptable to say the medical expenses were a "contributing factor" - maybe just the factor that pushed them over the edge.