I just listened to this week's Bill Moyers. It was on health care, and it was excellent. The gist of the show was that the Obama health plan is too vague at present but the basic elements that are apparent are that individuals would be required to purchase health coverage if they don't already have it, the coverage would be subsidized, and they will buy either private insurance or (we hope) go for a public option.
The women who were interviewed on the show felt that this was keeping a bad system in place and just adding money to it. They noted how Obama said that the costliest option is the current system, and said that that's not true. It will be MORE costly if we keep the current system and then throw more money on it. They also feared that the drug companies would take the healthiest patients for themselves and dump the sick onto the government's public plan.
If that's the case, that's bull shit. I want Medicare.
To all of the people who talk about rationing care, it's rationed now. It's rationed, and I don't get any. I'm fortunate, for the moment. I had health insurance until recently, so now all I need are occasional prescription refills. I pay out of pocket and it costs about the same I might pay in insurance premiums if I had insurance (drugs are $150/mo, assuming I fill the bare minimum of my prescriptions, and I got free birth control from Planned Parenthood... if I had to pay it would be $60/mo).
I'm not alone. Lots of us don't get any care. If you have a certain type of job, you get care. Many have high deductible plans, which are virtually worthless unless you have a medical catastrophe and accrue costs so high that the insurance kicks in after you pay the deductible. That's rationed care too.
I've seen a lot, during the time when I worked in health care, and when I had health insurance myself. One patient was on a successful cholesterol drug and then her insurer changed the formulary and it was no longer covered. The drug would now cost an extra $100/mo, which the patient could not afford. She worked with her doctor to try other cholesterol meds, with little luck.
She accrued lots of costs as she visited her doctor more frequently and got frequent blood tests to check if any of the new meds were working. None of them did. When I spoke with the doctor, he was about at wits end over this. It looked like his patient was going to have to go back to the original drug that worked - and she'd have to pay.
Then there's the time that I needed to go to a hospital in Michigan for a nationally recognized migraine program. It was a unique program, in that they give patients interdisciplinary care - IV meds, education, mental health care, perhaps biofeedback, etc - to help them find a way to reduce their headaches so they can live with them. My insurance said no.
My neurologist called the insurance. The insurance said I could go to the hospital locally. No, I couldn't, said my doctor. The local hospital doesn't admit you for headaches unless it's an acute case. You can be admitted if you have a bad headache, and as soon as you're down to a 4 out of 10 on the pain scale, they send you home. They don't help you manage your headaches long term. Too bad, said the insurance, still insisting I could go to the hospital locally.
Medicare doesn't pull that kind of bullshit. So why would we set up a new program that does? The idea that any single payer or government run system would ration care is totally bogus.
How about choosing your doctor? Right now I can't choose my doctor. Well, right now I can actually. They are all equally expensive because I'm uninsured. But when I had insurance, I couldn't choose my doctor at all. On my last insurance, a PPO, I couldn't find anyone who I was covered for.
They had an 800 number you could call and a website you could search to look for doctors. I tried using it and couldn't find just a regular, local, primary care doctor. Nor could I find a psychologist to see after my brother died. I found psychiatrists and social workers on the list, but not one psychologist.
Before that, I had an HMO. I picked an HMO that my doctor accepts, so in that case I was OK. For primary care, that is. But how about for my neurologist? I was referred (in network) to a neurologist, but I was unhappy with her. She was the only headache specialist in the network but she was not good, for reasons I don't need to elaborate on here.
Then I got another referral, in-network, to a general neurologist who wasn't a headache specialist but still saw headache patients. He was a jerk. He never even read my chart, barely paid attention to me, and then overbilled me. I paid my $20 copay and never complained about the bill because the insurance was going to charge me $20 as a copay no matter what the total bill was. But I didn't go see that doctor again.
Surely there must be a good headache specialist somewhere around here, but if one exists, they weren't "in network" and I never saw them. After those two visits to the two bad neurologists, I gave up and stopped looking. I'm done taking shots in the dark to find doctors based on who is in network. I found my psychologist (out of network) from a friend's recommendation and she's great. I'd prefer to do that for a neurologist - if and when I can afford it. If I had Medicare, pretty much all of the doctors would be "in network" because the entire freaking United States IS the network.
All of the other lies they tell about "government run" health care are equally flimsy. Ask anyone with Medicare if they hate it. Ask them if it's like getting their health care from the DMV. Ask them if they want Congress to repeal Medicare and make them buy insurance from a private insurer so they don't have to deal with having "government run" health care.
What about having your health care run by bureaucrats? Guess what? You already do. IF you have health insurance, that is. Take that dipshit who didn't want me to go to the hospital even though my doctor argued with him on the phone for half an hour that it was medically necessary. He worked for a private insurance company, not the government, but he was a bureaucrat nonetheless.
Yes, there is some degree of bureaucracy in Medicare too. But nothing like the amount in the private insurance industry. After all, Medicare's primary goal is to provide care; private insurance's goal is to deny it. It seems to me that given a suffocatingly expensive private system that already puts a bureaucrat in between me and my doctor, and a government system, I'll take the government system.
Repealing Medicare would be a political non-starter, and for a good reason. People like it. It works. So if it works - why is anyone believing this nonsense that so-called "government run" health care is no good??? And why are any legislators scared to stick their neck out for a good single payor or public system, knowing now what a success Medicare is?
After listening to Bill Moyers, I'm pretty upset. I like the idea of the government spending whatever money is needed to insure all of us. That's good. But requiring us to all have insurance, and requiring us all to buy it? No thanks. It makes sense that you're required to have car insurance. If you can't afford it, don't buy a car. But you don't get a choice about health care. We can't say "don't have a body" if you can't afford health insurance. That's not an option.
As for the quality of the public option, it sounded from Moyers like the health insurance industry was out to make it as shitty as possible. They like the mandate for everyone to buy insurance because it broadens their customer base. They can take the patients they want and dump the ones they don't want on the government. That doesn't sound like a solution to me.
I'm all for reforming health care and doing it now. I think the speed Obama's been calling for is a good thing. Get it done, and then move on to debate other things, because quite frankly, health care is sucking all of the oxygen out of the room and while it may be the biggest problem it's not the only one. But if we're going to reform it, let's REALLY reform it.
We know Medicare works. So why can't we give everyone Medicare? I don't even mind if it's an option to buy into Medicare or have your employer buy into it for you in lieu of a private plan they supply now. It's a good system, it's in place, it's popular, and it works. So let's extend it to everyone.