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Monday, October 12, 2009

Why isn't all health care like what I got today?
Posted by Jill | 4:49 PM
First of all, I want to thank everyone who posted comments in my post about the baby in Colorado denied health insurance because he doesn't look like a Photoshopped Ralph Lauren model for sharing their stories, especially those with colon cancer.

But here's what I want to know: Why aren't Americans entitled to the kind of health care I received today? Now it remains to be seen how much of this colonoscopy I have to pay out of pocket, what with history of polyps and all. I fully expect the whole thing to be denied, and when it is, you're going to see what the Wrath of Jill looks like. All I can say is that fucknuts Scott Garrett had better get ready, because his health care reform-opposing office is the first one I'm going to call. I'm fortunate in that even if I do have to pay for it, it won't bankrupt me. I would guess that this is not the case for up to 90% of Americans. The difference between me and Republicans is that I ask "Why can't everyone have this", whereas Republicans say "I get my health care -- fuck you."

The facility I go to is part of this group in Paramus, NJ. You can pretty much do one-stop doctor shopping here. The group has its own ambulatory surgery center where procedures like colonoscopies and urological procedures are done. For a wuss like me, this place is a Godsend. You see, I've never been a hospital patient. I've never had kids, I've never so much as broken an arm. I also some from a long-lived gene pool. Our heads may be a bit wacko in my family, but the packages that house them are as solid as a 1965 Dodge Dart. So I'm perhaps a bit more nervous than most people about this, less about What They Might Find than about being sedated. After all, what if I don't wake up? It doesn't help that you have to sign 4,967 release forms beforehand, either.

At any rate, in this place you're given a gown, fluffy socks with rubber smiley-face treads on them, and then you're put comfortably onto a rolling bed, where you sign more papers and answer a bunch of questions after being given a blanket that's still warm from the dryer. Because I wasn't having active panic attacks this time, I only had one nurse fussing over me instead of four. You're curtained off from everyone else, so despite the fact that the place is a virtual colonoscopy factory, you never have to parade in front of other patients with your ass hanging out. You meet the Russian anesthesiologist, who has infinite patience with people like me who know what Diprivan is and who says about your barely-over-100 blood sugar from your last blood draw, "So you skip the cake today, eh?" instead of jumping up and down and screaming that you have to lose 50 pounds - STAT! They wheel you into the procedure operating room, put a syringe into your IV, and the next thing you know you're awake and they're offering you apple juice. That's it. No pain, no nothing. Before you leave, they make sure you can walk OK, they'll make fresh coffee if you want it (and if you're like me, you will because by then you will have one wicked caffeine withdrawal headache) and give you a cereal bar. Then they'll escort you out of the building with whomever's accompanying you home.

Why shouldn't everyone get care like this? Why can't everyone, especially those particularly at risk for colon cancer, have this covered in a way that makes it less daunting to do? Not all of us want to be able to see the insides of our colon, thank you very much. For that matter, why, after paying premiums to various health care companies for 32 years, do I even have to WORRY about what part of this will be covered?

There are six insurance company lobbyists for every member of Congress. These lobbyists have spent $380 million in the last few months buying the minds of American Idiots and the votes of Congresscritters so that their gravy train will keep on rolling. That's enough to pay the premiums for family coverage for over 29,000 families. Assuming $5000 per colonoscopy (WITH anesthesia), that's enough to pay for 76,000 colonoscopies. Even if you believe that insurance company executives are entitled to eight-figure compensation packages, do you also think that lobbying is the best way to spend $380,000,000?

Here's how Wikipedia defines "protection racket":
A protection racket is an extortion scheme whereby a powerful entity or individual coerces other less powerful entities or individuals to pay protection money which allegedly serves to purchase protection services against various external threats, usually violence or property damage.

Those who do not buy into the protection plan are often targeted by criminals, often the racketeers themselves. Assuming the racketeers do actually protect paying "clients" from other criminals, when a person or group refuses to pay for protection, word is put out that they are outside of the racketeers' protection and that criminals can target them with impunity.

The protection money is typically collected by a "bag man". Although the organization might be particularly coercive in obtaining protection money, it is usually careful to shelter its "mark" from attacks by competitor organizations that similarly attempt to solicit or threaten the targeted individuals or businesses. Disputes between organizations concerning territory consequently arise from two competing organizations attempting to extort from the same "clients"

Now think about how your health insurance works. You purchase health insurance from a powerful entity (insurance company) to "protect" you against the "external threat" of illness. That protection ought to take the form of payouts for diagnostic and preventive procedures (such as mammograms, colonoscopies, and the like) and the peace of mind of knowing that if you do get seriously ill, your expenses will be covered. At least protection rackets usually DO provide protection, which means that the moral code of organized crime racketeers is stricter than that of insurance company executives. It's only a matter of time with these fuckers until being alive is a pre-existing condition with a 100% chance of death at some point so NOTHING will be covered.

Milt Shook at Please Cut the Crap has posted twice recently about Tales of American Health Care -- stories of people WITH insurance who found that their "protection" was no protection at all.

The health care reform debate has focused primarily on covering more people with health insurance. But what's the point of covering more people if insurance is nothing more than a proteciton racket? The fact of the matter is that these companies hire people whose job it is to act as a gatekeeper between you and your claim payout. The logic is: How much is this person willing to fight to get a claim paid? I don't know about you, but I work pretty long hours. I don't have time to spend navigating through three thousand layers of a voice response system trying to get to a human being whose job is to roadblock you for as long as possible until you give up in despair and decide to just write the check yourself -- which is the whole point.

Now, with some infinitesimal glimmer of hope that a public insurance option (which is still far from de-fanging the insurance racket) just might get a floor vote, the racketeers are threatening to increase the amount of protection money you have to pay if they don't get their way:
After months of collaboration on President Obama's attempt to overhaul the nation's health-care system, the insurance industry plans to strike out against the effort on Monday with a report warning that the typical family premium in 2019 could cost $4,000 more than projected.


Early in his quest, Obama wooed industry leaders in the hopes of neutralizing many of the players who helped defeat a similar effort by President Bill Clinton. Yet as the process has moved from high-minded concepts to legislative details, the tension has mounted. Hospitals and doctors have increasingly grumbled that the administration is not keeping bargains it struck over how many Americans would be covered under reform and what payment changes would be made.

But no industry has reacted with the same intensity as the insurance lobby.

"The report makes clear that several major provisions in the current legislative proposal will cause health care costs to increase far faster and higher than they would under the current system," Karen Ignagni, AHIP's president and chief executive, wrote to board members Sunday. "Between 2010 and 2019 the cumulative increases in the cost of a typical family policy under this reform proposal will be approximately $20,700 more than it would be under the current system."

(Here's a debunking of the AHIP report.)

And you know WHY it will be more? Because the insurance companies will raise premiums so that they can continue to have profit increases such as the ones they had from 2000 to 2007, when profits rose 428%. Did your salary increase that much over those seven years? Anywhere NEAR that much? I thought not.

Aside from having to (yet again) try to lose some weight and watch my sugar intake, I can rest easy for the next five years because I had a preventive procedure. Even if my insurance company decides not to pay, I was able to get this procedure because I had a piece of plastic from an insurance company so we can do this little dance of pretending that an actual payout will occur. There's no reason in the world why this industry can spend hundreds of millions of dollars in bribes and yet can't afford to, like, actually INSURE the people whose money they take.

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Anonymous Anonymous said...
and if there were Medicare for everyone you could have a colonoscopy the way i did a couple of years ago / along with the colonoscopy i had an upper GI exam and when the doctor still wasnt satisfied he had found what he was looking for (i was anemic, in my 70's) he recommended i have that drink barium procedure in which you are then x-rayed as the barium goes down the hatch / this takes about an hour / it was lunch time / i live in a small town in SE Utah with a nice little hospital / the x-ray techs agreed to do the barium procedure on their lunch hour so everything could be taken care of the same day ! i also have a 1965 Dodge Dart station wagon / we both run great / smile

Medicare for all !

Katherine (a daily reader for some time now)

Blogger skywind said...
Glad you came through it all OK. Why am I not surprised that you are blogging instead of, well, recuperating or something?

Anonymous Anonymous said...
This is great, right up there with Sen. Grayson! Posting it to my Facebook.