Health Care Sucks

So I recently spent some time in a hospital. (Everyone's doing fine, thanks.) It was an awful experience that drove home everything that I hate about health care, mainly:

• The cold demeanor of most of the doctors you deal with. The nurses are where you get both the real information and the real compassion.
• The discomfort about almost every aspect of the experience. From the beds to the bland food to the shared rooms, the entire experience seems to optimize your discomfort.
• The lack of transparency about what the cost of the services you're receiving, making it a confusing and bewildering experience. To that end, you need to be constantly vigilant about what the doctors are doing, since they don't seem to make decisions based on cost or need. For example, one test was scheduled simply because I have a tattoo, notwithstanding that it's 10 years old and i've had a clean bill of health since then.  

The whole thing was topped off with what was some really incompetent behavior from the attending physician, which i'm not calm enough about quite yet to detail here. Perhaps another time.

Coincidentally, I read a quote from Stephen Brill that seems to sum up why the whole experience is so bewildering - mainly, because you're not in charge:

There is no such thing as a free market in healthcare, if one defines a free market as a place where there is some balance of power between the buyer and the seller. Instead, health care is - except when Medicare is the buyer - a lopsided seller's market. That became clear at both ends of the money trails I followed - from the patients' lack of any knowledge of what they were buying or its prices, much less any leverage to bargain over it, to the sellers' ability and willingness to charge absurdly high prices on everything from gauze pads to ambulance services to cancer wonder drugs.

I have to read Brill's expose on health care costs - from what I hear, it's an excellent piece of writing.

So Much Trouble in the World

Two disturbing things I read on Boing Boing this morning:

1. The story of Dr. Jen Gunter who receives a patient who has undergone an unsafe abortion, and is bleeding to death. As the Boing Boing folks put it: "Required reading in this year of presidential elections in America, in which so many candidates would have us return to the dark era in which abortion was illegal. Outlawing abortion doesn't end abortion, it just makes scenes like this more common."
2. What China is doing in Tibet is just wrong. "The Guardian's Asia correspondent Jonathan Watts sneaks into Aba, a remote town on the Tibetan plateau, and captures this video report of how Chinese authorities are trying to stamp out dissent among ethnic Tibetans through military security, propaganda and forced 're-education.'"

I'd Want to Know

If you had the opportunity to know if you had a genetic disorder with no cure that would eventually kill you - would you want to know?

As Boston University bioethicist George Annas explained, "Since there is no way to prevent this disease, what good is knowing you will probably get it in the future?"

I'd want to know just because it would help you frame your life. There are some other good reasons here.

Stand Up For Yourselves Already

Part of the reason i've been disconnecting from politics lately is the incredible distaste I have for the Democratic party. They finally get themselves in position to pass progressive legislation, finally do pass Health Care Reform (albeit in a watered-down format, and despite themselves), and then run scared from any principled stand on it. It's almost like they aren't progressives at all! < / wink>
As Andrew aptly puts it:

One thing that still staggers me about the Dems (which is why I still feel so much contempt for that party). Why do they expect people to support something when they never make the case for it? You can listen very hard and not hear anyone defending the biggest shift in social legislation in a decade. Are they not proud of it? Or just, as usual, paralyzed by fear and political incompetence?

The Democrats' failure to define or sell themselves are going to lead to historic losses in November, and will then cause them to be even more scared in the future. It's a sadly predictable cycle.

Health Care: the Big Picture

So I haven't really been following the Health Care Reform debate very much because it's feels like conflicts in the Middle East: it's been going on forever, and I don't really know the underlying issues behind the problem nor do I know the parties involved.

However, Robert Reich has a good summary of the history of the debate and where we stand now, which is that "moderate" Democrats in the Senate are fighting to remove any single-payer feature out of any reform bill (ostensibly to assist their wealthy doners in the insurance industry). He writes:

First there was Medicare for all 300 million of us. But that was a non-starter because private insurers and Big Pharma wouldn't hear of it, and Republicans and "centrists" thought it was too much like what they have up in Canada -- which, by the way, cost Canadians only 10 percent of their GDP and covers every Canadian. (Our current system of private for-profit insurers costs 16 percent of GDP and leaves out 45 million people.)

So the compromise was to give all Americans the option of buying into a "Medicare-like plan" that competed with private insurers. Who could be against freedom of choice? Fully 70 percent of Americans polled supported the idea. Open to all Americans, such a plan would have the scale and authority to negotiate low prices with drug companies and other providers, and force private insurers to provide better service at lower costs. But private insurers and Big Pharma wouldn't hear of it, and Republicans and "centrists" thought it would end up too much like what they have up in Canada.

So the compromise was to give the public option only to Americans who wouldn't be covered either by their employers or by Medicaid. And give them coverage pegged to Medicare rates. But private insurers and ... you know the rest.
...
what more can possibly be compromised? Take away the word "public?" Make it available to only twelve people?

Excellent Idea

From a TPM reader, taking about the new restrictions on abortion included in the House's new Health Care Reform bill:

What would happen if a few female members of the House put in (or merely proposed) an amendment to the health care bill which stated that men would be barred BY LAW from purchasing health insurance which covered Viagra, all hair-growth medications or procedures or transplants, etc.?

The Title Says It All

Scary article:
Mom: Health insurance denied over condition she doesn't have
you'd think that the bad press alone would prevent practices like this but that doesn't seem to be the case.

In which I learn about rescission

It's a scary thing to contemplate.

More Insurance Absurdities

A doctor writes:

"Verifying coverage and benefits for our patients can take 20 hours or more per week. Another way to think of it: every hour of patient treatment time will require 30 minutes or more interacting with an insurance company."

Action must be taken.

There but for the grace of god...

Being someone that's been unemployed and self-employed a lot over my career, I read about all of the people lined up at volunteer free health care clinics because they're either un- or under-insured and am thankful for my wife's insurance. It may not be the best, and the deductables are very large, but at least we have coverage if something goes wrong. Not everyone can say the same thing.

This is why Health Care needs to be reformed, somehow

Andrew Sullivan's blog is again pointing out some of the awful absurdities in the current health care system, pain points that are being blocked out by the current "debate".

For instance, a reader writes in:

For a few months, I worked at an electronic medical billing company. I was astounded at how complicated and convoluted medical billing is, and this is ultimately why we need to have significant health insurance reform. What happens is a doctor's office will decide on a price for a procedure - for instance, a checkup typically costs around $180. Say I have Tufts. They might pay out $100 for a checkup - the rest the doctor writes off. Why not just charge $100 and not have to write off $80? Well, that's because other insurance companies - say Blue Cross and AETNA - might pay $120 and $150 respectively. So it make sense for doctors to charge significantly more than they would expect from most insurance companies. However, if somebody doesn't have good insurance or has no insurance, they are billed for the full amount -$180, even though the doctors office might expect to write off up to $80 dollars of that charge from somebody with good insurance. Given that the majority of the people without health insurance are lower income, this can cause crippling financial problems, or result in a denial of service. And why? Is someone with insurance "better" than somebody without? Are they more deserving of good health because they happened to not get laid off during a particular bad recession?

And another of his readers - who worked a job where they tried to automate medical procedure approval processes - points out the amazing waste that takes place in every doctor's office or hospital in the amazingly antiquated approval procedures that take place manually every day. Details after the link, but then there's this:

Of course we know that just because the insurance company says they will pay, it doesn't mean they really will. There's a whole different team of people who have to pick it up on the back end in that case.

Everyone who thinks that their current insurance is good, hold your breath that you don't get sick, because you never know what you will or won't be charged once the procedure is completed.

Cough Update

Because I know you're all worried about me.

I was told a few weeks back that I had contracted viral bronchitis and that there wasn't anything I could do about it. The doctor gave me some codeine-laced cough syrup (not as fun as you would suspect) and sent me on my way. Two weeks of sleeping on the couch later, there was no improvement in my cough, so, sight-unseen, they prescribed me a five-day Zpack of Azithromycin, an antibiotic for bacterial infections. This, combined with my uncle's advice (he's an Otolaryngologist) seems to have finally cleaned up the problem.

I'll blog more about this later, but my uncle thinks that the coughing was related to my acid reflux. The reflux tickles the throat, causing even more coughing and further aggravating the bronchitis. Taking stronger reflux medicine seems to have done the trick.

brutal sickness

Caught the latest flu going around last week and still haven't really recovered. These sickness just seem to get worse and worse with every year (or is it just that I'm getting older?)... regardless, i'm heading back to the couch for more healing vegetation, so continued radio silence for a while.