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cap, captain miss america
Getting up on the political soap box once again. This is not in my regular blog, only in my LJ.

I would like to point you all to a letter written by my Congressional representative, Mr. Jerrold Nadler.

And then I would like to point you to a little factoid. In the United States, 15.7% of American citizens and legal non-citizen residents are uninsured. That is 47 million people. That number comes from the beginning of 2008, and after the economic crisis that followed later that year and the rise in unemployment, I can only imagine that it has risen higher, although that is the number still being quoted.

I spent three years of my life uninsured. I was lucky in that I managed not to get seriously physically ill or injured. I did, however, have to see a psychiatrist for an anxiety disorder during that time period, which cost me approximately $350 a month, out of pocket. That was less than the lowest health insurance premium I could find that would have covered part of my visits to the psychiatrist. If I had chosen to insure myself, I would have had to pay slightly more for my premium, plus the cost of the co-pay, plus the cost of my medications-- in short, probably close to $600/month for the same quality of care I was receiving without paying into a private insurance plan. And my doctor would have seen less of that money than he did when I was paying him directly.

Now, that insurance plan, the one that would have raised my monthly healthcare costs by $250? Would still not have covered any truly serious illnesses or hospital stays. Like my little brother, if I had been admitted to the hospital, I would have been kicked out as soon as preliminary tests had been done, because they would have seen that my insurance, though expensive, did not cover the costs of the kind of hospital stay and treatment he really needed. I would have been bounced around from doctor to doctor when the doctors saw that the insurance was unwilling to cover the actual costs of the treatments he needed.

And yet, I would have been paying hundreds of dollars a month.

When I lost my last insured job, in 2007, I was not going to elect to keep my insurance. This time, the plan that was available to me would cost $547/month. That was more money than I made after taxes and rent. My mom was kind enough to step in and pay it-- which was lucky, because by that point, my asthma, which had generally been mild, had developed to the point where it required regular maintenance, including doctor's visits and inhaler refills.

I got a new job with insurance literally two months before my COBRA would have run out. I am now insured again, but every doctor's visit is still a battle with the insurance company to get them to pay what I am entitled to receive from them. And that is when I pay a premium of about $100/month. Many months, I do not go to the doctor at all. I have fallen back on visiting the free clinic at work because if I go there, I only have to pay for my prescriptions and not my visits.

But most people don't have free clinics at work.

I am a healthy, upper middle class, thirty-one-year-old woman. And the insurance industry in this country is failing me.

If it's failing me, someone who has enough education and a good enough support system to wade through the ridiculous red tape, to argue my rights with the insurance company that tries to nickel and dime every item in spite of taking my money every month, someone who can afford her doctor's visits when the insurance company refuses, what is it doing for all those uninsured people out there who maybe don't have well-off parents...or who are elderly, or don't speak English as their first language? What about people with serious pre-existing conditions?

I am sure all of you have heard by now about Sarah Palin's ridiculous accusations of death panels this week. Except to me, they're not so ridiculous. Right now, 47 million people living in this country face a death panel every time they get sick or severely injured. They face a choice of letting their condition worsen, or risking bankruptcy. They don't face government bureaucrats, who, at this moment, do run a public health care system with a high success rate, and whose jobs are dependent on the quality of service they provide. They face faceless megacorporations whose job is to pay out as little money as possible, doctors who are under pressure to cut costs in spite of the Hippocratic Oath, and the emptiness of their own pocketbooks.

It is embarrassing, the state of health care in the United States. It is embarrassing that we live in a country where people-- any people-- are not willing to pay into a system to help their friends and family when they need it most. I am embarrassed by the idea that someone making many times what I do might care more about saving a little money in their line-item deduction every year than they do about the idea that their neighbor down the road might not be able to afford to call EMS. And I am embarrassed that we live in a country where we allow our elected officials to take blood money from an industry that is behind the cause of more accidental deaths than any other in the United States. You want to see a death panel? There's your fucking death panel. Ask any uninsured parent of a Downs Syndrome kid who doesn't make as much money as Sarah Palin does.

The state of the health insurance in the USA has always baffled me. There is so much wealth to go around compared to pretty much every other place on the damned planet (except the UK and Japan, I guess), and yet people have to fight to get basic medical care? I've never lived in a country without state-sponsored health care, and to me the situation in the USA appears rather, well, barbaric -- no offense. Not just because the government has sat by for so many years, essentially letting people suffer as you describe, but also because becoming a doctor these days is equated not with healing the sick but with becoming rich. :\

No offense taken-- I agree that is is barbaric. The sad thing is that in spite of huge medical fees, many doctors don't become rich-- medical costs are spiraling just so that they can get a fair percentage after the insurance companies take their cut, or because the pharmaceuticals and medical supplies companies jack up the prices of the things the doctors need to have in order to practice medicine. I would have less of a problem with the whole system if the people who were, you know, actually doing the life-saving were the ones making the largest profit. While, yes, there are profiteer doctors, the health system as we now have it was originally intended to regulate medical profiteering-- to keep doctors from charging too much-- and yet all it has done has not been to lower prices, but to put that money into the pockets of insurers instead of the pockets of medical practitioners.

I am seriously horrified by the idea that having the government pay for our health care is considered dangerous. I hate the way that these people who are supposed to be members of our government are engendering feat in the government in order to get payoffs from these companies. And it is ironic that the Congresspeople railing against government-sponsored health care receive government-sponsored health care. If it is so awful, I would like to hear some anecdotes from them about why it is unacceptable. But they don't seem interested in giving it up for themselves.

Our system is failing, and we have these people trying to scare people into believing that an utterly broken, failed system is better than the system that they use to get their health care.

And I just totally expanded on my rant there, sorry!

Thank you. Thank you for this post. It's well thought out, it's articulate, and it's not based on complete bullcrap.

Granted, I've never fully understood the US health care system, but I also don't claim to. I'm getting really tired of seeing posts on my flist being SO against UHC because it means OTHER people decide who gets treated. It kills me because (at least from what I gather) isn't that basically what insurance in the states does? They choose to cover things, or they don't? And the people who don't have insurance, or it doesn't cover preexisting conditions are SOL, and have to hope to god they never get sick?

I said this on the only other post I've read that's not all "rawr this is bad" and I'll say it here. I'm glad to be in a country where if I break a bone, or get sick, or whatever, I don't have to weigh the pros and cons of going to see a doctor, or going to the ER. I just go.

Which brings me to the wow, how much do I hate people spouting off shit about countries with standardized health care when they really have no idea? I read one post with someone saying that it's huge, like, years long waits to see doctors, and that because a lot of it is through OHIP and the like, it's all substandard care. And all I can ever really think is that at least here everyone can get care. It's not substandard, but even if it was? I'd rather get substandard care (to a point) than have to go bankrupt to get any care at all.

...err, that comment got sort of long. Way longer than it was meant to. Sorry. But yeah, thank you. For at least being logical.

A friend of mine was upset with the idea of single-payer health care because supposedly if they had lived in Canada, her (very prematurely born) nephew wouldn't haven been considered a viable candidate for intensive care because "they would only cover the 750 most common medical procedures, and care of a preemie his size was #752" or something like that. (This doesn't mean that the care wouldn't *exist*, mind you, just that you'd probably be doing some fundraising to pay for it, much as is often done when you have a family member with a serious medical problem that insurance isn't covering. And I'm still not sure this was accurate.)

I'm also aware that the Veterans Administration health care system frequently sinks to a truly appalling level of fail, so I can understand the perspective of, "Wow, if that's what national health care would look like in this country, I don't WANT it!"

Some of the best health care my family had was when my husband and I were broke students on Medicaid, though. Really.

I don't even know where to start on the massive conglomeration of fail that is our current system.

I have a friend here who, thanks to the stimulus portion of unemployment insurance checks, now does NOT qualify for Family Health Plus. He would qualify for HealthyNY - which costs more than he can afford and for some fucked-up bullshit reason is NOT subject to Timothy's Law (which is potentially relevant for him, since he has fibromyalgia and a lot of meds used for fibromyalgia were originally psychmeds, which HealthyNY refuses to cover - so it all depends on just how stupid they get about that).

The alternative, while he's still in school, is to be on his parents' coverage, which a) requires someone in Kansas (where his parents live) to review every bit of non-emergency medical care he has in NY and b) may or may not be subject to getting yanked if his parents decide to continue being asshats about his being FTM.

And on a more personal note, if I'd decided to GO to the emergency room when I was 19 and twisted the hell out of my ankle instead of saying, "Screw this, they'll give me an ace bandage and Tylenol and charge me $50, and I have those at home! Besides, I need that $50 for a bus pass/new work-appropriate shoes/groceries for the next week/all of the above!" - maybe, just maybe, just possibly, I wouldn't have the chronic pain/mobility issues that I am now dealing with. I might not have gained quite as much weight over the 12 years since that happened. I might be less depressed and anxious because I can't move as well as I used to. Because maybe there *was* something else that could have been done, then.

Edited at 2009-08-12 01:58 am (UTC)

The last point is precisely why we need better coverage for minor and preventative care. So many people don't go for regular checkups when they're healthy, or get something that seems minor checked out, because they know that it is going to break the bank. Even people with coverage do this-- I know I put off going to someone about my asthma for a really long time, and self medicated with eucalyptus and caffeine for ages once I knew what it was. The fact of the matter is that if we had better preventative and minor illness/injury care, people like you wouldn't end up with worse and more costly health problems later.

I've spent most of my life without medical insurance. I really feel any amount of money would be worth knowing that I won't be in that position again. Because it's scary. And yeah, seeing people stand up at these town hall meetings and oppose any attempt to make things better as 'unamerican' because someone on the radio told them we'd be euthanizing everyone with cancer or something makes me want to cry. There are legitimate reasons to disagree with specific points of this health care reform plan, but I feel anyone who doesn't think the system needs to be changed at all is either willfully blind or has had a very charmed life.

Agreed! I do not know what kind of health care any of these people are on who oppose it, but the sad thing is that I believe a lot of them probably don't have very good health care but have been made to believe they will have to pay through the nose.

I think we need to make it illegal for anyone in a political office to lie or give out misinformation. Can we do that?

The health care in this country is absolutely embarrassing.

I am someone who suffers from a mental illness, which I'm not ashamed of, but I do need medication for it- unfortunately, the medication I need to be even remotely functional? $550+ a month. The fact that there is a very real financial barrier preventing me from getting help has just been... utterly disgusting.

I am sorry this has happened to you! I know several people in this predicament, including my grandparents, who can't afford their regular medications.

My mother is a metal health professional in private practice who wrote her masters thesis (in the mid- to late-70s) on how managed care was going to ruin the country.

My mom charges her patients $150/hr. If they have an insurance that she takes, she sees about $15/hr for the session. That does not count the time she spends formulating and submitting treatment plans, dealing with companies who don't want to pay, and convincing insurance companies that they need to give out more sessions.

My mom is not a doctor. She does talk work. If she is seeing someone in conjunction with a medical (prescribing) doctor, they both have to justify this. If she sees someone who she feels it will take more than ten sessions to "cure," she has to justify this.

My mother has had patients break down crying in her office because insurance wont okay more sessions, they can't afford to pay out of pocket and their work says they can't come back until they get their personality disorder in hand. Which isn't helping with the "pay for it" part.

Healthcare in this company is hurting the sick, it's hurting the people who want to help. The only people it's helping are the ones at the top of the healthcare companies.

Yeah, I have had a couple doctors stop taking insurance all together because they could charge less and make more money without the insurance company being involved-- One of the doctors I saw just asked people what the cost of their insurance co-pay was and charged based on that, without going to the insurance company because he knew the insurance companies wouldn't bother paying out.

Tell your mom thank you from me.

this post is incredible. it's so much more eloquent than I could ever put it and I almost want to print it out and give it to people when they say government health care would be terrible for America.

that sort of thinking is completely irrational to me--people who trust Sarah Palin and Rush Limbaugh and all of the drivel on Fox News instead of actually taking the time to sit down and check facts infuriate me. especially because a lot of conservatives (especially in the South) are not wealthy. they're the kind of people that would benefit the most from this system, but they're so blinded by these incendiary voices in the media that they don't question anything. so many of our laws benefit big business and completely ignore the needs of the individual. but I guess that's what happens in a country that cares more about making a buck than making sure everyone's taken care of.

rant aside: I'm 23, in good health, and uninsured. I've been uninsured for over a year. I have a family history for pretty much every disease (my mom alone has cancer, degenerative discs & chronic pain, high cholesterol, and an overactive thyroid). every time I get on my bike I know I could get hit (I've almost been hit by unaware drivers 3 distinct times) and I'd have no way to cover medical bills. I'm like a ticking timebomb.

I think that the best thing that we can do is to continually tell our stories. I do not know anyone who has been unaffected by the state of healthcare in this country, whether they are a patient, the friend or relative of a patient, or a doctor. We need to keep telling people. When people question the idea of public healthcare, tell them your story. Ask them what private health care has done for them and the people they love. All I did here was relate my story, and I think that there are so many powerful stories like mine-- more powerful, even-- to back it up. That is more cogent than any statistics or rhetoric in the world.

So I admit I haven't had much experience with insurance/healthcare because I have been generally healthy, and I'm still covered by my parents, and my parents are well-off enough to have the time, education, and inclination to read and go after any insurance company about their fine print. But I have been reading about the issue as it's popped up in the news, and some of the commentary that I see just baffles me.

What I don't really understand is why people are like, "I don't want somebody determining what treatment is covered! I don't want my choices limited as to what doctors I can see!" As far as I understand it, the insurance companies are already making the decisions as to what kind of treatments are covered. They also determine what physicians you can see, since insurance benefits only cover those doctors who are within the group or whatever. At least the government won't deny your claim for some bogus reason because they won't be providing healthcare to make a profit. Insurance companies, on the other hand, have economic incentives to withhold care and deny claims.

I had a seizure in the spring of 2008, while I was at school. Luckily, I am covered, so that was one less thing to worry about. It was still a pain in the ass, though, to find a doctor who would accept the insurance, and to get whatever tests her ordered done and interpreted. While I'm pretty sure that the doctors knew it was nothing major (my CT in the ER came back clean), it was more than a month after I had the seizure before a doctor interpreted all of the tests and such that had been done and determined that it was a one-off thing. People talk about how, with socialized medicine, you'll be waiting months and months for treatment. That's kind of what happened to me, and I'm insured. And even several months after the hospital incident, my dad was still on the phone with the hospital and insurance company trying to sort out billing matters.

The system is a mess. It positively frightens me to think of what would have happened had I not been covered by my parents' insurance. I worry now about what will happen to me if I can't get a job straight out of school where I will have an insurance option available, and even then I'll still have to pay (like you said) a fairly large sum every month. Something really needs to be done. I don't know what, but the system is broken and needs fixing.

Well, hell, you know my story. I'm the perpetually broke chick. You also know that when I lost my job, Grendel decided to terminate his health care from work, simply because we badly needed that extra five hundred dollars a month for basic necessities. It wasn't doing much for us, anyway--another reason we decided to drop it was because they had just made the announcement to raise the premiums by 14% while reducing coverage. Again. My insurance from any job I've ever held is so laughable that we've never even bothered to opt into it. When we're sick--really sick--we go to the ER, or to the local Doc in a Box, and pay out of pocket. If we can't afford that, and most often we can't, we swallow our aspirins and take our DayQuil and try to hope that this time, it isn't serious as it feels. And that's that. That's always been the way it's been.

To everyone who has complained and feared and decried socialised medicine, I can't help but be amused. They're afraid of long waits for doctors, that help will be refused if they do not meet a certain government-imposed criteria. Down here on the working poor level, that's what we've always had. Even if the Republicans' worst fears of socialised health care are realised, right down the death panels, there will be absolutely no change for me--except that I won't have to pay for it anymore.

This is a really fantastic post. I've been so incredibly angry about this, and it's nice to see someone articulate why so well. Thank you.

I know I've bitched about the Canadian system, but mostly because it's misrepresented to other countries, especially to the US. Our healthcare isn't "free" and I think it's ridiculous to wait thirteen hours in emergency room for any reason.

That being said? It's better than nothing. It also makes me think that even if the US gets a medical system that isn't about making money, it will still have a long way to go. It seems like it's punishing people for being sick or born with special needs. That is the number one reason I won't move to the States: I can't imagine going broke just for being sick.

I don't understand why anyone would think universal health care is evil. My only theory is that some people in power think that America is a capitalist nation, so even medical care is fair game.

I hope none of that was too harsh or ignorant. It's kind of a hot topic for me.

I'm British, and if there's one thing about the USA that has always perplexed me, it's this. Our healthcare system is far from perfect, but it's free and it does the job to a good enough standard - many of the imperfections are to do with the 'inconvenience' of having to wait, but to be honest that's just an annoyance.
I've just never understood why anyone would think it a good idea to turn healthcare into a business?

Oh, such agreement.

SUCH agreement.

After a decade being uninsured, last year I got my first job that offered insurance: $60 a month for a thousand dollars if I went to the ER and fifteen hundred worth of money if I got cancer.

And that was the best one on offer.



I'm Canadian and I have a friend in the USA who has lupus and fibromyalgia. With her insurance and her medication costs, she is constantly struggling to make ends meet - and medicaid looks at people's gross income rather than what they're actually making after cuts and after missed hours.

I have a fair amount of medical problems...and the only real flaw I've found with the Canadian health care system is that you can wait a long time in the emergency waiting room to be seen (I was once given an estimate of 12 hours for how long I could expect to wait). I think a lot of this could be solved by having more family medical practices a) open later, and b) equipped with X-ray machines and labs for bloodwork and such.

At the moment, the wait times are a problem - and in spite of them, I would much rather wait than go bankrupt.

...I would really like to slap people who go immediately to emergency when their problem is something a walk-in clinic doctor could address though.

Oh, that can happen in the US, too. The way most emergency rooms work is that non-life-threatening injuries and illnesses-- things you could go to a regular doctor for, or things that can wait-- get queued up differently than life-threatening items. My mother once put a knife clear through her hand and waited four hours-- because there happened to be a heart attack and a respiratory ailment that came in around the same time. If you go in for a sniffle or whatever, then you will wait for a really long time. The difference is that we do have regular medical practices that can run standard lab work open late, so going to the emergency room over a regular doctor or clinic is a choice that can be avoided if you have insurance that covers the regular doctor in your neighborhood.

you got it sister. dead on. I couldn't have said it better myself. I was without health insurance for about two years... generic meds paid out of pokcet. and really expensive meds sent by the drug company (it's called the "Bridges to Access" program. my pharmacist at the sliding scale clinic knew about it. geniuses, all of them!)

anyway. I agree. you're awesome.

Sister SMiley agrees.

(mind if I repost?)