Playing health care roulette

The Thinker by Rodin

My two weeks out west on vacation were great. While I love the extra oxygen we have here in the lower altitudes on the East Coast, I do not particularly welcome the return of hazy, hot and humid, which passes for normal summer weather around here.

Nor did I particularly welcome the stack of unpaid bills, many of them large co-pays from various specialists for various procedures for my wife and I. My co-pay to have a varicose vein cauterized was $490.30. Still, at least I am insured. Anthem BC/BS paid the doctor another $3,268.71. The list price for the procedure was $4,843.00. Bear in mind the procedure was done out patient and including time in the waiting room took no more than two and a half hours. I was sedated but awake through the whole procedure.

Wednesday afternoon while I was still recuperating from the jet lag, I went in for a second procedure, this one taking about an hour longer. I expect I will pay at least another $490.30 co-pay for this procedure too. I hope that as a result the pressure will ease on the nerves in my right foot, although there is no guarantee.

While I sat in the waiting room, a working class man shuffled into the office. He did not have insurance and inquired on how much it would cost for a consultation. The fee was $475. Yes, it would cost $475 just to find out how bad his varicose vein problems were and to determine a treatment plan. If he requires surgery similar to mine, he can look forward to $10,000 or more of out of pocket costs to address them. As a self-employed individual, he is priced out of the health care market. His best hope is to work out a payment schedule with the doctor. Since he is not insured, it is likely that he is looking at years of payments to deal with his vein problems, assuming the doctor decides his credit is good enough to go ahead with the surgery, and assuming he can convince his wallet to go ahead with the work. With luck at age 39, this is his only major medical problem. What is clear is that like millions of uninsured Americans, he is playing health care roulette.

According to Republicans, he must be protected from socialized medicine at all costs. While he clearly cannot afford health insurance, according to Republicans he is better with no health insurance reform. In particular, Republicans, who are so much about “choice”, want to deny him the option of belonging to a public plan, perhaps similar to Medicare. For that would be “socialized” medicine, which must be bad, although would be perfectly acceptable if he were 65 instead of 39 and thus eligible for Medicare. We know the public option is bad because so many disgruntled Americans are shouting down speakers who say otherwise at community forums. According to Republicans, Americans will be better off, more solvent and presumably healthier if uninsured people like this man remain uninsured.

The disinformation campaign is working to some extent. P.T. Barnum famously told us a sucker is born every minute. Americans seem to revel in their ignorance.

About 11 percent of young citizens of the U.S. couldn’t even locate the U.S. on a map. The Pacific Ocean’s location was a mystery to 29 percent; Japan, to 58 percent; France, to 65 percent; and the United Kingdom, to 69 percent.

With such widespread geographic illiteracy, it is not surprising that well-funded campaigns financed primarily by insurance companies who are benefiting handsomely from the status quo are succeeding in convincing many Americans to act against their own interest. It is like we are living the novel 1984: Ignorance is Strength!

Republicans have proven adept at exploiting America’s ignorance and paranoid tendencies and seem to have no problem with bald-faced lying. The “problem” with Democrats is they seem incapable of the same disgusting behavior. Perhaps this is nowhere more evident than in shameless and bogus claims that health care reform will mean government-sanctioned “death panels” that will determine whether you live or die.

What one bill proposes is that Medicare will reimburse your doctor if you are in Medicare (i.e. age 65 and above) and choose to meet with him or her to discuss end of life care alternatives, such as whether you would like to be placed in a hospice toward the end of your life or should get a living will. This is certainly not a death panel, and such sessions are not even required. The patient chooses. If this is a government death panel then apparently our doctors are going to be secretly inducted into the civil service and given strict marching orders. It is such a mind-bogglingly false claim that it is amazing that anyone with two brain cells would believe it. Nevertheless, this is America, and our paranoia is always close to the surface. Thanks to Republicans, we are conditioned to believe the ridiculous. After all a plurality of Americans (45%) believe the earth was created by God no more than 10,000 years ago.

News flash: we already have medical death panels that effectively determine whether you live or die. We would be fortunate if the government was deciding, then we might have some say in it. Instead, the insurance companies often decide whether you live or die. If you don’t believe me and are insured, simply take the time to read the fine print of your health insurance contract to find out what conditions they will not cover. If your particular condition is not covered, assuming they do not unilaterally drop you as a client, you have two choices. If you are independently wealthy, you can pay for these other treatments out of your pocket. Alternatively, you can sell pretty much everything you own until you are nearly destitute and hope that the socialized medical system called Medicaid will cover the treatment you need.

It is legitimate to question the cost of a new national health insurance program. It is not legitimate to focus the debate on spurious and bogus claims that are simply boldfaced lies, like these imaginary government death panels. Other bogus claims: that illegal aliens will get health insurance, that federal dollars will be used to fund abortions, and that you will be required to sign up for a government health care plan. It’s a public option, not a public requirement.

What you will likely get from any bill that the president signs is the right to be insured by any insurance company licensed in your community, including a nationwide government plan if you prefer or if no insurance companies are available in your area, regardless of your preexisting conditions and with no fear of being dropped because your conditions have become too expensive. What you will also get is the ability to buy into any plan offered, including a government plan if you choose. If you are poor or have modest means, most bills would subsidize the cost of your insurance for a period. In short, you are much more likely to be able to be insured and more likely to stay insured. Logically, this should trickle down to those of us who are lucky enough to be insured now. For our premiums are already marked up to cover the cost of the uninsured clogging our emergency rooms.

I am sorry, but if you really believe that the government is getting ready to set up death panels for grandma, you are dumber than a box of rocks. Please send me your name and address so I can invite you to purchase some fine land that sits in the middle of Lake Okeechobee. Moreover, if by shouting down other voices at these rallies you succeed in stopping health insurance reform, you and millions of others who desperately need insurance will needlessly reap the foul results of your ignorance and rank stupidity. Instead of the government you need, you will get the government you deserve.

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