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September 5, 2009

We're fighting for *this*?

-- by Thomas Leavitt

Six of [California's] largest insurers rejected 45.7 million claims for medical care, or 22% of all claims, from 2002 to June 30, 2009, according to the California Nurses Assn.'s analysis of data submitted to regulators by the companies.

The rejection rates ranged from a high of 39.6% for PacifiCare to 6.5% for Aetna for the first half of 2009. Cigna denied 33%, and Health Net 30%. Anthem Blue Cross, the state's largest for-profit health plan, and Kaiser, the state's largest nonprofit plan, each rejected 28% of claims."

Source: HMO claims-rejection rates trigger state investigation, LA Times, September 4th, 2009.

The saying, "if you're not outraged, you're not paying attention", has never been truer. This is the system that the Democrats in Congress, and Obama, want to force us to participate in. One in which we'll be forced to pay $13,500 a year to private sector health insurance companies, plus deductibles, co-pays, and uninsured ancillaries, for the right to be randomly screwed over and financially devastated (if we live through the process) when we place a claim for coverage.

We're being played, folks - the debate over inclusion of a "public option" is a classic diversionary maneuver by the powers that be: get all of us radicals and progressives and liberals worked into a lather over defending and demanding that they follow through on some bullshit half-assed compromise which they've arbitrarily defined as being within the realm of political feasibility, and keep us off the street and from demanding what we really want, and NEED - Canadian style SINGLE PAYER healthcare.

Instead, we're sitting here desperately hoping the god damn yellow bellied Congressional Democrats will squeak some kind of lame ass, watered-down "public option" into what my local Congresscritter Sam Farr is now deliberately calling "health insurance reform" (because it doesn't touch anything else about the system other than how we pay for our health care). This despite the fact that a vast majority of physicians support universal health care[1], and at least 40% of the population at large does so as well (despite constant demonization by entities with a vested interest in the status quo).

Here's what they're talking about forcing everyone to pay for - this is the plan that Senator Roy Wyden, D-Oregon, is covered by:

Plan: Blue Cross and Blue Shield standard family plan Cost: $1,120.47 a month (or $13,445.64 a year)

Wyden's share: $356.59 a month (up $42.12 from 2008)

Annual deductible: $300 per member or $600 per family

Routine physical: $20 for doctor, screening tests fully covered*

Well-baby care for the twins: fully covered*

*with preferred providers

Source: Just how good a health plan does Congress have?, The Oregonian, August 3rd, 2009.

One way or another, the person covered pays for the insurance -- as anyone knows who has watched their local public employee unions accept a three year contract with no wage or salary increases, and increased employee contribution levels, just to keep their healthcare coverage intact. As a self-employed individual, I don't even have the fig leaf of pretending that my employer is paying a portion of this. ... and you there's no doubt that the "public option" will be priced right in the same range (otherwise it would be "anti-competitive").

Where the heck am I (or most other self-employed Americans) going to come up with over $1k a month to pay for crappy insurance?!? Plus deductibles and co-pays?!? My wife and I booked $35,000 in taxable income last year, after expenses, and we still owe roughly $5,000 in taxes. ... and that was when I was steadily employed for much of the year, billing out at least 25-30 hours a week. I'm supposed to drop almost half of my net income on health insurance?!? Pay almost as much for health insurance as I do on rent for my apartment?!? Are the folks in D.C. insane?

Seriously, this is what we're fighting for? The right to be forced to cough up $13,500 a year for health "insurance" to a private company (in most cases) whose sole goal is to turn as large a profit as it can by denying us access to healthcare (as the quote at the beginning of this posting strongly suggests is the case, and as the video except from Sicko that Dave posted earlier explictly states is the case)?!?

... and don't go ahead and think that giving everyone access to Congress' "Cadillac" health insurance plan will save the day. It's basically the same crappy insurance that everyone else has to put up with, with the proviso that they have to take all comers, and there are no lifetime limitations on coverage.

What does that actually get you? Let's take my Dad, who had essentially the same plan as Senator Wyden, via the state of California: last fall, he got sick with some mysterious illness, and wound up in the ICU - where he was taken care of beautifully... twice, as soon as he recovered enough to be let out of the ICU, he then wound up being dumped almost straight into an understaffed nursing home facility - the first time, he was left unsupervised for a long enough period to fall down on his way to the bathroom, aspirate (inhale vomit into his lungs) and have a heart attack... the second time, he was sent back to ICU less than a week after being released, and the nurse on duty immediately diagnosed the pnuemonia he had contracted (which lead to low blood oxygen and his eventual death) as being the product of inadequate "mouth care" (not being able to properly clean his palate after eating meant that unless a nurse did it for him, rotting food fell down his throat and into his lungs). Flat out, I believe that Blue Shield's cost-containment efforts killed him. A "public option" is going to function in the same marketplace, and provide care and treatment coverage that operate similarly.

For a more factual analysis, see what Physicians for a National Health Program has to say about why covering everyone the same way the Federal Employee Health Benefits Plan does won't work. (PDF)

It's hard to convey the disdain and disgust I have for how the Democrats (and Obama) have let the debate on healthcare be framed. The white hot level of outrage I feel when I see headlines like the one quoted at the beginning of this article. The tears of rage and sadness I felt as I watched the woman in Sicko talk about how the hospital she worked for let her husband, her best friend, die of cancer because they wouldn't cover him.

This is a life and death issue, but it's not being framed that way. I'm actually in the process of applying for residency in Sweden (my wife is a citizen, so are my kids), for no other reason than I can't see any other way to be sure I'll have access to adequate health care... as soon as I get my national identity registration number (about six months from now), I'll have full and complete access to all healthcare services. Imagine that. Walking into a hospital and getting treated without worrying about how you're going to pay for it. Guess what? Most of the developed world doesn't have to.

I'll put it in the bluntest terms possible: the Democrats in Congress (and Obama) can take their $13,500+ a year "public option" and stick it where the sun don't shine. I want a Canadian style single-payer healthcare system. Anything short of that is unacceptable. Period.

Posted by Thomas Leavitt at September 5, 2009 9:27 AM


Comments

Agreed. AGREED!!

And I am a Republican. But don't say "Canadian-style." That scares people. "Medicare-for-all" scares people too. We need a new name.

"Free-and-decent-healthcare-for-every-single-citizen-so-that-we-can-all-lead-happier,-healthier-lives-and-not-worry-about-financial-ruin-due-to-unexpected-medical-costs."

How does that sound? Might be a tad wordy.

Posted by: willickers [TypeKey Profile Page] at September 5, 2009 1:56 PM

That's the problem. The institutional forces who profit from the status quo -- and thus are opposed to "reform" -- are experts at the politics of nihilism. It is far easier to sabotage agreement than create it, and ultimately, we're talking about re-engineering the cash flow of a huge and growing portion of the economy - there are a *lot* of vested interests whose oxes stand to be gored.

Canadian-style shouldn't scare people (in Canada, their healthcare system is even more of a "third-rail" than Social Security is here), Medicare-for-all even less so - America's senior citizens are overwhelmingly happy with it (80%), and think it is well run (68% as opposed to 28% in respect to private sector plans). See the National Journal article here: http://www.nationaljournal.com/njonline/mp_20090629_2600.php for more details.

We've got to do better are defending the memes we create against attack, and at attacking the memes used to undermine ours.

Posted by: Thomas Leavitt [TypeKey Profile Page] at September 5, 2009 2:16 PM

Thomas, I couldn't agree more with every single thing you said. I also agree with "Willickers": the phrase "Canadian-style" *does* scare people, whether or not it "should." As they say in advertising: perception is reality (to the customer). Why push people's buttons if you don't have to?

Bunny

Posted by: Bunnyfeet [TypeKey Profile Page] at September 5, 2009 4:29 PM

Thomas, I couldn't agree more with every single thing you said. I also agree with "Willickers": the phrase "Canadian-style" *does* scare people, whether or not it "should." As they say in advertising: perception is reality (to the customer). Why push people's buttons if you don't have to?

Bunny

Posted by: Bunnyfeet [TypeKey Profile Page] at September 5, 2009 4:30 PM

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