broadsideblog

The Cost Of Staying Healthy — Or Alive

In behavior, business, Health, Medicine, Money, news, politics, science, US on February 2, 2011 at 5:34 pm
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There are times I read an article about the hideous, unfair mess of what Americans call their “health care system”and I thank God I do not have a weak heart as my pulse begins to race with fury.

This, from The New York Times business pages:

For example, Hillary St. Pierre, a 28-year-old former registered nurse who has Hodgkin’s lymphoma, had expected to reach her insurance plan’s $2 million limit this year. Under the new law, the cap was eliminated when the policy she gets through her husband’s employer was renewed this year.

Ms. St. Pierre, who has already come close once before to losing her coverage because she had reached the plan’s maximum, says she does not know what she will do if the cap is reinstated. “I will be forced to stop treatment or to alter my treatment,” Ms. St. Pierre, who lives in Charlestown, N.H., with her husband and son, said in an e-mail. “I will find a way to continue and survive, but who is going to pay?”

As judges and lawmakers debate the fate of the new health care law, patients like Ms. St. Pierre or Alex Ell, a 22-year-old with hemophilia who lives in Portland, Ore., fear losing one of the law’s key protections. Like Ms. St. Pierre, Mr. Ell expected to reach the limits of his coverage this year if the law had not passed. In 2010, the bill for the clotting factor medicine he needs was $800,000, and his policy has a $1.5 million cap. “It is a close call,” he said.

It is an obscenity, plain and simple in my view, that every American who pays taxes cannot rely on a seamless, safe, affordable way to stay healthy and, when they become ill, have access to excellent care. Because, you know, they’ve got that all figured out in virtually every other nation on earth.

I am acutely aware of what a sham this “system” is because I grew up in Canada and lived there until I was 30. And my friends and family remain there, using a health care system that is so profoundly different in every respect that it is hard to believe sometimes.

My mother, 76, had surgery yesterday in a major Canadian city hospital. Because her condition , while horrible and uncomfortable, was not life-threatening, she had to wait weeks for it. That was lousy for her and for me. But that is how Canada (and other nations) control their health-care costs.

But by the time she had the surgery, she had already been in the hospital since early November, attended to by a physical therapist, an occupational therapist and a variety of physicians.

There are no bills.

There will be no sudden, surprising charges we did not anticipate. We will not have to face medical bills of five or six figures, or bankruptcy because — like most people — we would not be able to pay them.

It is wearying in every possible way to deal with a relative who is ill with multiple conditions, some chronic. It is even more terrifying if that illness is potentially life-threatening.

But to have to worry about paying for it?

What else is there worth having in this life but our health?

What will it take for American politicians to find the most useful organ in the body politic, and physical — a heart?

  1. Sadly, healthcare for all Americans smacks too closely to Socialism. And God forbid we become like those pinko commies in this country, the land of the free and home of the brave who cannot get the care they need or 100% of the disability owed them despite fighting in Iraq or God knows where to preserve the liberties of this country.
    Sorry, will get off of the soap box now.

  2. Indeed, which is why it never gets anywhere. People are terrified of losing what they have — until what they have suddenly and shockingly proves terribly limited, and limited by the greed of the free market, not by the necessary conservatism of making sure EVERYONE gets something.

    Better, then: “I got mine” than “We’re all safe.”

    Not in my world.

  3. Its easy to take shots at the health system in this country. Lets see Canada has a population of about 34 million. The US has over 300 million. Slight difference. Vanderbilt University Medical Center rights off over 100 million dollars each year on services they are not being paid for. We can all pick out examples to make a point. There is this notion that the United States has some sort of National Healthcare System. It does not and never has. What it does have is a series of regional,state and local systems. Nothing personal but I hear how great the Healthcare system is in Canada then why didn’t you stay there? You mentioned affordable in your post. That is part of the problem. Many Americans believe that they are entitled to every test and procedure that is possible. Regardless of the cost. I do think in the end that the Supreme Court will rule the mandate as unconstitutional.
    Your point about your mother is another angle. I do hope that she is doing ok. The waiting of weeks is something that people would be up in arms over. Canada and the US have two different forms of government and that gets lost in all of this debate.
    I’m not saying that there are not serious problems with the Healthcare system There are many. In the end people can holler they want but something doesn’t mesh. People want all this healthcare but do not want their taxes raised to pay for it.

    • Lots of points here…

      I don’t think the U.S. has a national system but it loves to crow about how great the free-market economy is at dealing with people’s health. Only when it is profitable to do so. Yes, some hospitals and individual doctors do write off bad medical debts — but chicken and the egg — why are they so costly in the first place?

      I chose to leave Canada for professional reasons; it’s a smaller job market.

      I agree that many Americans see “every test and procedure” as some sort of right, and that attitude is unlikely to change. If you grow up in a system more focused on prevention (which saves the collective — i.e. everyone, i.e. taxpayers — money) then you don’t expect a gazillion tests but you also know they are not generating terrific profits for the hospitals, health insurance companies, etc. as well.

      There is a fundamental difference indeed in how Canadians and Americans view their rights and responsibilities — Canadians take enormous national pride in their health systems (which are run by each province, albeit with federal funding as well) and knowing that no one in their nation will ever face medical bankruptcy or homelessness because they cannot afford treatment, surgery, hospital care or even a visit to a GP for an annual check-up. Nor will they, as broke Americans must, avoid seeing doctors for basic tests (mammograms, colonoscopies, to name only two) which can detect life-threatening (and terribly expensive to treat) diseases like cancer early.

      People might not wish to pay higher taxes, but they are anyway…the money is going to bail out the banking system, while the bankers who wrecked it with their greed took home, and kept, billions in salaries and bonuses.

      Would you rather pay more taxes for someone who cannot afford it, who may be one of the millions who cannot find a job in this recession, to have chemo — or keep a banker in his Greenwich mansion? I know my choice.

  4. I like these kind of comments. You are right about the bankers. This whole concept of to big to fail makes no sense. If your business doesn’t make money then that’s life. My comment about leaving Canada was not directed at your personal situation. I think what happens is that people say how great Canada’s System is without knowing anything about it. My wife works for one of those big bad insurance companies and they have a wellness plan for their seniors. Well in all the talk about healthcare reform they were going to kill it. It took the heads of the company to go to Washington and raise holy heck to make them stop. She has been an RN for over 35 years and she is very open about the changes that need to be made. One of the issues they are dealing with now is to get doctors to do hospital rounds during the day. More and more they are having hospitalist do them. She works on getting patient care approved. The funny thing about that is the last 5 years she has probably recommended 5 times that something not be covered. She had a doctor who was sending her patients to the hospital to get blood drawn as an out patient. There is the issue of rural hospitals dumping patients of bigger hospitals on Fridays so they can lower their staff. Knowing that the patient will not have the procedure until Monday morning. Those kinds of things drive up cost. There are very few hospitals that do not have to write of bad debts.
    You raised a very valid point on prevention. It would make my wife’s job so much easier if that was the focus. People complain about the issue of so many children being so overweight. One of the first things that schools cut back on is P.E. We probably agree on more that not. This whole thing is a mess and those clowns in Washington will not fix it.

  5. You really have seen it in detail, thanks to your wife…I wish more people were as aware of all these games and tricks!

    The emphasis here on profit-making versus prevention, and for intervention versus a more conservative approach is very challenging. I have been told I need to replace my left hip; the doctor said “You need surgery!” and expected me to rush into the OR. I told him I was in no rush at all and, instead, chose to spend three months on crutches — which has made an enormous difference in my pain level and allowed me to postpone a major operation.

    But Americans, for all sorts of reasons, want solutions fast. I think many people think of their bodies as machines: it’s broken, fix it. Not….this is something I need to keep flexible, strong, well-nourished and healthy. That is a basic point of view and millions just don’t get it or care enough to do what’s necessary.

    And that is surely not the government’s job!

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