Healthcare Costs: Appealing to the fiscally concerned

1 September 2009

Related to the effects of rationing are the effects of high-cost medical care. After discussing the impact on family finances and stability when a member becomes severely ill, Steve Benen notes:

No other industrialized democracy on earth allows its citizens to endure such nightmares. […] an American Journal of Medicine study that found 62% of all American bankruptcies are linked to medical bills — and more than three out of four of those bankruptcies occurred among those with insurance. Again, every citizen of every other industrialized democracy on the planet need not worry about such a scenario. [emphasis mine]

He offers this as a suggested appeal to the Republican sense of cost consciousness.  You’d think this would work.  It probably won’t.

Rationing

30 August 2009

Steve Benen, at the Washington Monthly blog, once again tipped me and other readers off to a couple of good articles by Ezra Klein and David Leonhardt, concerning health care reform and the issue of rationing.  Leonhardt sums it up:

The choice isn’t between rationing and not rationing. It’s between rationing well and rationing badly.

One of the more clear discords between What Is and What Is Imagined in the health care debates seems to be rationing. Some seem to fear that the Government will institute rationing of health care.  But it seems clear to me that we’ve had rationing since health insurance was invented. Choices are made to restrict or deny care by people above our nurses and doctors, folks who routinely limit care from their desks at insurance companies.  Unlike most of the health reform issue (elsewhere, I described the confusion of issues as spaghetti), the issue of rationing seems very obvious to me. 

Leonhardt is right.  It’s not a question of whether we get rationing or not.  We currently have it.  It’s done by folks we have absolutely no control over – we are customers (or not) of private companies, not shareholders.  If we had government involvement, we’d be like shareholders, with some right to have a say over what goes on.  We can elect leaders who are able to shape the system.  There’s a significant chance that what rationing must inevitably occur in any system will at least be meted out fairly, and not because of profit incentive.  And we, as citizens have standing to complain if things go badly.

As Leonhardt says, the choice is between good and bad rationing. We can’t be perfect, all things to all health consumers.  But certainly we can do better than what is happening right now.

The important, but irrelevant issue of Health Care Reform

21 July 2009

Today, a friend of mine asked me what I thought about Obama’s proposed health care reform platform.

Her question found me at lost for words.  Not that I haven’t thought about health care, and  health care reform.  Believe me, every time I feel a suspicious ache I think about health care.  I have none, you see, and can’t afford any, and so aches and pains are an open question. A not-well-planned for question.

But I don’t really look at actually acquiring health care coverage.  I can’t fork over three or four hundred bucks a month for it – and being 50, I’ve noted that the few among my contemporaries who are buying health insurance are indeed forking over several hundred a month for the privilege of having something like 75% of their potential  medical expenses paid for through insurance.

Now, it’s not that I have no health care coverage.

First of all, there’s workman’s compensation.  For injuries while I’m being a "workman" of course.  Should I be injured on the job, I’m covered, at least up to some sort of cap I haven’t really bothered to investigate.

And then there’s the car insurance.  For a few bucks a month, any (human) body damage endured due to a car wreck is covered.  Good, yet small comfort.  Particularly because there’s yet another cap once I hit some high water mark on medical bills.

So, as long as I’m working or in my car, I’m okay.  Hmmmmm…. So, anyway, back to my friend’s question.

Though I haven’t been tracking every detail of the health care debate, I am not unaware of the changes to health care being proposed by the White House and members of Congress.  I am not unaware of the potential, the great advance this would offer to our society and our financial crisis, and I do not believe that some kind of socialist system will sneak in.  It’s pretty hard to label something as socialist when the plan is to create a competitive market for health care options.  Competition, market… sounds pretty NON socialist to me.

But in my situation, with absolutely no money to spend on health care other than  out-of-pocket, nickel and dime expenses, all I can hope for is that the Obama administration can push things that much farther, getting closer to a time when I can afford basic health care.

I won’t get it during this term, or most likely the next, but eventually all the struggle around something I cannot afford will ripple down to me in some form of cheaper options.

I hope.

We’ll see.