Thursday, June 11, 2009

Health care

Why I support a universal single payer system, a case comparison based on personal experiences:

Patient A: 30-something woman with a husband and young daughter is diagnosed with breast cancer. Despite receiving first class care, the cancer metastasizes and becomes systemic. After approximately five years, she dies.

Patient B: slightly older woman, single mother with a teenage daughter, is diagnosed with breast cancer. Her cancer progresses in much the same manner as Patient A, and approximately 5 years after the initial diagnosis, she dies.

So what's the difference? First, Patient A never had to argue with her doctors about whether or not her insurance would pay for a particular treatment, never had to worry about her own co-pays and deductibles, and did not leave her family holding a stack of medical bills several feet high. She and her family went through hell, but the one thing they never had to deal with was the possibility of her not being treated because she couldn't afford it.

Patient B, despite being a public school teacher with a supposedly comprehensive health insurance plan through her employer, wound up relying on loans from relatives, spaghetti dinners, bake sales, and other fund raisers, worried constantly about money, exhausted her sick leave so found herself with no income, and died many thousands of dollars in debt. Given the debilitating effects of stress on the human body, a person can't help but wonder what impact worrying about money had on her disease.

And why the different financial scenarios? Patient A lived in Sweden; Patient B lived in Michigan. When we live in a country where people who are employed full-time at what are supposedly decent, middle-class jobs and have what are supposedly good health insurance benefits find themselves relying on charity to pay for their prescriptions, something is seriously wrong.

My friend Tracy frets occasionally about end of life issues, like being maintained on life support when she really wouldn't want to be. I always tell her, hey, you want to make sure no one tries any heroic measures? Just show up at the Emergency Room of most hospitals without insurance.

On a related note, in terms of how a universal system might actually work, Utah Savage had a good post on the realities of living with Medicare a day or two ago. It's worth looking at.

1 comment:

  1. A couple of years ago I had to have some "minor surgery" that resulted in one night in the ICU and a couple more nights in a hospital room. Fortunately, I'm one of the lucky ones in this country who has really good coverage. The next couple of weeks while I was at home recovering I kept thinking about how unable I would have been to deal with any kind of bills and paperwork and problems with the insurance company. It would absolutely have affected my recovery.

    Statements kept arriving in the mail listing the thousands of dollars that this short stay cost, and even with a head full of painkillers, I knew there was simply no way I could have paid for that out of pocket. And I had a sudden understanding of how it must feel to read those numbers not as a "statement" but as a bill ....


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