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Tuesday, September 18, 2007

The problem isn't just access to health insurance COVERAGE, it's about access to CARE
Posted by Jill | 6:58 AM
If you read Firedoglake, you're already familiar with Jane Hamsher's battle with breast cancer, followed by her battle with Blue Cross to have her tests and surgery covered:

As I said before, I just thought everyone knew that when you had a catastrophic illness you wound up with huge bills despite being “fully insured,” with your insurance company working overtime to find reasons to deny your claims. “Out of network,” “in excess of usual and customary” or “not medically necessary” are the mechanisms they use to keep you paying. And paying. And paying.

So I thought I’d share yet another one. The bill at the left is from another doctor. The “your responsibility to pay” portion — $5,336.13. So just in case anyone was thinking that the bill for $15,684.94 was some kind of anomaly, lemme tell ya — I got a box full of ‘em.

For anybody keeping count, this is in excess of the $11,000 I had to pay in “out of pocket” expenses last year, as well as this year (because my treatment fell across two calendar years), and the $307 per month I pay for the insurance in the first place. And the $4000 test I mentioned that which diagnosed my breast cancer that has been deemed “not medically necessary?” I checked and I was wrong. The bill is for $4500.

While Jane wrestles with Blue Cross to see who blinks first, Tony Snow sleeps like a baby, secure in the knowledge that he doesn't have to deal with the scumbags of the insurance industry, because HE is insured by the Federal Employee Benefits Health Program:

As far as my health, I'm doing fine. I know a lot of folks have been thinking, oh, come on, it's really the cancer. No, cancer has nothing to do with this decision. I finished chemo two weeks ago today. We did CAT scans and MRIs in the last week and it indicates that the chemo did exactly what we hoped it would do, which is hold serve. The tumors that we've been tracking have not grown. There are no new tumors. And that's what you want. I'm going to be speaking later today with my oncologist. We'll be doing what's called a maintenance dose of chemotherapy just to keep whacking this thing.

As I described I think upon returning from the cancer surgery, I'm in one of these positions now where we're going to try to turn cancer into a chronic disease rather than a fatal disease. And fortunately, that's one of the things you can do with modern medicine. We'll be doing CAT scans and other scans every three months, just to stay on top of everything. And it certainly gives us the ability to respond quickly to any medical emergencies that may arise. But right now I'm feeling great. I've finally put weight back on. I feel strong.


I've been lucky I work at the White House, I've had the use of diagnostic care. I'd like to find ways to help those who, for whatever reason, don't get the -- don't get diagnostic treatment, don't take care of themselves, may not have the resources that I've had at my disposal. So I'll look for ways to try to make it possible for people to get healthy. That does not mean that I'm going to be necessarily banging the tin cup for federal funding.

Of course not. After all, Snow was the willing shill for the "I Got Mine and Fuck You" party.

Because the insurance industry has proven to not be good-faith players in the health care game, you'd have to be an idiot to believe that any health care plan that is dependent on the for-profit health insurance industry is going to be an improvement over the mess we have now.

But Hillary Clinton, good corporatist that she is, isn't about to cut off the insurance industry for something as trivial as improving access to health CARE for Americans:

Like the plans put forth by former Senator John Edwards and Senator Barack Obama, her chief rivals for the Democratic presidential nomination, Mrs. Clinton’s proposal would try to strengthen and build on the existing, employer-based system, through which most Americans under 65 already receive their coverage. She would create new options for buying private or public insurance at affordable rates, require everyone to obtain insurance, and provide subsidies and tax credits to small businesses and individuals who could not afford it.

The plan, with an estimated cost of $110 billion a year, would be financed largely by rolling back President Bush’s tax cuts for Americans making over $250,000 a year and by savings in the health care system.

The title of Mrs. Clinton’s proposal sums up her carefully calibrated new approach: “The American Health Choices Plan.” It is clearly aimed at the middle-class Americans who feared that her earlier plan would limit their choices, force them into health maintenance organizations and subject them to new government bureaucracies deciding what their benefits could be — concerns stoked by a devastating campaign by insurers.

It isn't that the Edwards plan has ideological purity either; for it still relies on the current employer-based insurance model, though it purports to make it more affordable for employers to provide insurance and for individuals who do not have access to employer-based care because they are independent contractors or do not work to purchase their own. But it's clear that Clinton has drawn heavily on the Edwards model in creating this plan.

The biggest problem with the health plans offered by all of the Democratic candidates is its continued reliance on the private insurance industry. All of the candidates give lip service to not allowing insurance companies to cherry-pick who they will cover, refuse to approve care advocated by doctors, or refuse to pay after-the-fact. But does anyone honestly believe that a Congress awash in insurer cash is going to go along with this?

The bottom line, which all of the candidates, obviously still smarting from the right-wing attacks on Clinton's original health care proposal in 1993, are unable to articulate, is that there is a fundamental disconnect between providing care and the for-profit model. If the function of a for-profit company, especially a public company that sells stock, is to maximize shareholder profit, then there is no way that it can fulfill this function and still provide health care.

It may very well be that Americans still aren't ready for a single-payer plan. Certainly those who would once again spend millions of dollars on a propaganda campaign in order to keep their gravy train going aren't ready. Any candidate advocating single-payer is going to find his or her campaign bombarded with propaganda ads warning against having the government control your health care -- an ironic position, considering that those most against universal access to care are also the ones who think the government should control WOMEN'S health care decisions. But those who are concerned about who controls their health care might want to consider that much of the time as it stands now, it's a clerk with a headset in a health insurance company boiler room reading codes on a screen who decides what care you receive.


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