Some of you may remember the diaries I wrote many months ago about Catherine Seipp the National Review Online columnist who is battling lung cancer.
Thankfully she seems to be doing okay and I wish her good health as I know all of you do. But her thinking in recent columns about healthcare and health insurance in America is so wacky, I almost don't know where to begin.
In her recent NRO essays, she continues to sing the praises of healthcare in America. Her heroes are two Republican governors, Romney and Schwarzenegger, who she believes are struggling to reform the broken system.
In an column entitled Mean Old Republicans Care: Health-insurance myths and misconceptions, she laments to her readers about an endless wait be seen in a Los Angeles emergency room. I gather, the place was overrun with uninsured patients. She needs to address her complaint to those responsible, the apologists for our broken system like Messrs Bush, Romney and Schwarzenegger.
Ms. Seipp, I have some bad news, I predict ERs are gonna get busier.
The proliferation of High Deductible health plans, otherwise known as junk insurance, (with or without a Health Savings Account), could in fact drive up the costs of health care as more underinsured people are forced to use emergency rooms.
This is from a study called HEALTH SAVINGS ACCOUNTS UNLIKELY TO SIGNIFICANTLY REDUCE HEALTH CARE SPENDING from the Center on Budget and Policy Priorities.
If a medical condition or illness goes untreated because lower-income individuals are unable to pay out-of-pocket for appropriate primary care or prescription drugs, their health could decline, forcing them ultimately to make greater use of costly services like emergency room visits or hospitalization. As a result, to the extent that low-income individuals and families fail to use preventive care, primary care, prescription drugs, or other cost-effective, lower-cost services, HSAs could actually drive up the health-care costs that such people incur.
http://www.cbpp.org/...
But back to Ms. Seipp. Did I say wacky?
As someone who’s spent an unpleasant amount of time lately in emergency rooms, I’d also like to see these places stop being used as walk-in clinics for people with stomach viruses or the flu. In October, for instance, I sat in the Cedars ER waiting room for five and half hours before being admitted.
While there, I noticed a couple of robust guys next to me in the waiting room who had giant plates of hamburgers-and-fries from the cafeteria. Whatever was wrong with them, it certainly didn’t affect their appetites.
[emphasis added]
http://article.nationalreview.com/...
We'd all like to see less crowded emergency rooms, but I fear as the ranks of the uninsured swells, it's going to get worse before it gets better. Surely Ms. Seipp knows that hospitals are required under federal law to provide emergency care. [EMTALA - The Emergency Medical Treatment and Active Labor Act] http://www.cms.hhs.gov/...
As I said, Ms. Seipp, pretty soon, emergency rooms across America may also be filled with holders of the latest Republican scam du jour, mandated health insurance. This is known as the law of unintended consequences.
Many of these low-income Americans will undoubtedly have purchased high deductible health insurance, which will probably also mandate that certain emergency room vists be covered in some pitiful fashion. Hence, you can bet emergency rooms will get a lot of customers. Consumer directed high deductible health insurance (junk insurance), is nothing but a giveaway to the for-profit insurance industry. Forcing people to buy stripped down, bare-bones health insurance policies is not universal healthcare.
The Massachusetts Plan is a case in point.
The minimum plan detailed by Governor Patrick would cover the average uninsured Massachusetts resident, who is typically around 37 years old. It includes prescription drug coverage and covers basic medical care, such as emergency room visits and outpatient medical care.
http://www.courant.com/...
Now who do you think is going to buy this "minimum coverage"? Low-income Americans. High deductible insurance is also known as catastrophic insurance because it is for catastrophes. It provides little or no "first dollar" coverage for routine healthcare problems. So the impulse, particulalrly when the choice is food and rent or treating a urinary tract infection, is, well, food or rent. But when that annoying urinary tract infection becomes bad and unbearable, you head to the ER where the care is expensive and covered. Again, think: law of unintended cinsequences.
I have an alternative theory about those jolly people who were taking up space in Ms. Seipp's Los Angeles emergency room. Perhaps they had high deductible health insurance and they had delayed seeking treatment. This is the normal course of events with junk insurance. Repeated studies have revealed that when people are responsible for first dollar payment, they delay seeking care and small problems become big and expensive problems. And where do many of these people end up? Clogging emergency rooms across America.
Ms. Seipp, this is America. Emergency rooms are where uninsured and underinsured people go to receive very expensive healthcare.
Here's a little more of her own odd thinking.
I first began noticing the many odd notions people have about health insurance last year, after I wrote a Los Angeles Times op-ed about my troubles with Blue Cross and my cancer treatments. A commenter on Kevin Drum’s liberal Washington Monthly blog observed: "I can’t help but notice that this woman is a writer for the National Review."
http://article.nationalreview.com/...
Despite finding herself--she's a lung cancer patient--in the grip of the notorious Blue Shield of California retroactive review department and denied treatment, she finds all is good in the world.
(In my case, Blue Cross had retroactively denied an almost-approved lung-cancer treatment, even after two CT scans showed it had been working. I protested to the state of California, who sided with me and my doctor against Blue Cross.)
Like I said, only her Republican friends, great minds like Arnold Schwarzenegger and Mitt Romney, are coming up with solutions to the health catastrophe.
But for some reason, the only politicians pushing expanded access to health care right now are Republicans: Gov. Arnold Schwarzenegger of California and former Gov. Mitt Romney of Massachusetts, who’s just left his post to become a (mean old) Republican presidential candidate in 2008.
The Republican solution is to mindlessly repeat "mandatory health insurance, mandatory health insurance" a la other idiot Republican mantras, like "mission accomplished".
Both Schwarzenegger and Romney believe in mandatory health insurance — as do I, because it spreads the risk among a wider pool and so makes insurance more affordable for everyone.
In fact, Ms. Seipp, emergency rooms will be overflowing with uninsured and underinsured Americans until and unless we eliminate the waste inherent in our for-profit healthcare system and adopt single-payer healthcare just like the rest of the civilized world.
Many of us believe, the Massachusetts plan is DOA because it just delivers more bodies to the for-profit insurance industry. Maybe Governor Spitzer in New York will heed the advice of physicians who know the only solution to our national shame is single-payer.
Family physicians from across the state gathered in Albany Monday to lobby lawmakers. Their concerns include the fact that nearly 3 million New Yorkers are uninsured and many more are underinsured, while others have insurance that does not cover significant items like medications.
When medications are not covered, this is what we mean by the term underinsured. High deductible health insurance is bogus, it is "insurance" in name only.
Rising costs have a growing number of employers either dropping or reducing coverage. The doctors also complain that dealing with multiple insurance plans, with their different rules, forms, and procedures, wastes an estimated 20 percent to 30 percent of the health care dollar.
The Academy, which represents about 3,000 family doctors and more than 700 medical students, would like have all payments funneled through a single payer, eliminating multiple rules and procedures, enrollment and eligibility problems.
"A single payer health plan is the best way to control costs and reduce administrative waste and thereby insure long-term survival of universal, affordable coverage," said Dr. Linda Prine, chair of the Academy's Commission on Public Health.
"In Albany, the attempts at expanding coverage and cost control, though laudable, only tinker with the current system. The weakness we all witness with tinkering is that New York has achieved neither universal coverage nor effective cost control. Instead, we are bankrupting ourselves, making small dents only in adding broader coverage, and implementing even more administrative procedures. Moving to universal coverage is a big step. The current system is not working; we should not take a failed system and make it a bigger failure."
http://buffalo.bizjournals.com/...
One more thing, Ms. Seipp is now engaged in an interesting battle with the son of Barbara Ehrenreich which you can read about on Barbara's blog here.
http://ehrenreich.blogs.com/...
And Ms. Seipp's version here:
Young Ben Ehrenreich — a lefty true-believer, like his author-mother Barbara — wrote an opinion piece for the Los Angeles Times earlier this month about getting his girlfriend’s broken ankle set gratis, via the emergency room at L.A. County-USC Medical Center. I wish he’d told us what he thought the experience should have been like, rather than giving us his slice-of-life account of how it was — because what struck me were the similarities between my experiences as an insured patient at the excellent L.A. private hospital Cedars-Sinai and Ehrenreich’s uninsured girlfriend’s at County-USC.
http://article.nationalreview.com/...
And here's a link to Ben Ehrenreich's original piece in the L.A. Times.
'THIS IS THE county hospital," they would say. They would take one look at me and would seem to feel that an explanation was required, a preface for whatever arcane rule or routine humiliation it was their duty to inform me of. "This is the reality," they would add, repeating the phrase like a mantra, voiced with dull defiance, resignation and apology.
I heard those words from an ER nurse, a surgeon, an X-ray technician and a county police officer. And I never heard them addressed to anyone but me. My girlfriend had broken her ankle and needed surgery. She was between jobs and between health insurance plans. We couldn't afford the thousands of dollars the surgery would have cost at a private hospital. So I bundled her up at 4 o'clock one cold morning in January, drove to Boyle Heights and checked her in at the emergency room at L.A. County-USC. (That's the best time to go, a friend had advised. And it was. After just five hours, a gurney opened up.)
http://www.latimes.com/...
Too much to chew on today. I know.