Health Reform -- You Say ToMAYto, I Say ToMAHto
by PunditMomThings always get a little heated in the nation's capital this time of year. July and August along the Potomac tend to be humid and steamy and that makes it hard for anyone to compromise and negotiate in a bipartisan way. Not to mention that it's awfully difficult to find happy people when they're all having bad hair days!
So I guess it shouldn't be a surprise that we find ourselves with only herky-jerky momentum for health care legislation. Or health insurance legislation. Or whatever you want to call it -- I really don't care, I just want to know that we live in a country where we really do care about the tens of millions of families and children who need just basic medical access and that we're not going to split hairs on what we call it, as long as we can get it done.
I know everyone is concerned about money. Trust me -- I'm not happy about the prospect of premiums going up more. Given the work situation here at Chez PunditMom, we pay the full freight for our policy -- not like the days when I worked for the federal government and had a fabulous plan that was actually affordable. If one of the options is to be able to provide that same plan that *ahem* our Representatives and Senators have, why is that a bad thing?
After reading a zillion articles and watching people on the TV machine talk about the various proposals and overhearing conversations at BlogHer '09, I've come to this conclusion -- we are a nation that's more concerned about the money in our own pockets than in giving up some of it to make sure everyone has health care.
Please don't go calling me names. That's one of the concerns that was raised at our BlogHer get-together with Valerie Jarrett, one of the President's closest advisors -- that so many in the country think we're on the road to socialism if we try provide health care for all Americans without sending them into bankruptcy. (You can find the live-blog of the session here!)
But there's something wrong with a country where for-profit insurance companies can deny coverage to a pregnant woman because her pregnancy is considered a pre-existing condition. I mean really -- the part of the discussion that we're not having on health care is that insurance companies exist for one reason -- TO. MAKE. MONEY. To do that, they have to deny coverage to as many people as possible. And as long as that's the standard, good people who work hard and try to play by the rules -- the people described in a speech by Harry Truman over 60 years ago when he thought it was time to change the health care system -- will never get what they need. And as long as lawmakers take money from the insurance company lobbyists, where is the incentive to change the status quo?
And what about the people like Erin's dad? And my dad? Part of her question from our session with Ms. Jarrett was this:
Erin: I'm afraid for people like my dad who will only take half of his pills because he can't afford to buy. Can you assure me that those average people who really need health care aren't going to get left behind?
Jarrett: At least every other day [President Obama] says to us, let's remember we don't want to get just something done. Our goal is to improve the quality of the health care. We have to provide the stability and the security so families don't wake up every day taking half a pill.
When you talk about compromise, true believers don't want any compromise. I think that the president is a pragmatist but he's not going to compromise fundamentals. He thinks the public plan is the right thing to do. He thinks it will prevent insurance companies from having a monopoly and better serve the American people.
Is it going to be ideal and perfect? No it's not. [But] it is going to be much much better.
I hope she's right. Given all the GOP wrangling and Blue Dog Democrat balking over the idea that health care for everyone has to be paid for and is something that all Americans ought to have, I'll believe it when I see it. In the meantime, if you think it's important that our moms and dads don't take just half a pill or that pregnancy shouldn't be a pre-existing condition that an insurance company won't cover, it's time to contact your lawmakers -- even if they're cranky about staying in the humid weather by the Potomac in the summertime.
BlogHer News & Politics Contributing Editor Joanne Bamberger is really excited about the new look of her blog about motherhood & politics, PunditMom. Joanne is also trying to figure out how to keep up with her regular blogging and get her butt in gear to write Mothers of Intention, her book about political motherhood that's scheduled to be published in October 2010 (Bright Sky Press)!
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Comments
Well Put
we are a nation that's more concerned about the money in our own
pockets than in giving up some of it to make sure everyone has health
care.
Totally. Well put!
Visit me at http://somebodyhealme.dianalee.net
I wish it wasn't so ...
... but it seems that's what all this really boils down to. :( You can bet if any of our lawmakers' families had to take a half pill instead of a whole one or had a daughter or wife who couldn't get insurance because their pregnancies were deemed pre-existing conditions, we'd have health care reform in two minutes.
PunditMom
aka Joanne Bamberger
BlogHer News & Politics Contributing Editor
I loved the president's closer on this
video--hat-tip: Momocrats
To your point about what would happen with health care if people in office didn't have it? Or didn't have excellent health care? Check out the president's closing comment:
Lisa Stone
BlogHer Co-founder
Surfette
BlogHer is non-partisan but our bloggers aren't! Follow our coverage of Politics & News.
I don't like government managed health care
I really don't think it is the government's job to make my health decisions for me. Just as most women don't want government to make decisions about their womb regarding abortions it is illogical then to have government make decisions about the rest of my body. They do a bad enough job managing medicare and veteran's hospitals, why would I have them manage my health? As for the insurance companies, of course they are there to make money, what's wrong with that? Aren't you trying to make money by working for someone or starting a business? I would prefer that the insurance companies actually start some kind of national insurance policy where they can compete with each other to provide a health insurance package. I think that this would be one way of mitigating the pre-existing condition problem because we are so dependent on employers for our health coverage.
No one is going to have the perfect policy and not all our health care needs are going to be addressed because there isn't enough to money to go around to be able to do that. Unfortunately we still have to deal with budgets even when it comes to health so it's not about keeping money in our own pockets as much as it is being able to spend the money wisely instead of handing it over to the government to spend it haphazardly.
flightkeeper
Flightkeeper.blogspot.com
Cutefuncool.blogspot.com
Unfortunately ....
... as long as insurance companies are motivated by profit, medical decisions are going to be out of the hands of doctors and health care providers. There is absolutely no incentive for insurance companies to go to a model you suggest.
There is no easy answer, but the system we have now is broken and needs badly to be fixed.
PunditMom
aka Joanne Bamberger
BlogHer News & Politics Contributing Editor
It's not only insurance companies who are
motivated by profit
A lot of what goes into increasing medical costs is because of litigation. It is the ridiculous amounts of awards and the threat of litigation that have increased the insurance premiums that are being demanded of doctors and providers that have required them to order additional cover-your ass tests so that they won't get sued, requirements by state and national agencies that add costs to medical practices and processing have contributed to making sure that medical decisions are not going to be made by doctors and health care providers.
Your argument seems to be that a company that makes a profit wouldn't provide adequate health care. Then I would assume by extension of that same argument that a non-profit organization would be able to provide adquate health care. Well they aren't around, why? Because it's not feasible. After all the training that doctors, nurses, and health care providers go through and the level of care that is expected from them, do you not expect them to make a a good salary to cover the debt that they went into to go into training and to be able to pay for the continuous education that they need to meet to be good health providers? Guess who pays them? A profitable insurance company.
I don't think that the answer to fix something that you think is broken should be provided by the government. Other alternatives should be explored and I don't want the only choice to come from government.
flightkeeper.blogspot.com
cutefuncool.blogspot.com
I disgaree with your premise ....
.... litigation isn't a bad thing. If people who are truly injured by negligence have no way to recover, what kind of country are we living in? If you were the victim of medical malpractice, wouldn't you want to have to right to recover your medical expenses, lost wages, etc.? The right likes to make the argument that all things bad are cause by litigators. Trial lawyers are just easy targets, but where would so many injured people be without them?
Profit isn't always a bad thing when it comes to insurance companies -- but ultimately, the obligation that trumps all is to the bottom line and to shareholders of those companies, not to the policy holders. It IS the job of for profit insurance companies to deny as many benefits as possible -- how does that help you or me?
If you, or many in the GOP, have a better alternative than what's being proposed, people want to hear it. But the right is merely criticizing the current proposal without offering anything better. That doesn't help anyone either.
PunditMom
aka Joanne Bamberger
BlogHer News & Politics Contributing Editor
Litigation and the threat of litigation
is a bad thing when it changes procedures so much that it adds huge costs not only in terms of money but in time. I also said that it was the award amounts that whas increasing the costs of running a practice as well as the liability premiums. You as a lawyer should know that lawyers troll for siutations where they can litigate for high damage awards. If you were to analyze the cost to replace a productive person's salary for the next 30 years plus the cost of treatment it would not go anywhere near the money that is being awarded.
Also, your claim that insurance companies deny as many benefits as possible is unfounded. If that were true, people wouldn't see health insurance as a benefit, yet people do want it. What is more likely is that health insurance companies denies paying for experimental types of treatments or treatments that may not have shown better results than what currently exists. That does not stop you from paying for these treatments yourself if you really believe in them.
I have said that a national health insurance policy from various companies should be explored. But you were totally dismissive. I am disappointed that you have made this a right or left issue. I was hoping that we could discuss this issue without that kind of attitude creeping in. As for you want to hearing other alternatives, you are not being honest. For you the only solution is through the government and that is what the current bill does. You yourself have not offered any choices other than what the government can provide.
http://flightkeeper.blogspot.com
http://cutefuncool.blogspot.com
There are many road blocks
Insurance does cover a lot, but when you become ill you quickly realize there is road block after road block after road block put up in your way when you try to get the medications and procedures your doctors suggest you try. If that isn't the policies of the insurance companies why does every single one operate that way and why do the vast majority of very sick people face the same challenges regardless of how savvy, educated or intelligent they are?
Visit me at http://somebodyhealme.dianalee.net
Well I'm glad that you said insurance does
cover a lot
Some people don't even want to admit that. From what I can observe, health insurance doesn't cover experimental procedures if there is an existing procedure that already shows good results.
I understand that when people are sick, they desperately want to become well if traditional measures don't work. And they will try anything no matter how untried that solution may be and expect insurance to pay for it. That is expecting a lot from an insurance company. I also know that sick patients want insurance companies to pay for their chronic illnesses. Again, this is a high expectation because insurance companies don't want to go out of business they try to limit their expenditure by capping their payouts. These things won't go away if we move to the government health care proposal. If you look at that bill in detail, the government will take more of those decisions out of your and your doctor's hands.
Everyong should examine that bill carefully to understand what it is proposing instead of just trying to pass this quickly. Would you sign a contract without reading it? I wouldn't.
http://flightkeeper.blogspot.com
http://cutefuncool.blogspot.com
What's the Difference?
You said that health insurance companies deny people treatment because the company believes a different procedure produces better results. (Experimental or not - I've seen patients denied coverage of a superior procedure in favor of a cheaper one, despite the fact the superior procedure was now considered the gold standard of treatment for that condition.) So you're saying that the health insurance company knows how to care for you better than your doctor, right? Isn't that taking the decision out of your and your doctor's hands?
And a question I'm very curious to know the answer to: do you believe that all people deserve equal rights to health care, regardless of health status and income, or that your wealth or genetic predisposition to chronic illnesses should dictate the level of care you get? Then, based on your answer, what do you think is the best solution for solving the healthcare crisis in this country? I think the answer to these questions could show the ideological difference that is creating this debate.
Christina
A Mommy Story
Superior vs cheaper
What makes one treatment superior to the cheaper one if the cheaper one can get the same outcome? That's really how the insurance company looks at it.
Your question of equal rights to health care is interesting. I've never heard of equal rights to health care. How is that possible? First off, you don't have a right to health care. Before modern medicine people just died from illnesses. If you had a right to health care now how come we didn't have a right to health care before? If you had a right to health care shouldn't that come with responsibilities to keep yourself healthy? Are you goint to force people to have healthy habits; to exercise, eat lots of vegetables and lean meat so that they don't get fat. Are you going to abolish cigarettes, liquor, and drugs so people won't develop health effects from overindulging in it?
Second, all our bodies are not of equal condition so how does that position people to equal rights to health care. Reactions to treatment and medicine are not the same. An individual may need more or less depending on their condition.
If a rich person who can basically pay for any kind of treatment but a poorer person can't, will you deny that rich person that treatment even though he can pay for it because the poorer one can't pay for it? Or will you force all rich people to pay so that the poor person can get the treatment. If that's how you look at it, then you really want control over people and every aspect of their lives. I personally will try to get the best care I can get with my resources. I expect others to do the same. I however, don't expect to force a rich person to cough up money to pay for my health care. I think you do.
By the way, in the end we're all going to die. It sounds as if the health care crisis you want to solve is how to stop people from dying and that's unrealistic. And how is it suddenly we have a heath care crisis during Obama's presidency when we didn't have one in Bush's? Obama is manufacturing this crisis basically to increase government control, that's how I look at it. If he really wants to reform the way health care is addressed in this society, why doesn't he work with medicare or medicaid first and get that fixed so that the rest of us can have confidence in him.
http://flightkeeper.blogspot.com
http://cutefuncool.blogspot.com
Seriously?
No healthcare crisis? I guess it's not a crisis until it effects you personally.
I understand now
You state: "If you had a right to health care now how come we didn't have a right to health care before?" So by your argument, why should women now have the right to vote when they didn't before? Why should slavery be illegal when there was a time when it wasn't? If we only lived in the way we have always lived before today, we'd still be using candles for light, riding horses instead of cars, and using bloodletting to balance the humors as a legitimate and superior medical treatment. Shouldn't we instead be seeking progress towards a better world for everyone?
Replace "right to health care" in your comment above with "women's right to vote" and "responsibilities to keep yourself healthy" with "responsibilities to keep yourself educated enough" and see how silly it sounds. Would you deny a woman the right to vote because she didn't read enough books to meet your standards?
I see now that you and I will never find common ground because we have different ideologies. You believe that all people do not deserve equal access to health care (yes, all people have different health needs, but it's equal access to treatment I'm talking about), while I believe it to be a basic human right we should work towards in our modern society. I don't believe that one person's health is worth more than another person's health because that first person has more money or power.
Yes, we will all die someday, but I believe that we should strive to ensure that no one has to suffer or live in pain unnecessarily while they are alive, or have that life cut short simply because they couldn't pay for the better care.
Christina
A Mommy Story
I'm pretty sure
she (he?) believes in those advances for those who can afford it.
Dead on
You are absolutely right. Somewhere along the line people in this country have decided that everything is supposed to make a profit.
I'm a cancer survivor (3 1/2 years, yay me) who was fortunate to have had health insurance during my illness. I was 38 when I was diagnosed with two small children. I dragged myself into work on a daily basis while undergoing 12 rounds of chemo, 35 radiation treatments and more because my job is was made my health insurance possible. I have a friend who had cancer 9 years ago and did not have health insurance. He was able to get his treatment and is still making payments.He wss 24 when he was diagnosed.
What gets forgotten in this debate is that these are actual human lives in the balance. I am a blogger and I still have my day job. I investigated what it would cost to purchase health insurance so that I could blog full time. There was only one company that would cover me and it cost $1,400 dollars a month, with a $5,000 dollar deductible and a 50 percent copay. Needless to say I'll be keeping my day job.
It is insane to me that the "greatest nation in the world" has been convinced that it is more important that a few become wealthy and decisions be made by an insurance company than the people have the security of their own health.
Kate
I blog at http://www.aftercancernowwhat.com
This is the part ...
... that I don't understand. In the discussion on this topic, it tends to stay focused on the abstracts rather than focusing on stories like yours and your friend's. Why anyone in America should have to be in debt for years to have decent health care is beyond me.
PunditMom
aka Joanne Bamberger
BlogHer News & Politics Contributing Editor
It was the motivation for proft that provided
the treatment
First off, I think it's great that you are a 3 1/2 year cancer survivor because every year is a victory.
Secondly, I think we should all appreciate the work and motivation that went into the years of research to make cancer beatable. And I have to insist that it wouldn't have happened if companies didn't put money into research so that they could make a profit.
Third, I don't think your friend should begrudge the payments he has been making for the last 9 years when you consider what his alternative would have been if he didn't get the treatment.
I don't understand this mentality that you think health care should not cost anything. Do you not expect to get paid for your work? I look at it the same way I look at paying off my college tuition way after I have already graduated.
flightkeeper.blogspot.com
cutefuncool.blogspot.com
Where do you think most research happens?
You seem to be assuming that most medical advances have come about at the hands of for-profit corporations seeking profit, but this simply isn't true. The majority of medical advances of the past hundred years were researched and developed in one of three places:
1. Universities - including public and private (non-profit)
2. Public health organizations - also non-profit (and also responsible for nearly all infection control advances in the early 20th century)
3. Military research
And who should you be thanking for all of these medical advances? Well, first, the doctors and scientists who did the actual research. But who is partially or totally providing the location and funding for them? The government. They're the ones who are running research facilities and/or providing grant money for research and development.
Sure, we do have large pharmaceutical companies developing drugs now, but our original vaccines and medicines were developed by non-profits. (And many big pharma also receive government and non-profit grant money for research and development.)
As a side note: I made more money as a technical writer than I make now as an RN, but helping my patients be healthy is 100% more rewarding than writing technical documents. I make enough to pay our bills and live modestly. (And yes, pay a fortune for health insurance, too.) My hospital is a small county hospital that can't afford to pay me as much as a larger hospital, but I'm happy to have my job. I didn't go into nursing as a money-making scheme, and I think most researchers would agree they didn't have that in mind, either. Although you may not believe it, there are actually people in this
world who work with the goal of creating a better place for humanity as a whole, not make a profit
individually.
Christina
A Mommy Story
Most Selfish Nation
I'm starting to thnk we should rename ourselves Most Selfish Nation in the world. We're the only prosperous nation ("first world") that has no paid leave for families. How can this be? We claim to be all about families, yet our policies and laws hurt families terribly. We've got things all wrong in a lot of areas. I think our Constitution is brilliant, but I'm ashamed that we're so selfish and hateful toward people who are less fortunate than we are.
Visit me at http://somebodyhealme.dianalee.net
You only think it's a selfish nation
Because you are thinking about what the government can provide for you.
It used to be you ask not what the country can do for you but what you can do for your country--we are so far away from that.
http://flightkeeper.blogspot.com
http://cutefuncool.blogspot.com
No, ....
... actually, I'm thinking about what we can provide for each other. After all, it's our money that we pay to the government to fund whatever the government does.
I'm not asking what the government can do for me. I think it's time to focus more on how we can help each other and if that means having some of my tax dollars provide basic health care for children who have none, I am more than willing to do that. I don't think the insurance companies, or many in the GOP, can say the same.
PunditMom
aka Joanne Bamberger
BlogHer News & Politics Contributing Editor
Yes you are asking what the government can do
for you
You want the government to take money from the general population and depending on their income level, you want the government to force people to pay more and get less. This is not how tax was supposed to function. If you don't pay taxes and you are on welfare, you are getting more than what you put in.
You mentioned children, but it is not only children that need the health care if they can't pay for it, are you going to provide only for children and ignore the teenagers, elderly and adults? If you are willing that is a personal decision but that doesn't mean you should force other people to pay more tax because you feel like it.
In fact, it makes more sense for you and people who think like you to donate your money into a pool and buy health insurance annually for the needy in your community. I think that is fairer than mandating people to pay more taxes if they make over a certain amount of money.
Also, trying to position yourself and the democrats as virtuous against the thoughtless GOP and insurance companies doesn't help find solutions. If anything it makes me think that you are more concerned with gaining political power.
http://flightkeeper.blogspot.com
http://cutefuncool.blogspot.com
Nobody says health care shouldn't cost
anything
And most people are willing to pay more than what is fair. But there is something wrong with a country that makes cancer patients go into bankruptcy and/or years of debt for treatment -- if they can even get it.
Comparing college tuition to health insurance? Apples and oranges. Not even close. That's actually insulting to the people who have no insurance, to suggest that there has been a choice made to forego needed treatment.
PunditMom
aka Joanne Bamberger
BlogHer News & Politics Contributing Editor
Fair is a relative thing.
You should know that as a recovering lawyer. Would you prefer living in a country that has a social health care system where the government decides whether you should get that expensive treatment like in Britain or where you have to wait according to their schedule like they do in Canada. Do you think that is fairer?
And I am not comparing college tuition to health insurance. What I am saying is that you begrudge paying for something that is important to you. Why is it a bad idea to pay for your own health care in monthly intallments? That's how many people pay for big items. People gladly buy a house they can't afford or a flashy car and complain about having to make payments but they don't expect other people to pay for it.
As an adult, it is your choice to forego or buy health insurance. I don't think it's insulting to expect adults to act responsibly.
http://flightkeeper.blogspot.com
http://cutefuncool.blogspot.com
And sues the surviving
And sues the surviving spouse if he can't pay the bills after his wife passes away. This happened to a close family friend. Talk about insult to serious injury. :(
Visit me at http://somebodyhealme.dianalee.net
Complete misreading of the statement
Okay, I have to respond to the assumption that I expect health care to be free. By no means do I think that I should be able to walk in and get whatever health care I or my family need. What I am saying is that there needs to be a way to make healthcare affordable. One of the biggest barriers to this is the health insurance industry.
Anyone who thinks that the way that we are providing health care today is the most efficient is sorely uneducated.
Let me give you an examples.
David Polly is an orthopedic surgeon. He should certainly be paid for the work he does as an orthopedic surgeon. However, the surgeon was also working as a consultant for Medtronic, a company that makes products that he would surely use. He billed over a million dollars in "consulting". If you would like more information the Star Tribune has written a four page article about him. Funny, there is no mention in the article that he was providing surgery for free since he was using products he was consulting on.
I have no problem with him making a living, by all means he has spent years studying and learning his skills. The problem I have is the massive conflict of interest involved.
Finally, did you know that in the 1800's fire departments would not put out your burning house unless you had purchased insurance from them? Firefighting was a private for profit industry. Around the time of the Civil War, firefighting in big cities was
reformed and taken over by the government. Currently firefighters in
most major metropolises are trained by the government, employed by the
government and given health care -- wait for it -- by the government.
You can rebuild a house, you can't some back from the dead.
Kate
I blog at http://www.aftercancernowwhat.com
Your examples show exceptions and not the
rule
You have given an example of a young man who unfortunately had a terminal disease that was cured but because he didn't have an insurance plan, he had to pay for his treatments even 9 years later. It seems that the hospital and the doctor worked with him to make the treatment affordable by letting him pay a little at a time. Most treatments don't take 9 years to pay off and again, he should be glad that he was able to pay the plan off that way. We don't begrudge the mortgage payments or the car payments, and yet many people are upset at having to pay for health care that saves their lives which is more important that any material stuff that you can buy.
You have also given an example of an orthopedic surgeon who is also a consultant. Do you think most doctors become head of a major research university's division of orthopedic surgery and become consultants on the side who get paid millions of dollars? That is not the norm, most doctors aren't making as much money as you think they are with their practice. If you have a conflict of interest, then it is based on that example, you can't apply it to the entire profession.
As for your fire department example, it was deemed a public good to have the city pay for the fire department because in the 1800s most cities were not built to any fire prevention codes. In a city, one fire could quickly spread and kill thousands. The Chicago fire for example. That makes sense. I would say that is akin to the treatment you get in emergency room. And that is what you have now. In an emergency a hospital cannot turn you down.
But you will note, it was not up to the city to provide permanent shelter for all those people who lost their homes and possessions. It was still up to people to rebuild and replace their own homes. It's the same way with health, if you want treatment for a terminal disease so that you have additional years, it is up to you to find out what is the best treatment for you and for you and the hospital and the doctors to determine how to pay for that. It should not be up to the government to decide these things for you.
http://flightkeeper.blogspot.com
http://cutefuncool.blogspot.com
What about
those who have health insurance but still spend years paying off medical bills? It took us two years to pay for the birth of our first child, and we were insured. The guy in the example above has been able to pay for his treatments over the years but many families cannot. Like some friends of ours who had coverage but whose bill for a high-risk pregnancy, delivery and preemie care resulted in over 300K in bills to them. They had to declare bankruptcy.
And do you really think it is cheaper for us to pay for eveyone's emergency room visits than to provide preventative care (since you suggested above that trauma care is like fire service)? Even the insurance companies say no. I don't understand people who say that the uninsured should just choose to be insured. Have you SEEN the cost of individual coverage? It's impossible for many people, even those who are gainfully employed.
I guess this explains how I
I guess this explains how I feel
Kate
I blog at http://www.aftercancernowwhat.com