Today, I got the following via email:
Dear Mr. President:
During my shift in the Emergency Room last night, I had the pleasure of evaluating a patient whose smile revealed an expensive shiny gold tooth, whose body was adorned with a wide assortment of elaborate and costly tattoos, who wore a very expensive brand of tennis shoes and who chatted on a new cellular telephone equipped with a popular R&B ringtone.
While glancing over her patient chart, I happened to notice that her payer status was listed as "Medicaid"! During my examination of her, the patient informed me that she smokes more than one costly pack of cigarettes every day and somehow still has money to buy pretzels and beer.
And, you and our Congress expect me to pay for this woman's health care? I contend that our nation's "health care crisis" is not the result of a shortage of quality hospitals, doctors or nurses. Rather, it is the result of a "crisis of culture", a culture in which it is perfectly acceptable to spend money on luxuries and vices while refusing to take care of one's self or, heaven forbid, purchase health insurance. It is a culture based in the irresponsible credo that "I can do whatever I want to because someone else will always take care of me".
Once you fix this “culture crisis" that rewards irresponsibility and dependency, you'll be amazed at how quickly our nation's health care difficulties will disappear.
Respectfully,
STARNER JONES, MD
Assuming that there is any truth to this email (and I tend to think that the “facts” are fabricated to make a point), one person’s misplaced priorities are not an indictment of health care reform. (And even people with wacked out priorities deserve medical care.) I agree that Medicaid fraud is an issue that should be addressed, and lord knows that when I worked at Atlanta Legal Aid, I had my share of clients who were on TANF and Medicaid but had nicer cellphones than I did.
This, however, is not what the President’s proposed healthcare reform is about. I can put a face on what it is about for you.
What healthcare reform is about is allowing middle class families like my own, particularly those who have self-employed wage earners or wage earners who work for companies that do not provide health insurance, to afford the health care that their families need. It is about allowing people both to have health insurance that is affordable and to access health care that is affordable, so that families do not have to make a choice between health care and other necessities.
Just as a for example, we have the cheapest health insurance that we can afford with a reputable carrier, yet we currently pay almost $700 a month for health care coverage that has a $5000 family deductible, plus an additional individual deductible for each person in the family, which means that the ACTUAL deductible is closer to $7500 a year. Since we had a child last year, I fully expect that our insurance company will raise that premium come review time in October without providing us any concomitant increase in services.
Health care reform is also about getting rid of pre-existing conditions clauses that force families like ours to pay thousands of dollars to correct a medical condition that our daughter was born with simply because she was so young that ANYTHING wrong with her was a pre-existing condition under our health insurance policy.
Health care reform is about eliminating pre-existing conditions clauses that mean that my mother-in-law can NEVER change insurance companies because she has had breast cancer. (And that also mean she pays a LOT for her coverage.) It is about preventing her insurance company from canceling her simply because she has been sick.
Health care reform is also about putting decisions back into the hands of patients and doctors, rather than allowing insurance companies to call the shots. Because of clauses that insurers are allowed to require in private insurance policies, we had to wait almost two years before having a second child because we could not get insurance to cover anything related to maternity without accepting a one-year waiting period. Our first policy was a piece of crap, and because we switched insurers to get better coverage for our family, we had to wait through not one but two one-year periods.
It’s very easy for people who can rely on group policies provided by employers or for people who have never had to use their insurance policies to think that everything works smoothly with the system. There are, however, great disparities in our health care system that must be addressed. Many families like my own are forced to pay a lot out of pocket for benefits that others get subsidized by employers or to risk bankruptcy by going without health insurance and taking the risk that someone in the family could need expensive, catastrophic care.
Certainly, there are cultural issues to address – Americans actually receive a lot of unnecessary health care services, and some people clearly have wacked out priorities – but the President’s proposed changes for health care reform are just the first step to fixing these problems, not the whole enchilada.
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2 comments:
Great post - would make a good editorial.
I doubt the case here was fraud, however - the woman was probably poor enough to qualify for Medicaid, with no assets and a very low income. The problem is the M.D.'s conclusion, that the new health plans would somehow create more such cases. The problem is the current system.
One of my roommates in fact, who btw also collects unemployment, frequently accesses health care services (including psychiatric and psychotherapuetic counseling services) and pays practically nothing. She is billed when she goes to emergency rooms but just ignores the bills, like many people on the edge of poverty. She has far better health care than I do (on my high-deductible plan) because she doesn't worry about what anything costs and sees doctors or psychologists whenever she wants at an assortment of "free" clinics and emergency rooms for those too poor to be able to afford their own health insurance. She also has a lot of health problems, possibly related to smoking and weight and other somewhat controllable lifestyle issues, so her care is expensive. If I accessed health care services with the frequency and facility with which she does, I would very soon have no money and qualify for Medicaid. I also know someone else who is on disability who prefers to call ambulances when he has even non-emergency medical problems because it's more convenient than driving himself.
There is plenty of room for resentment, therefore, but it is our *current* health care system that generates it. Those 30 million (or whatever) uninsured are not going without health care, and it is true that those of us who pay premiums and taxes pay for their care. So either we cut off emergency care and end Medicaid for them (which no one ever proposes we do, and for good reason), or we figure out a way to integrate them into the system. That what the health care reform plans are really all about. (And I haven't even mentioned illegal immigrants, who also access emergency care.)
Perhaps using such cases as a pitch for reform would be better spin? We currently have a system with a large percentage of freeloaders - let's make them pay for their care. Even healthy younger people who don't buy insurance are freeloaders b/c they depend on the implicit assurance that emergency rooms and Medicaid will take care of them if something catastrophic happens.
This is obviously a plant by one of the "TEA Party" groups who are confusing libertarian principles with the existing populist policies being proffered by Sarah Palin and her ilk.
But here's the rub - the "Doctor's" email says, "And, you (President Obama) and our Congress expect me to pay for this woman's health care?" Well, guess what? YOU ARE ALREADY PAYING FOR HER HEALTH CARE. Medicare is a Government program, paid for through taxes. And those "illegal" immigrants currently going to the emergency room for care the TEA Party idiots don't want to "pay for?" Well, WE ARE ALREADY PAYING FOR THEM TOO! Who do these people think pays for all those emergency room visits? We ALL do!
But then, this is also a "movement" that has sported signs stating "Government keep your hands off my Medicare."
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