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Stuck In The System

Posted by PATRICK EDABURN in At TMV, Health, Politics, Society.
Dec 6th, 2008 | Comments

An article appearing in a local paper today struck me as an excellent illustration of both the current problems in our health care system and a possible warning of problems with a nationalized health care system in the future.

The basic story is that a woman was admitted to the hospital with severe pneumonia. She spent more that three weeks in the hospital intensive care unit but eventually recovered enough to be released. The only condition of her release was that for a few months she would need to use a ventilator during the night.

Such a unit costs $40,000 to buy or around $4,000 a month to rent. But her insurance has a cap of $2,500 per year for durable medical equipment so they turned down her request. But they agreed to KEEP her in the hospital at a cost of nearly $10,000 a day.

After almost 3 weeks of haggling, they finally agreed to pay for the respirator but not before paying the hospital an additional $200,000 in fees. So they basically could have bought the unit five times over for that amount.

Of course we all look at this and see it as a ridiculous bureaucratic nightmare, but it is a symptom of what happens when we get giant companies running the health care system. Imagine how much of a mess it could be if we had the government running the whole thing (ask anyone on Medicare about their idiotic policies).

We all agree something needs to be done to reform health care but, as part of the process, we need to try and develop a system where these kinds of things do not happen.

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jdledell

Patrick - As someone covered for Medicare, I consider it WONDERFUL and easy compared with my experience while in the employer sponsored health plans. It's easy, no hassles. the EOB's are easy to understand -what is not to like?

rfyork

Mr. Edaburn,

I too have been covered by Medicare for quite a while. While there is no doubt that there are inefficiencies in the system, the problem you are describing is a direct result of the absurdity of for-profit medicine, not medical bureaucracy. Free enterprise fundamentalism misses the obvious problem with for-profit health care. That no one wants second class care. There is little or no real market efficiency when we all want the best care for ourselves and our families. When examined with any degree of objectivity, Medicare is the most efficient and effective health care delivery system extant in the US today. It maintains an overhead under 8%, compared to the average of 20% in most private health insurance.

The private health insurance system we suffer with in the US is the most expensive, least effective and least efficient in the first world today. This is fundamentally related to profit. Please look carefully at health care systems in France, the Netherlands, Switzerland and Japan. All deliver solid medical care to their populations than the system we have in the US. And, by the way, many do include private insurance.

In no other advanced country in the world can a family be forced in to bankruptcy by trying to care for their own. In no other system does 1/6th of the population look to emergency rooms as their first providers.

I truly do not understand the almost willful blindness of conservatives to the complete failure of the American health care system. No system is perfect, and all systems ration health care. But, in the US, health care is rationed on a purely economic basis. Our system costs over $6,000 per person, while virtually all other systems run under $3,000.

Richard York

jeff_pickens

Patrick,
with all due respect the argument goes something like this: look how bad the present system is, but BE AFRAID of a single-payor one!

And as rfyork and jdledell testify above, most people who have some national-health-care coverage are happy with it, including those in countries where it is already in place. There is coming a time when we need to stop being fearful of SOCIALISM in a way the prohibits good social services in this country.

And yes, we might someday have to drive farther than 5 miles and have less than 3 options in that space, to have our CT scans on the same-day basis. According to generally any study out there I've heard about, that private-market availability and cost hasn't added one iota of lifespan onto our American lives compared to people who are cared for in a national health care system.

Davebo

I'm very happy with my VA care. But then again, they are allowed to negotiate drug discounts, unlike Medicare.

Jim_Satterfield

Sorry, Patrick, but you're spreading Republican memes. The primary goal of private insurance is to make a profit for the corporation, damn the consequences for the insured. Many Republicans want government provided health care to look bad so they do things like Missouri did to their Medicaid program. Once again, the hell with the patients. We will provide people who can't walk with a battery powered wheelchair, we just won't pay for the ongoing need for batteries. If you have a system where the primary goal is to provide a decent health care system where the employees are trained to understand that there is no goal other than efficiently providing health care and you don't have shareholders and Wall Street analysts hanging over you like the sword of Damocles just maybe we might do something positive. It won't be perfect but it will be better than the system where 7 or even 9 figure salaries and bonuses are your main reason for existence.

Patrick E

Well I am glad for responses.

My point was actually that the current system is very messed up and needs reform but that the immediate leap to a single payer system may not be the solution either.

As to the bashing of one side or the other on the issue, that's hardly productive but hardly shocking either.

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