Friday, June 5, 2009

If It Takes Socialism to Get Us All Healthcare

socialism, health care, insurance, bankruptcy, single, payer, obama, liberal,
Then fuck it, I'm a socialist.

From Americablog:

Medical bills are involved in more than 60 percent of U.S. personal bankruptcies, an increase of 50 percent in just six years, U.S. researchers reported Thursday.

More than 75 percent of these bankrupt families had health insurance but still were overwhelmed by their medical debts, the team at Harvard Law School, Harvard Medical School and Ohio University reported in the American Journal of Medicine.

"Using a conservative definition, 62.1 percent of all bankruptcies in 2007 were medical; 92 percent of these medical debtors had medical debts over $5,000, or 10 percent of pretax family income," the researchers wrote. "Most medical debtors were well-educated, owned homes and had middle-class occupations."

The researchers, whose work was paid for by the Robert Wood Johnson Foundation, said the share of bankruptcies that could be blamed on medical problems rose by 50 percent from 2001 to 2007.

You know why we need this? It's not just the 40,000,000 or so people without medical insurance, it's the millions more people like me, who have insurance and can't afford to use it.

Monday night I was swiffering my floor and I accidentally knocked a surround sound speaker off the stand. It landed right on my bunion, and I ended up with a deep purple/blue bruise on my foot up to my bunion, and a bruise on my toe past the bunion. The pain was indescribable. I'm still limping and that bruise looks bad, and I'm not sure why it's to either side of the bunion. That worries me.

I thought about going to the hospital, but then I thought, nope. I can't afford to pay the hospital to xray it, or for the ER charge. If something did need to be done, it'd be a visit to an orthopaedic surgeon, and my copay for specialists is $50. I don't have $12 for hair dye. I didn't have it last week or the week before, either. (Yes, I'm a little vain.) And you know it wouldn't be just one visit to the specialist. And forget about surgery. I've seen my copays for that. If I could afford that sort of thing, I'd own a car.

So, I grabbed one of the crutches in the basement closet (leftover from when my MIL had knee surgery) and used that for a few days.

I have health insurance. I may as well not.

Imagine what my story will be if I am diagnosed with breast cancer next month. What will I do then? I'll tell you what I'll do: I'll choose between eating and dying. I'll choose between being homeless and letting cancer eat me alive. I'll choose between what is no doubt a really horrible death and having heat in the winter.

So the next time somebody whinges at you about socialism and rationing* and Canada, ask them what they'd choose: cancer treatments or eating, cancer treatments or having a roof over their head, cancer treatments or not freezing to death.

*We already are rationing health care treatments in this country. We're rationing it according to who can afford it. When somebody starts bitching about rationing, what they're really saying is, "I'm on the good side of the rationing right now, and I'd rather not end up on the bad side of it."


  1. Amen. The scaremongers who cry wolf about socialism wouldn't last five minutes in Quebec...

  2. I just got the hospital bill for when my daughter was so sick last month and needed to be admitted for a few days.
    I'm lucky, I have insurance. With a $1000 co-pay that I can not, in fact, pay. I have to contact the hospital and set up payment plns. And I didn't have a choice, it was take her to the hospital or watch her die from the virus.
    We were lucky. It could have been so much worse. And when that is lucky, there is something very very screwed up with the health care system.

  3. No thanks. More government control will just lower quality and restrict access to care. The government is terrible at managing & running anything. As many problems as our medical system has, it's still the best. I far prefer getting the medical treatment I need and going into massive debt, than having some bureaucrat decide whether I need it at all.

    I've gone without health insurance and known plenty of others who haven't had it either. You can still get medical treatment if you need it by showing up at an ER. We used to have friends who went to the ER even for minor medical problems. They never had any difficulty getting treatment. And if you are below a certain income level you can already get Medicaid. In my state, NJ, the NJ Health insurance program pays for everything, including prescriptions.

    That's the main problem, prescriptions, not treatment. You can get treatment and just be in debt. But if you have no insurance, or can't afford it but don't qualify for Medicaid, you can't get the medicine you need. I would support some sort of greater government assistance in the area of covering prescriptions for those who can't afford them.
    Even people making a decent income are going to find it difficult to pay for a few 300 dollar (or worse) prescriptions, especially if they have to be on them for any length of time.

  4. UNRR: I can see your point, but I think you're looking through the lens of a person that's never had, say, diabetes. Or MS. or any chronic/rare/difficult to treat condition.

    ERs do not replace doctors and specialists. ER doctors are not trained to diagnose uncommon illnesses, and they don't have the resources to be primary care for diabetics or MS sufferers, etc.

    ERs are set up to care for people suffering from trauma or from immediate, life threatening illnesses. Parsing out the consequences of a lifetime of diabetes is not really within their purview. And people die every day because of that.

    Feel free to step in Primary Care Doc Commentor!

  5. The next time you hear somebody ranting against socialism, ask if he favors eliminating Social Security.

    Most people who use "socialism" as a scare word hardly know what it means.

  6. I agree that the government screws up lots of stuff, but they don't screw up everything, in fact, the federal student loan program is one of the best run programs around.

  7. My wife has severe diabetes (4 shots of insulin a day), had a stroke several years ago, and is on full disability, unable to work. You are right that the ER doesn't replace visits to specialists and so forth. And I know how insanely expensive it is. Even with insurance the co-pays for visits and prescriptions are a killer.

    But even in my wife's case the main issue is the prescriptions. She can survive without seeing all the various doctors and specialists, or at least seeing them much less often. But she can't survive without those medications. And your average person can't pay 2000 a month to buy medicine.

    I'm not opposed to some sort of expansion of government medical assistance, but I think it needs to be done in a way that keeps the quality and flexibility of the current system intact. Unfortunately with more government involvement usually comes more government control. Also, just because some type of government health care might be beneficial to my family or yours, doesn't necessarily mean that it would be good for the country as a whole.

  8. UNRR, unfortunately people may be like me, and make just enough to not get medicare. If I lost my insurance, god help me. My daughter can go on the state insurance for kids, but I would be up the creek, even with my job.
    Besides, it's people without insurance who treat the ER like a family dr that take up many valuable resources. That's not what ER's are designed for.
    One of the great points of the government insurance plan is that they will take treatment out of the hands of the insurnace companies, whose job is to deny everything, and put it back in the hands of the doctors. There will be approved preventative care, treatments will start sooner thus improving chances of survival of serious illnesses. This is, of course, A Good Thing. The more people we treat in a timely manner, the less people show up at the ER, the less resources that are taken up and can be instead turned to people with emergencies.
    If we model our system after Canada we will do just fine. And we'll have less people leaving the country to get life saving surgeries and proceedures done because their insurance here won't approve it.

  9. It's so unbelievably frustrating that many of those who would benefit most from Teh Socialist Health Care are the ones who ignorantly use red scare tactics to shoot it down.

    I bet they don't even realize we have socialized roads, schools, police, and fire department systems already.

  10. I'm sorry about your wife. I hope she continues to be as well as she can.

    I understand about medications- I take half the meds I'm supposed to. I pick and choose by what allows me to get through the day, and while that's the most practical way to choose, I'm going to pay for it sooner or later. Probably sooner.

    I don't really think the government could do much worse than the insurance companies. Leigh, or Lynne?, well everybody had good points, but the fact of the matter is, insurance companies aren't in business to provide good care. They're in business to make money. When providing good care =/= making money, they choose making money.

    I worked customer service for one of the biggest health insurance providers in the country. We spent 5 weeks learning how to tell people what their benefits were, and no time at all learning how to tell people why claims were paid the way they were or denied outright.

    You want to know why they didn't bother to teach us about claims? Because, as one claims processor told me, straight out, insurance companies underpay a certain percentage of claims and deny a certain percentage of claims without even looking at them. They do it because a large number of people with insurance don't bother to investigate, or quickly get frustrated dealing with customer service reps who have no idea what's going on, and give up.

    So, right now, if you're lucky, you pay crazy premiums that go up every year, then you pay crazy deductibles and crazy copays, and for all that you get the wonderful privilege of being denied necessary care so the insurance company can post obscene profits.

    How much worse could the government be?

  11. I think what a lot of people don't realize is that the US was most socialist during WWII. During WWII we had a totally planned economy. The US gov't came in, had factories stop producing whatever it was they were producing, and told them to produce Sherman tanks until told to stop.

    That is socialism. And it worked great.

  12. Well, I don't want to get into a whole argument about socialism, other than to say that plenty of people who argue against it are well aware of how it can and has worked. Everything has a price.

    And most people seriously arguing against it are also aware that we have had socialist programs in in place since the New Deal. There are plenty of people who would in fact like to do away with Social Security, or at least privatize it. There are also quite a few people who aren't crazy about public education. If you doubt this, try reading some libertarian sites like CATO and Reason.

    All you have to do is look at almost any government run program and see how well it's managed, and how high the costs are. Ask yourself how the post office can possibly ever lose money, as it does in some years. And then you might realize why numerous people are highly reluctant to place our healthcare system under government control. Government "solutions" often tend to make things worse, not better.

    Although I will admit this. It is much easier to hold principled free-market policy positions on healthcare when you are young and in excellent health, than it is when either you or your family have serious medical difficulties and problems with medical bills.

  13. I agree with PF. And on another note let's all remember...government is *US* not *THEM*. We the people are the ones who should be calling the shots. If we don't like it and want it changed it's up to us, it's on *US* to change minds and elect the right people. We're not victims. Yes, it can be hard to create change. Sometimes mini-revolutions are necessary. Peaceful protest is a good thing. Speak your voice. Change minds.

  14. UNRR, I appreciate what you're saying about the inefficiency of government solutions. In my real life, I deal with government bureaucracy on a daily basis.

    But, when faced with our current system, I simply believe that government-run healthcare is a better alternative than our private system that is set up to deny people claims (as PF mentions recounting her experience working for an insurance company) and within an economy in which millions of people have to file bankruptcy because they cannot afford health care costs.

    In a sense, we already have socialized healthcare for the old and for the very poor via Medicaid, Medicare, SCHIP, Ryan White funding, etc. While this case isn't always wonderful (no offense to the providers as it's a capacity issue) a bunch of people who can neither afford private insurance and co-pays yet who also are not eligible for these socialized programs are left out. There's a pretty big misperception that those who are left out are lazy, not working, or otherwise "undeserving" of health care, but as many people have testified here, that's not the case. I don't think it's okay for anyone in our country to have to go without healthcare, but even hardworking people with jobs have had their lives ruined by health care costs, go without medications, or use the emergency room as their primary care provider.

    I'd like to think this "only lazy people can't afford health care" misperception changes when people who hold that perception are confronted with health care crises of their own in which costs quickly spiral out of control, but I'm not sure. Americans aren't happy with the current situation but they're petrified of Socialism, so nothing ever happens on the health care front.

    Go us.

  15. Well, according to at least one study 49 cents out of every dollar spent on healthcare goes to administrative fees. (insurance employees, executives, hospital clerical staff, etc...)

    Over 30% of all those employed in the 'medical field' (not counting insurance) are simply administrative workers.

    This stupid system we have cobbled together with hundreds of insurers and dozens of variable coverage plans is nothing but a hugh redundant waste of resources and money. I see at least one person here has caught the republican meme that everything the government touches turns to sh*t. Actually the medicare/caid and social security programs are extremely well run with a miniscule proportion of their budget going towards overhead.

    I'm not saying that congress has not mismanaged their funding horribly, but the programs themselves work very well. The United States Government ALREADY spends more per capita than any other western nation on healthcare. What are we getting for that money? More than 40 million uninsured, tens of millions more "under-insured", and healthcare plans that deny routine procedures and preventative care.

    We need to go to a "single payer" health system like Canada's where everyone is covered the same and all that redundant overhead is eliminated.

  16. All I know is this. I never had health insurance, and figured I got what medical care I could pay for. even for broken bones I didn't go to doctors. So when I found I had "an inoperable tumor" I expected to die.

    But then my relatives convinced me to apply for all these government programs, and now, amazingly, I'm still alive.

    So I may be a little biased.

  17. I live in Denmark where health care is universal and socialised. And I have now repeatedly been screwed over by the health care system. I've been denied my rights. And currently my only option of further treatment is seeking it out in the private field and paying for it myself. Of course this would mean I could no longer pay my rent and would have to give up everything I've worked for.

    Socialised health care sucks because the docs get paid whether or not they treat their patients right. They know it's not the patient that pays them so they don't actually have to give a shit. And if they've decided that nothing more can be done, then there's jack shit I can do to prove them wrong unless I have the spoons to file an official complaint and quite possibly get into a legal battle - 'cause yeah, psych patients are totally up for that all the time. We've nothing better to do with our mental resources.

    Belive me, socialised medicine is not the be-all and end-all of good health care. Not by a long shot.

  18. i think one thing being missed, whenever people say "do you really want beurocrats making your heath care decions" is - they already do. and these are not unbiased beurocrats, who don't really care one way or the othr - the are biased beurocrats, who REALLY want to just deny you coverage, because they make more money that way.

    see, government beurocrats would at least have the virtue of not having a personal stake - they won't get commission or bonuses based on how much money their companies make (profits, the amount made after paying doctors, etc)

    given a choice between a disinterested beurocrat who is just going to follow the guidlines until nudged, and an interest beurocrat who stands to make actual gain from me not getting treatment, oh fuck yeah i prefer the disinterested.

    as much as i hear bad about other countries - doctors "not caring because the patient isn't the one who pays them" and "doctors get paid whether they fix the patient or not" i have to ask
    how the FUCK is that any different from what we have HERE, only we pay MORE?
    you schedule a 15 minute appointment with a new doctor, who is supposed to, in that whole 15 minutes, diagnose and set up a treatment plan. which A) is 100% impossible in most cases and B) you never get that full fucking 15 minutes anyway.

    i have, more than once, laid out my personal experience with the medical field in the comments of this blog; they don't need to be repeated, and i'm afraid PF will soon think i'm just whining for attention. but those experiences - which mirror PFs and other commenters, different only in the specifics, not the actualities - speak volumes about the fucked up state of our health care. if you are not rich and/or don't have the BESTEST health care ever that pays 100%, you get VERY little attention. doctors are paid to fix the most obvious thing, not look for the real problems, and this has been expanded and encouraged GREATLY over the past 25 or so years, with our "new" health insurance system. if you have ANY sort of pre-existing anything, no matter what it is, you can kiss your chance of getting insurance at something you can afford, and in MANY cases you can't get insurance at ALL - the best case scenario is getting insurance that excludes those pre-existing conditions... and the insurance company WILL say that ANYTHING wrong with you is related to that condition, and deny even MORE claimes.
    people LITERALLY lose jobs, or don't get hired for jobs, because the hiring company doesn't want to pay hire insurance rates for a person with a disease.

    it's sick and wrong for huge mega-corporations to feed off of the money of the poor, and even the middle class. but that's what they do - they feast on our misery, because its all gravy to them. we pay, and pay, and pay for insurance if we have it, and then end up pay most of the actual cost of anything out of pocket for various reason. and those without insurance? except for the ER (which has already been covered DOES NOT TAKE CARE OF NOT IMMIDEATE AND ACUTE ISSUES - the ER won't treat a long term illness, cannot - if you get cancer, you can't go to the ER to get treatment, for example) those without insurance get jack and shit.

    i am not ALLOWED to work, medically. and yet, i don't qualify for medicaid or medicare, because i am not *old* and SSI/SSDI keep rejecting me for bullshit reasons (because SSI and SSDI are being told to reject everyone they can). and i'm not alone - of the people i know in my age group, 25-35, maybe 5 people have actual insurance. and they STILL don't go to the doctor for non-emergency stuff, because they STILL can't afford it.

    in many cases, having insurance just makes it WORSE. you pay the insurance, every month a LARGE amount of money... so you THEN don't have the money to cover co=pays and etc.

    its fucked up and needs to be fixed. people deserve real health care. we aren't machines.

    PF - i hope it gets better, that actually sounds kinda scarey (the bruising). i wish i had something i could do to help...

  19. It's amazing, isn't it? The rest of the world has caught on, and we haven't. Universal health care would SAVE this country so much money.

    All the crap the conservatives are spewing about it - the quality will go down, we won't get to choose our doctor, long waits, blah blah blah - all of that's being fed to them by insurance companies. Blue cross blue shield has spent a disgusting amount of money to put out adds against universal care. Why are they so afraid of it?

    I have blue cross blue shield. Our premiums through my husband's employer is roughly $800 a month for our family. They didn't pay for my fucking mammogram last month.

    Our country has been running on near Socialism for decades. It's about time for our health care to follow suit.


  20. UNRR, you are seriously citing the USPS as a business run badly by the US Government? You realize it is not run by the Government. It is granted a few special privileges that other companies are not, and the Post Master General is a government appointed position but that is as far as governmental involvement as it goes. The USPS doesn't even use tax payer money.

    Please try again.


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