Alex Blaze

The vicious cycle known as the American health care system

Filed By Alex Blaze | December 15, 2008 4:00 PM | comments

Filed in: Living
Tags: economic policy, health care reform, insurance, pharmaceutical industry, recession, starla darling

If there's a lesson to be learned from the finance or the auto industry crises (and the soon-to-come credit card industry crisis), it's corporate management doesn't put the long-term interests of the company's stakeholders before a quick profit. Why should they? They can just as easily turn a quick profit and jump ship. All that long-term stuff requires intelligence and patience, and obviously doesn't pay.

The NY Times has an article up about the growing health care crisis. One of the major culprits opposed to a system that covers working people and non-working people alike is the corporations that make excessive profits from health care as it exists.

The article's been linked to all over the internet because of the story of Starla D. Darling, a pregnant, laid-off Archway Cookies factory worker who, upon learning that her insurance would run out in several days, rushed to her midwife, induced labor, and had a Caesarean section so that the birth would be covered. The insurance company denied the claim anyway, and now Darling is stuck with a bill almost twice as large as that from her first child.

While this particular case is certainly extraordinary, what the Times article highlights is that people are generally less able to use the medical industry when they don't have insurance (duh). That takes its toll on the medical industry:

M. Harvey Brenner, a professor of public health at the University of North Texas and Johns Hopkins University, said that three decades of research had shown a correlation between the condition of the economy and human health, including life expectancy.

"In recessions, with declines in national income and increases in unemployment," Mr. Brenner said, "you often see increases in mortality from heart disease, cancer, psychiatric illnesses and other conditions."

The recession is also taking a toll on hospitals.

"We have seen a significant increase in patients seeking assistance paying their bills," said Erin M. Al-Mehairi, a spokeswoman for Samaritan Hospital in Ashland. "We've had a 40 percent increase in charity care write-offs this year over the 2007 level of $2.7 million."

In addition, people are using the hospital less. "We've seen a huge decrease in M.R.I.'s, CAT scans, stress tests, cardiac catheterization tests, knee and hip replacements and other elective surgery," Ms. Al-Mehairi said.

This is the absolute worst place to be cutting back in a depression. Not only does it only ripple out and eliminate other people's jobs, as drops in consumer spending always do, it makes people sicker, which only prolongs the amount of time needed to get the economy going again.

During a recession, spending on infrastructure should increase for a country to work its way out of economic hard times. And health care is the foundation of our country's infrastructure because everything else depends on healthy people.

Considering the bankruptcy of conservatism, I wouldn't be surprised if Darling's case gets used by Republicans to point out how people try to cheat their insurance companies, and the real problem here is insurance fraud. But the real culprit is that the insurance industry knows its days will be numbered if a viable alternative to private insurance (like the program proposed by Obama) were implemented, and its accomplices are the medical industries, like the pharmaceutical industry, that weren't willing to take an opportunity to recession-proof their corporations when it presented itself.

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Another part of the problem is that we don't have a healthcare system, we have a sick-care system. The industry is anchored on curing people when they get sick, rather than on keeping them well.

The next time we revisit sCHIP it should be universal. No exceptions all children under the age of 18 and pregnant women should be covered. There needs to be an emphasis on prenatal and well baby care to include funding for healthy school lunches, nutrition education in grades PreK through 12, and PhysEd at least twice a week for PreK through 12.

Robert Ganshorn Robert Ganshorn | December 16, 2008 7:01 AM

Another point Alex is that the very poor must use emergency rooms as primary care, cannot pay for it, and is the most costly type of medical treatment. Open clinic "wellness centers" placed where people live are a far better solution. The costs of emergency room care could provide a heck of a lot of "wellness care" that would keep the costs down and allow better use of emergency rooms for trauma cases.

Over a stretch of 10 years my wife was quite sick with a variety of things, mostly caused by diabetes that could not be controlled. Some of the nightmares in her care:
--We had over $4000 waiting for reimbursement and were living paycheck to paycheck with no wiggle room
--She had significant nerve damage and wouldn't fund nerve cell transplants being done in Italy.
--a hospital giving her twice as much insulin twice as often instead of half as much twice as often. We were expected to [pay for the ICU and subsequent care she required until I threatened to sue.
--I also was quite ill. At least half of the Explanations of Benefit were wrong.

Some disasters I faced
--I was suicidally depressed and admitted to a psychiatric hospital. An RN in California (I was in Oklahoma) said I should be cured in 3 days. The hospital wheedled her into five days, even though my doctgor said I was in danger. I overdosed the night of my release.
--1.5 years spent getting LAB CORP to straightened out a bill. I provided the information by phone and in writing, still I kept receiving a bill for the total amount of my blood work. It took providing them the information written by my lawyer to get them to do it.
--Numerous times my doctors have been convinced of the treatment I needed to have and it took up to 8 months of haggling to get it approved.
--I have been taking what is now Mucinex D with 1200 mg of Guaifenesin and 120 mg of Sudafed for 40 years. On the box it states take one every 12 hours. However, I am allowed to get one box of 24 every month or risk trouble with the DEA. That covers 12 days--what about the other 19 days of the month?
---I am on disability. My medical treatment which I am required to have to keep the disability costs me 3.5 months of the money I receive. How much sense is there in a system in which those with the fewest resources pay the brunt of the health care costs?
--I spent three days in Spain for treatment of cellulitis. The bill including doctor, all treatment and transportation at a private hospital for foreigners was $798. I spent 1.5 days in a recent stay. The bill was $25,538. An ER visit in Canada including x-rays and the doctor cost me $250. My latest ER stay was over $3000.
--A friend who has no money, severe asthma and COPD cannot get to see a doctor. It's going to take 6 months for her to be able to get the cafe she needs for indigent folks. What does she do in the meantime?
Our health-care system is broken--I believe beyond repair. Even folks with insurance experience hassles that are completely necessary.
Concerning managed health care, I'm a historian and I have never seen a situation in which adding another level of bureaucracy saved money.
I have a panic disorder. 90% of the episodes involve managed health-care.
I'm at [email protected] I'd like to hear from you

Robert Ganshorn Robert Ganshorn | December 17, 2008 8:19 AM

Rick, you are very right, I and my partner both just had full physicals and blood work including chest xrays and an MRI scan of his brain tumor. Full cost was $600.00 for the both of us in Thailand. The King of Thailand pays half the cost of preventive/diagnostic medical care for foreigners during the months of November and December. My monthly insurance premium here (age 55) is $90.00 with a policy that will carry me through until I am eighty.

Since I could be involved in my partner's health care in Thailand without question it was a logical choice to relocate.