Health Care Blues

Two things happened over the past few days that caused me to think more seriously about health care reform.  First, my daughter, a physician, brought me a copy of a documentary film, Vanishing Oath, by physician-filmmaker Ryan Flesher.  The film looks at the lives of health care providers under the current health care system and documents the abandonment of the profession by seemingly good and dedicated physicians.  The film is well-balanced but offers no suggestions about change, focusing only on the likely doctor shortage.  I recommend it to anyone teaching a law and health care policy course.

Second, today I spent almost an hour on the telephone with Social Security and the Medicare Coordinator of Benefits trying to determine why I had been enrolled in both Medicare part A and B since I am still working and covered by my University’s health care plan.  I did not want to be charged the $115.40 monthly premium for Medicare part B.  Even though it was their mistake I still had to send a written request to Social Security asking to be dropped from Medicare part B.

Although I support universal health care provided by a single payer, this experience gives me pause.  Do I really want to government in control of health care access?  An Associated Press-GfK poll found that public support for comprehensive health is dropping.  My concern is timely given the ongoing and fractious debate in Congress about the budget, including discussions about reform of Medicare.  Further, on Wednesday President Obama is expected to propose modest changes in Medicare and Medicaid.  (Please comment on his proposal.)

I agree with Princeton economist Paul Krugman that privatizing Medicare is problematic.  I prefer to spend that hour on the telephone talking with a kind public servant.  But I also realize that cost controls are necessary if the program in some form is to be preserved.

I a relatively affluent educated American am fearful about my access to health care and physicians in retirement and the future of Medicare.  Barring some health catastrophe, I will survive, but I cannot image what the majority of Americans will do if needed reform substantially undercuts these benefits.

You may also like...

8 Responses

  1. Fraud Guy says:

    Suffer, and die, unfortunately, to answer your last statement.
    Though I am in the top 20% of income, seeing my parent’s health problems and their attempts to obtain consistent health care within the current system makes me realize that if things get worse, there will be little I can do in case of a treatable catastrophic health issue as I get older.

  2. anon says:

    My grandparents are in Canada, and one grandfather died, I am convinced, because he never went to a specialist for his condition, and the other almost died because he was sent home extremely sick from the emergency room (as I am told often happens in Canada1). In light of their experiences, it is hard for me to get behind a single payer system. I realize I don’t have data to support the feeling, but I just don’t want my family’s health care experience.

  3. Joe says:

    Many haven’t gone to doctors in this country because they don’t have the money. Some get very sick or don’t stop preventable deaths because of it. Many also have had problems with private insurers making mistakes. Many get limited coverage and are sent home still sick. What about their experiences?

  4. Diane says:

    It is hard to imagine that a comprehensive unitary system could possibly be worse than our current mix of public and private. For every Medicare bureaucracy nightmare story, I can give 10 similar private health insurance nightmare stories. The idea that privately funded health care works better than centralized government funded health care — or that the current amalgam of variously regulated private + government providers and payers works better than either — is pure fantasy.

    Would a single-payer system be perfect? Of course not. Do we have a lot of reason to believe that it would have significantly fewer flaws? Yes, absolutely.

  5. Ken Rhodes says:

    We have many discussions in forums such as this, as well as debates in legislatures and among candidates in elections, about “health care.” Few of them are really about health care; usually they are about health care insurance.

    If we paid more attention to our careless use of terminology, we would realize we really have three different problem areas: (a) general approach to health care; (b) provision of specific individual health care services; and (c) payment for health care.

    Making that distinction, is there anybody familiar with the data who really believes that private insurance companies pay out a higher percentage of their revenue in benefit payments as compared to the Medicare system? Of course not. There is not, nor has there ever been, an insurance system any more efficient at turning revenue into benefits, with a miminal percentage of the revenue subtracted for administration and profit.

    The acrimonious ongoing debate about “government health care vs. private health care” is based largely on failure to distinguish between health care and health insurance.

  6. John Doe says:

    I second Ken Rhodes about the failure to distinguish between health care and health insurance. Each has problems, but they’re not the same.

    On actual care, our ideals about equal access, and health as “special,” just don’t wash with the reality of limited resources. You don’t have to be a libertarian free-marketers to recognize that the “best” health care, including the best doctor in the world and the latest advances, cannot be offered to all comers on day one. You can expand what’s at the bottom or middle, or shrink the gaps. But pure levelling can’t happen.

    That means that someone, somewhere, won’t get a treatment that someone else gets. You can pick your poison about whether the approval/denial is based on wealth, an insurance bureaucrat, a government bureaucrat, or a lottery. But it’s going to happen. I never cease to be amazed by hearing people acknowledge this truth in on breath, and then deny it in the next.

  7. Fraud Guy says:

    True; the question is, do you want your care denied because you can’t afford it, because the claims auditor gets bonuses based on their approval (denial) rate, because the cost/benefit of the procedure does not warrant government funding, or because you failed to be selected for a random trial.

    Right now the majority of people can’t afford the first, get stuck with the second, have no chance at the third, and pray for the fourth. If we cut down/out the second, more would get the third, possibly the fourth, and then maybe more could afford the first.

  8. The future of health care is really scary for most Americans especially those who cannot afford it and those who do not understand how it works for them. It’s just so disappointing that the government is making things worse for the common people.