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Health Care

Cenk Uygur of The Young Turks appeared on CNN’s Paula Zahn show last night to talk about health care and the film Sicko. You can watch the video here. Be sure to check out the spokesperson for the Right, Amy something.

My comments:

The young lady representing the Right kept going on about how she didn’t have health insurance because she was self-employed and wanted some kind of tax credit so she could afford it. However, I’m reasonably certain self-employed people already can deduct 100 percent of their health insurance premiums from their federal income taxes (Form 1040, line 29). So I’m not sure what other tax incentives she might need.

Which takes me to the next point — she was complaining about those awful “regulations” that make insurance so expensive. When the COBRA policy from my last job ran out I was able to purchase a private Blue Shield HMO policy, even though I am 55, overweight, and have high cholesterol. This is thanks to New York state regulations. I’m paying almost $700 a month for it, but by damn I’m insured. In many states I probably could not have purchased private insurance at any price.

This is, I think, critical: Empire Blue Cross/Blue Shield could not deny my application because I applied the same month my COBRA insurance expired. I didn’t have to get a physical or anything; just provide proof of my prior insurance. This was New York law, they told me. Had I waited more than a month, they could have turned me down. In many states I wouldn’t have had even the grace period; I could have been denied coverage just because. These are the kind of “regulations” the Right says are so onerous.

Also in New York, if you start a new job, your new employer’s health insurance provider has to insure you even if you have pre-existing conditions. There may be some loopholes somewhere, but I have never heard of an employed co-worker being denied coverage in all the years I’ve lived around here. That’s another of those damn “regulations” the Right wants to do away with.

Ms. Amy the Tool (who is a pretty girl, but a twit) exemplifies another problem with “The System.” She’s young and healthy and thinks it doesn’t make sense for her to purchase health insurance when she sees a doctor maybe once or twice a year. Never mind that she’s gambling she won’t be in an accident or come down with something serious. Insurance is about risk sharing, and if healthy people aren’t in the system it drives up costs for everyone else.

Finally, the segment implied that Sicko focuses on the problems of uninsured people, but it’s more about insured people who have been ripped off by their insurance providers.

I hope I’m not being too hard on Cenk, who did good.

Also: Nice commentary on Sicko by Maggie Mahar.

Update: I forgot to answer one other thing — Ms. Amy Something mentioned all those Canadians who are dropping dead while on waiting lists for elective surgery. I don’t remember the number she gave. I want to repeat something I wrote last month:

Nearly a year ago the Institute of Medicine issued three reports (key findings here) saying the nation’s emergency rooms are inadequate and getting worse. Among other things, it found:

  • Demand for emergency care has been growing fast—emergency department (ED) visits grew by 26 percent between 1993 and 2003.
  • But over the same period, the number of EDs declined by 425, and the number of hospital beds declined by 198,000.
  • ED crowding is a hospital-wide problem—patients back up in the ED because they can not get admitted to inpatient beds.
  • As a result, patients are often “boarded”—held in the ED until an inpatient bed becomes available—for 48 hours or more.
  • Also, ambulances are frequently diverted from overcrowded EDs to other hospitals that may be farther away and may not have the optimal services.
  • In 2003, ambulances were diverted 501,000 times—an average of once every minute.
  • After these reports came out, David Brown wrote in the Washington Post:

    The number of deaths caused by a delay in treatment or lack of expertise is especially uncertain, though it may not be small. San Diego established a trauma system in 1984 after autopsies of accident victims who died after reaching the ER suggested that 22 percent of the deaths were preventable, said Eastman, one of the Institute of Medicine committee members.

    Our system doesn’t kill people by putting them on waiting lists for elective surgery. Out system has other ways to kill people. If it doesn’t kill them in the ER, it kills them by denying them necessary surgeries. Experimental, you know. And it kills them when it denies them basic medical care.

    A report came out in 2002 that 18,314 people die in the US each year because they lack preventive care services, timely diagnoses or appropriate care. They lack these things because they are uninsured.

    Those people would have been better off in Canada, wouldn’t you say?

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    16 Comments

    16 Comments

    1. PurpleGirl  •  Jun 27, 2007 @1:15 pm

      In 1993, with no prior lower back problems I was “felled” by two herniated disks. After conservative treatment for several months, the problem only worsened and after 6 months my doctor decided I needed surgery. Luckily I was working full time. My insurance plan was HIP. Due to complications I could not return to work as planned and was out on disability when my organization changed insurance coverage. Because of NYS law, HIP had to continue providing care until I was released by the doctor to return to work. The less regulation people would probably like to end that rule too.

    2. grayslady  •  Jun 27, 2007 @1:18 pm

      Haven’t seen Sicko yet–it’s due here this weekend, I believe–but my understanding is, as you say, that a large part of the movie focuses on how even people who pay for health insurance aren’t receiving what they think they’re paying for. Cenk did a great job IMO given the focus of the Zahn’s interview, which was not about the movie but about the whole issue of universal health care.

      I think this distinction between a discussion of universal health care, generally, and what Moore’s movie is pointing out, is an important one. To me, what Moore is saying is, “Look, even you people who think you have health insurance coverage aren’t really covered. You’re paying a lot of money and for what? Denied claims?” This is an important point to stress in the argument for universal health care since, as I understand it, many people with “good” insurance coverage are afraid that they will receive an inferior package under universal health care and are, therefore, opposing the concept. My response to that type of concern is this: if you make sure that all members of Congress have to have the same medical program as the rest of the citizenry, then you can be certain you will receive excellent health care. The first time that a member of Congress has to wait one year to be scheduled for a mammogram, then you will see the wait times for mammograms decreased. The current unfairness, as Moore apparently points out, comes from disparate programs that rely, primarily, on the negotiating strength of corporations rather than the negotiating strength of the government.

    3. joanr16  •  Jun 27, 2007 @1:19 pm

      Nothing in the world is worse than living paycheck to paycheck and having either no insurance, or really crappy insurance with a high deductible that plays coverage games, in the manner exposed in Moore’s film.

      But of course, Ms. Amy Corporate-Tool would have no idea what that’s like.

      The response is to do just what maha’s done– point out, through a combination of hard facts and personal anecdote, that Ms. Corporate-Tool has no freaking idea what she’s talking about. I bet if you checked, you’d find that she works freelance for a PR firm representing a major health insurer. Either that, or she’s the “self-employed” daughter of an insurance executive.

    4. maha  •  Jun 27, 2007 @1:28 pm

      Because of NYS law, HIP had to continue providing care until I was released by the doctor to return to work. The less regulation people would probably like to end that rule too.

      Exactly. In many — most, I think — states, HIP could have dumped you.

    5. A Canadian Reader  •  Jun 27, 2007 @2:13 pm

      Maha, you pay $700 dollars a month for insurance!!!!!! And yes, I know of people in the States who pay a lot more than that so…can someone who defends low taxes explain to me how living in Canada is so expensive?

      If I could compare my income, family status and taxation levels to those of an American, by virtue of the fact that my taxes include health care, I’m sure that financially I would come out way ahead of my U.S. equivalent.

    6. moonbat  •  Jun 27, 2007 @2:39 pm

      I remember being young and healthy and oblivious, and so I have little patience for young twits like Amy when it comes to subjects like medical insurance. Sure, some of us can get our own private health insurance, with huge premiums, lousy coverage, and we tremble if we dare use it – the insurer could drop us at any time.

      Obviously people dying on a waiting list for elective surgery is a canard, as you wrote:

      …Our system has other ways to kill people. If it doesn’t kill them in the ER, it kills them by denying them necessary surgeries. Experimental, you know. And it kills them when it denies them basic medical care.

      Exactly. I don’t stick my head into the right wing “idea” stream very often, and I don’t plan to on this issue, but it seems like what I’ve heard of their defenses of the status quo are overall pretty lame.

      I sort of wonder if we’re going to eventually get some form of socialized medicine in this country as a tradeoff – we have to give up something else. I think the major corporations are seeing that the status quo isn’t working for them (you’ve no doubt heard the statistic that an American made car includes about $1500 of cost for health care, largely for pensioners, versus about $100 for a Toyota), the big holdouts are the insurance companies and their vast army of clerks and decision bots that try to “manage” care. I just wonder what horrible deal we’re going to eventually be “offered” in order to get some form of single payer in the US.

    7. Gordon  •  Jun 27, 2007 @2:47 pm

      If you need surgery to prevent you from dying, it’s not “elective” surgery.

      Ms. Amy wants a tax credit, not a deduction. She wants the gov’t to pay for her insurance directly (and regressively). Basically single-payer for rich people. I’m sure she’s similarly selective in what regulations to do away with.

    8. grayslady  •  Jun 27, 2007 @3:12 pm

      Update on Ms. Amy Holmes: she was a former speech writer for Dr./Senator Bill Frist and currently bills herself as a “Republican strategist”. Hmmm… Do you think Frist favors universal health care? Wonder if they ever discussed it?

    9. maha  •  Jun 27, 2007 @3:17 pm

      If you need surgery to prevent you from dying, it’s not “elective” surgery.

      Exactly. My understanding is that if a Canadian is in real danger they fast track him into surgery about as quickly as they do here. And it is not necessarily all that quick here.

    10. maha  •  Jun 27, 2007 @3:25 pm

      Maha, you pay $700 dollars a month for insurance!!!!!!

      And that just covers me. That’s not a family plan. Private insurance is cheaper in other states, but in those other states the insurance companies have more discretion to refuse to cover people. If they can dump out clients who are really sick, the insurance companies do save money. But it sort of defeats the purpose of health insurance.

      If I could compare my income, family status and taxation levels to those of an American, by virtue of the fact that my taxes include health care, I’m sure that financially I would come out way ahead of my U.S. equivalent.

      Oh, I’m sure you would. I have no doubt. That’s a point that’s hard to drive home here, though. People who get health insurance through employment aren’t paying as much out directly as health insurance, but the cost gets taken out of their pockets in other ways.

    11. QrazyQat  •  Jun 27, 2007 @4:13 pm

      Again, personal anecdotes:

      Girlfriend’s son needed hernia surgery, got into specialty clinic in Toronto within 6 weeks, no problem, no cost.

      My mom was to undergo knee surgery last year, earliest time for her to get in was 3 months, unless she wanted her choice of surgeon in which case it was 7 months. Cost: it’s the USA, you figure it out.

    12. biggerbox  •  Jun 27, 2007 @4:47 pm

      Amy the tool said she was going to see her doctor soon, hinting that she hadn’t been feeling well. Let’s hope it’s not the pneumonia she mentioned, or worse a lymphoma like the one I had when I was younger than she is. A hospitalization would quickly make her rethink the idea of having insurance. Of course, she’ll never be able to get coverage once she’s sick, because of her “pre-existing condition.”

      (BTW, since I don’t normally watch it, is that Paula Zahn thing supposed to be some kind of news show? I couldn’t figure out if I was watching a policy debate or Entertainment Tonight.)

    13. dr. luba  •  Jun 27, 2007 @4:57 pm

      If the Canadians spent as much for healthcare as we do–they currently spend only half as much per capita–I’m sure all the wait lists would go away.

      What’s our excuse?

    14. khughes1963  •  Jun 27, 2007 @11:06 pm

      This ties in with a book I just finished-Sick, Jonathan Cohn’s new book about how our dysfunctional health insurance system is causing real problems for real people. Unfortunately, no one will think it’s a problem until too many people are without insurance, or until it happens to them.

    15. Avedon  •  Jun 28, 2007 @9:50 am

      It’s my understanding that Americans not only spend plenty of time waiting for their insurance companies to okay treatment, but they have vital treatment refused all the time.

      I don’t have to think about whether I’m eligible; I am. I don’t have to wonder whether they will schedule treatment in reasonable time; they will. I don’t have to ask whether it will be covered; it is.

      I’ve never had any reason to feel that I got better healthcare when I lived in America than I get here in Britain. But damn is it a relief to not have to think about what it’s going to cost me to see a doctor or spend a couple of nights in a hospital. If I need to see the doc, I just go. If I need treatment, I just go. That’s it. There’s no bill.

    16. derek  •  Jun 29, 2007 @8:02 am

      If Amy Holmes thinks that because she’s young and healthy, the insurance premium she is spending on private health care is not worth it, then the premium is too high, either because:

      a) the insurance process is extremely inefficient, or:

      b) insurers are taking her for a sucker.

      I’m sure she’s right on at least one count, if not both, but how could either of those things be a defence of private health insurance? Please feel free never to defend me, that’s all.



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