Thursday, September 3, 2009

About Healthcare

OK, so I'm going to try and sort out some things here. I know that people are making all kinds of noise about the government deciding what kind of care (or insurance that provides access to this care) is available and wresting control from the people. There is also talk of death panels and a whole load of other stuff that seems patently absurd and diversionary, and in those terms the discussion is working on some of the populace. I've also seen people outside of Whole Foods with signs protesting the company's policy of medical savings.

Ideologically, it seems natural to consider basic health coverage a right. If you get sick, you should be able to get treated whether you're a billionaire or living at the minimum wage. The healthcare that our representatives receive is footed by the taxpayer. A public option is still just an option--and I'm wary of United Healthcare getting handed a big contract since I was covered (or under-insured) by them when I worked for the bookstore.

While Shannon and I were in Italy herding cats over the summer we met an Italian couple on a bus ride back into Florence. I know this sounds all fancy--European travel and all, but it is work and more work than I do when I'm normally working. At any rate, the woman who we were talking to was excited to have someone to speak with in English. Her husband was a policeman and he didn't say too much. We covered a few of the basics--where are you from, what are you doing and then eventually got to talking about healthcare. It was a decently long ride. We asked what their coverage was like and if I remember right, she was talking about a dermatologist. In order to get seen she had to pay and she told us that it was terribly expensive to see a specialist and that even after paying she still had to wait a few days for an appointment. We asked about cost. She said it was an outrageous amount--120 euro. We were taken aback. I guess when you're accustomed to receiving free treatment for all of your normal ills, it can be disconcerting to have to pay and wait a few days. I tried to explain that I was paying a 1200 dollar bill for a visit to a skin doctor for a biopsy that was "covered" under my insurance. It didn't seem to make sense to her. It could have been the language barrier or it could have been wholly incomprehensible.

I also understand that our system isn't nearly comparable to Italy's and to be honest, I don't really know how their tax system works. But I do know that something has to happen, both with the costs that doctors are allowed to charge because of the relationships established with insurance companies and the payouts they receive and with the structure of the insurance companies themselves. There should be a medical database that crosses all insurance providers. There should be investment on the part of the medical field into preventative measures as well as less of a payout for running tests, particularly when these tests have been run previously. Patients should have ready access to their own files--but this could get really messy considering all of the self-diagnosing that happens. Whether the public option or another serious reform that will bring true price competition is introduced, or if some combination of these things is introduced and people can get behind it, our legislators need to get away from the partisanship that this issue engenders so that a serious deconstruction and overhaul of this failing system can happen. The fact that our healthcare system is one of the worst run in the developed world is hard to stomach and I'm getting off my soapbox now...


Anonymous said...


gideon sockpuppet said...

Here in Canada, we look south and just shake our heads. How can the richest country in the world not have universal health care? How can the educated, politically savvy American people let the HMO's get away with sucking people dry financially, while making them fight for every little bit of health coverage (if they're lucky enough even to have coverage). I am so glad to be Canadian and to pay my share of taxes, and know that everyone in my family and in my community will get what ever treatment they need if they get sick.