Monday, June 18, 2012

Worried Sick

It turns out that even if you're lucky enough to have health coverage, you've probably denied yourself the privilege of indulging in actual health care. By the time the profit-bloated insurance leeches have bled you dry, there's precious little left over to actually see a doctor. The USA has the unique distinction of spending the most on health care without actually providing much of it to a sizeable chunk of the population.

But the insurance leeches are sure getting richer and richer from their bloated premiums, which have skyrocketed in anticipation of the "Affordable" Care Act kicking in. Or not, depending upon the whim of nine jurists in black robes.

How sickeningly perverse is that?

The Kaiser Family Foundation is reporting today that many people are worrying themselves sick about how to pay their medical bills. They are not filling prescriptions, not going for follow-up visits, not seeing the dentist. The poorer and sicker and older you are, the more you worry, and the sicker you get.

About a quarter of Americans (26 percent) report they or a family member had problems paying for medical bills in the past year. Difficulty paying bills can lead to tough choices as people negotiate tight budgets. In an effort to allay costs, roughly six in ten (58 percent) report foregoing or delaying medical care in the past year due to the cost.

Half of those with private insurance report that increasing premiums and co-pays are causing them financial hardship. They're worried about losing their jobs and their coverage. That can't be conducive to good health.

Meanwhile, it turns out that quite a few people don't even know about the Affordable Care Act. Here's another story from Kaiser, called "Uninsured and Unaware." It talks about dirt-poor people sleeping all night in their cars to get a place in line for a free medical check-up in rural Tennessee. Patients did not seem to know that if the ACA does eventually go into affect, it would drastically increase the number of Medicaid enrollees by raising the threshhold for poverty up to $31,000 for a family of four. Woulda, coulda, might, maybe.... in 2014. People have so much gall to be getting sick right now, huh?

Everything I have read lately predicts that the Supremes will trash some, most or all of the ACA. And that Obama and the Democrats have no Plan B. It leads me to believe that their hearts were never in it in the first place. Or that they know something we don't know and are kind of hoping that, like the rural Tennesseans, we never even heard about it.

Typical politicians -- maybe if they ignore it, ObamaCare will just go quietly into that good night. As Sen. Tom Harkin (D-Iowa) told Politico, there's no point in doing any planning until nine unelected people decide the fate of 330 million people.


Jay - Ottawa said...

The American people ought to slap a malpractice suit on the Frankensteins who tacked the ACA together.

The Nine in Black Robes are not likely to do much more that is helpful. In fact, the worst the Court might do would be to keep it alive with another cut here and a patch there. ACA should be allowed to, or made to, expire. Single Payer is always waiting patiently in the wings until our zombie majority snap out of it and flick the flies off their teeth.

Other advanced nations -- somebody check to see whether we're still in that club -- provide pretty decent health care, with better all-around statistics and lower cost than we do. Furthermore, the citizens of other advanced countries are not eternally faced with the birth-to-death Sophie's Choice of either bankruptcy or self-neglect.

While we're burying Frankenstein's monster, let's remember to drag the Health Insurance Industry to the crossroads and put a stake through its heart.

Valerie said...

Oh, how incredibly tragic! I had seen some short clips over the years and read articles on people lining up for hours and hours in rural towns for free medical care. You would think some of those doctors who took a freaking Hippocratic Oath could donate half a day of their time to help out those less fortunate! But I shouldn't get on the doctors too terribly much! My dad, bless him, had lots and lots of people not pay him and he NEVER went after them for the money, just wrote it off and saw it pragmatically. And obviously there are very decent doctors who ARE running these free clinics. I'm just sayin' ... even lawyers have an unspoken obligation to do pro-bono work.

I remember the insurance salesman telling us not to claim on our 1920's brick condo building (when I was condo association president) unless something REALLY bad happened because the insurance company was just looking for a reason to drop us and no other company would insure a building that old in an earthquake zone. It worked - we didn't claim for ANYTHING, always fearing that it wouldn't be there for us when the BIG ONE hit if we did anything to anger the all powerful insurance company.

What gets me about all these Republicans is they CAN'T WAIT until they are on Medicare. Even my parents, a doctor and his wife, who had good medical insurance, were always conservative about going to the doctor while they had a deductable. Once on Medicare, they got everything they needed and they loved it!

So WHY on God's green earth, don't they understand that universal health care is a good thing? I have a Republican friend who is in all kinds of pain, needing a surgery, who is counting the days for when he can get on Medicare and get the surgery. I pointed out to him, “Socialised medicine is pretty nice isn’t it?” He looked at me blankly. “Medicare is socialised medicine, isn’t it? I am just saying – it is really good to have it there for you when you need it!” He grudgingly agreed but I am sure it won’t make a difference in how he votes. People are SO MARRIED to their political paradigms that they can’t even entertain the idea that the other side might have a point!

Valerie said...

Right on! Jay!

Denis Neville said...

@ Jay – Ottawa re: “the Frankensteins who tacked the ACA together”

Indeed! The Affordable Care Act is 2,000 pages plus long! American exceptionalism!

The Affordable Care Act…what an oxymoron! It will do little to make healthcare affordable. It forces people to buy health insurance, or face a financial penalty, from investor-owned insurance companies at whatever price they set. What a shitty deal! And out of pocket health costs - high co-pays and deductibles - will continue to soar and many won’t be able to afford the health insurance. Unfettered free markets! As Thomas Frank told Bill Moyers, “their vision, the future of our country is pure free markets.”

I am betting that ACA will be overturned by the men in black (the court's Republican majority) to undermine Obama. The right thing to do, but for the wrong reason.

Let's remember not only to drag the health insurance companies to the crossroads and put a stake through its heart, but also the irresponsible Democrats who support it and the irresponsible Republican who oppose it, both for their own political gain. Put a stake through their hearts.

Unfortunately, stakes will go through all our hearts instead [Karen’s excellent “Worried Sick;” I worked in one of those free health care clinics, line blocks long in subfreezing temperatures].

I am not optimistic about single pay anytime soon. There are too many “I got mine Jacks,” who think that those not smart enough to have a Health Savings Account can go to a “healthcare soup kitchen," where they can, if they are “lucky” get bare bones care to barely stay alive with minimal expense to taxpayers. Those politicians are typical “I got mine Jacks.” They all have the best health insurance in the nation. A pox on their heartlessness!

We were born on the wrong continent.

“The rise of the Super PACs, and the sheer volume of cash they enabled candidates to devote to mudslinging without ever dirtying their hands, was something new. Just as new, and equally alarming, was the public’s cognitive capitulation to the process. Over the course of the past few decades, the power of concentrated money has subverted the professions, destroyed small investors, wrecked the regulatory state, corrupted legislators en masse, and repeatedly put the economy through the wringer. Now it has come for our democracy itself.” – Thomas Frank, “It's a rich man's world - How billionaire backers pick America's candidates,”

Valerie said...

I can always count on you for great links, in addition to a thoughful comment, Denis! Thanks

Pearl said...

The New Democratic Party leadership in the past (our progressive party in Canada) introduced and lobbied forcefully for universal health care here. It was supported by the people of Canada despite protests by the medical profession and once in place, was accepted by all the parties and is now a permanent part of its existence here. Friends here cannot understand the inability of the U.S. to put a similar plan in place.

Although it could be strengthened in many areas, the present Conservative government is not too anxious to provide more funding into the system but that is continually being challenged. Anyone legitimately living in Canada and therefore paying taxes is entitled to complete medical coverage. Costs for care are lower than in the U.S. since the Canadian government buys medications in bulk, reviews and negotiates the salaries of doctors and other medical personnel. As a senior living in Canada despite my U.S. citizenship, all my medications which are approved are paid for and I am glad to pay my taxes here especially since they have withdrawn from Afghanistan and the military budget is modest compared to my birth country.

When Obama was elected, he could have instituted universal health care as the majority of the voters were in favor of such a plan. His excuse for a health care bill is a disaster and will end up bankrupting the country and as mentioned by others in your comments section will and is denying many people proper health care. Medicare is unable to function properly with so many people needing its coverage and doctors and nurses and other medical personnel are avoiding offering their services at very low pay. I tried to warn my fellow liberal democrats who were fighting to get Obama's health care bill passed, that it was a grave mistake to support it and all the propaganda about its usefulness was false, catering to the private health care organizations and the pharmaceutical companies. Another major reason I refuse to vote for Obama.

Jay - Ottawa said...

“Wherever suffering is ignored there will be the seeds of conflict, for suffering degrades and embitters and enrages.”

Aung San Suu Kyi, Nobel Peace Prize winner, on her recent acceptance in person of the prize awarded to her in absentia in 1991.

The Black Swan said...

Over the winter I broke my leg; I was a poor student without health insurance. I have since signed up for a catastrophic plan that costs me $100/month and has a $3000 deductible. Beyond the deductible the insurance covers 60% of all costs.

Without insurance I will end up paying just under $1000 of my total $80,000+ medical bill. This is all due to charity coverage.

With insurance I would have paid over $5000+ of my medical bill. Plus the $1200/year just to be insured.

Could someone please explain to me the benefit of having health insurance in this here USA?

Zee said...

Aww, Valerie--

Medicare is not socialized medicine. It's a very successful single-payer system. The government is the principal--though not sole--insurer, but the doctors are not in the sole employ of the government, nor are the hospitals and clinics owned solely by the government, nor does the government dictate to the patient which doctors the patient has to see and in which order.

The U.K. has socialized medicine, but Medicare is not socialized medicine. Nor is the Canadian system, nor, I think, is the Australian health care system.

In the U.S., once I reach Medicare age I can still buy quite a range of insurance supplemental to Medicare that give me additional benefits. The Canadians are trending in that direction, and, I thought, in our off-line discussions you re-affirmed my understanding that supplemental insurance was available in Oz, too.

Also, Medicare Part A is available to all taxpaying citizens. However, one still has to pay extra to receive Medicare Parts B and D, I think. (I'm not totally sure, as I'm not of Medicare age yet.) In the U.K., the patient pays nothing because it's all covered by his/her taxes. Again, Medicare is not socialism.

Am I being nit-picky? Well, yes. As I have tried to point out in prior remarks, language is important in terms of trying to win over converts to your Progressive cause.

Better to point out to your Republican friend that almost everyone likes Medicare once they're on it, and then ask him to explain back to you what kind of system it is.

That's more likely think make him think, rather than to immediately scare him with the dreaded word "socialism." Then ask him why, if it's good for the elderly, it's not good for everyone?

He may still go ahead and vote Republican because, as Eric Alterman pointed out, people tend to ignore political promises and go ahead and vote for the person that they think is "most like them."

But the next time someone tells him that Medicare is socialism, he may be more inclined to defend it as a prime example of a successful single-payer system.

Then, score one for your side.

Pearl said...

In my previous comment to Karen's excellent column, Worried Sick,
I meant to say Medicaid coverage (not Medicare) which was not attracting medical personnel to the increased needs which have developed. However, it could also hold for Medicare and its eventual downgrading although Medicaid is now oversubscribed for the people who qualify for care. Regardless, it is not working well and will continue to have problems as more and more citizens fall through the cracks. Many private health organizations have created complicated requirements for people applying for their services which is a devious way of eliminating those who will cost them more and dig into their quite substantial profits. They know how to avoid attempts by the government to force them to accept people whose health needs require care beyond what they are willing to cover.
Many far poorer countries than the U.S. have excellent coverage for their people and give them top notch care for more than reasonable cost. The U.S. is pretty low on the totem pole in regard to the national health indices such as infant mortality, life expectancy especially among minorities, ad infinitum. If Obama had gotten a proper medical bill passed when he had the chance to do so and removed the country from Afghanistan instead of increasing troops, he would have developed a strong base with which to fight the right wing dragons. For all his education, he is basically a stupid man politically and personally.

Valerie said...

Yes, we do have supplimental insurance in Australia, which kicks in for things like chiropractor and dental visits and physiotherapy in addition to hospital coverage - getting a private room, etc. All the main medical care - all doctor visits, all emergency care, all medical care in the hospital - is covered by Australian Medicare. Medicare is a government agency, funded 100% by taxpayer dollars which basically works as an agency to distribute the appropriate funds. Agreed, health care professionals don't work directly for the government per se, but they all have contracts with the government and receive payment according to what the government deems is fair. Our health care system in Australia is very much like Medicare in the States only it extends to everyone.

Perhaps you are right about antagonising the Right with the "S" word but THEY are the ones that have coined any kind of single payer or public option as "socialised medicine." I am just pointing out that it is pretty nice if you can get it – when you get it.