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The Health Care Fiasco

Beth Grimes
Message Beth Grimes

Your money or your life. That's the choice we have. The insurance industry is made up of profit-making commercial enterprises, my friends, and your medical insurance provider is one of them. These companies don't pay for your illness or injury unless you have already blessed their outstretched palms with a hefty chunk of your hard-earned cash.

They may not cover your expenses even then. Your insurance company loves to put limits on your benefits and their claims adjusters are skilled at finding reasons to deny payment of them. Of the insured, most are under-insured, usually because they can't afford costly comprehensive coverage. Three quarters of the two million Americans who went bankrupt in 2007 had health insurance that didn't cover all their medical costs.

Reimbursement for the cost of our health care and prescription drugs should come out of the pool of money we policy-holders create by paying insurance premiums. Why is it so hard to get that care and those meds? Could it be because so much of our premium money is spent for budget items unrelated to our care? Expensive advertising? Corporate executive officers' six-figure salaries plus additional lump sums given those execs for keeping costs down and profits up? Do we really want to finance some CEO's bonuses and other perks while the health care we get for the money we pay is often inadequate, sometimes even denied?

The Los Angeles Times recently reported that average health care costs to Americans was a staggering $7,026 per person in 2006. Yes, that's per person, not per family. The tab for medical care increased 6.5% in that year. Did your pay increase by 6.5 percent in 2006?

Could some of the added cost be related to the medicare prescription drug benefit? Oh, yeah, baby. The New England Journal of Medicine, March, 2006, titled a report on the so-called drug benefit a "Part D for defective" program. The NEJM states that Part D was flawed from the get-go, because of its dependence on multiple private companies to create a complex public program that could be comprehended by millions of elderly patients. More than half of American seniors say it is hard to understand.

Lest we forget, Part D came into existence only after an unheard of 3-hour marathon session in the House of Representatives. During that time, reluctant members of Congress were pressured until they gave in and consented to approve this perpetration. Would you be upset to learn that Part D will cost us all around $80 billion a year? Are we a little bit angry because the authors of Part D included a provision making it illegal for Medicare to negotiate lower prices for drugs needed by old people? The way the Veterans Administration can negotiate? The way other industrialized countries can negotiate?

The Medicare drug benefit is only one piece of a flawed health care system in the USA. There are 46.6 million uninsured people in our country. The number of uninsured children has grown to 8.3 million and those numbers keep increasing. Most Americans who have health insurance are under-insured. By now experience has taught us that under-insured means: budget-busting deductibles, co-payments, lab fees and the exclusion of pre-existing conditions.

In spite of President Bush's claim that the federal government is meeting its health care obligations to those who cannot afford insurance, his budget cuts $5.1 Billion over ten years from Medicaid, the program that provides med coverage to low-income kids, their parents, the elderly, and the disabled.

Think there might be a better way? There is. A proven, workable proposal for universal health care is a single payer, tax supported system. The USA is the only industrialized country without publicly financed, comprehensive health care. Many will say, "but that would be socialized medicine and we don't want government bureaucrats interfering in our medical care." Well, friends, interference is exactly what we have now, except that it's insurance company bureaucrats who interfere. Horror stories abound of legitimate claims of policy holders being denied reimbursement for treatment ordered by their physicians.

No matter what the medical insurance industry and its handmaiden, the pharmaceutical corporations, say, single payer is not socialized medicine. Socialized medicine is a system in which hospitals are owned by and doctors work for the government. Our veterans administration and military doctors get their paychecks, and hospitals are owned and maintained by the plan, this way. Spain and Great Britain have similar structures to provide for med-care of their populations.

In Canada, Japan, Australia and most of western Europe, it is only payment for health care that can be called socialized. Patients are free to choose their own doctors and those providers receive fee-for-service reimbursement. Our own Medicare is such a system. Although a single payer plan would raise our taxes, those tax increases would be offset by freedom from the insurance industry's demands for exorbitant payment to cover services we may have to fight for or never receive.

No matter how hard it may be, no matter how much political and health insurance industry resistance will have to be overcome, we must find a way to replace our broken health care system with one that provides tax funded, affordable, readily available, good care to all Americans.

Unless and until that happens, here's the best medical advice you'll find anywhere: don't get sick.


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Beth Grimes is a freelance writer in Petaluma, California.Her opinion pieces have been published in the Petaluma Argus Courier, Coastal Post, Santa Rosa Press Democrat and San Francisco Chronicle. She has written and published short stories of (more...)
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