What's All This Then?

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Thursday, February 16, 2006

I’m having a lot of medical expenses lately - which makes me even more aware than usual of the convoluted state of our healthcare system compared to other western nations. Critics of national healthcare systems like to point out that those are "rationing" systems - that you can wait months for such things as needed surgeries or even for an appointment to see a specialist. But of course that could be highly descriptive of our healthcare system - and in those other countries of which we are so critical, when a patient does receive care - even lengthy and highly complicated care, he or she doesn’t have to worry about how to pay the medical bills with money he or she doesn’t have!!

There was a horror story in my local paper yesterday about an "undocumented" Filipino - someone who had a stroke while in this country and landed up in a nursing home where he slowly improved but also ran up a huge six figure bill that he couldn’t pay. The nursing home tried to get him to leave - even threatening to call the police to evict him. He didn’t qualify for Medicaid because of his undocumented status and finally the nursing home solved their problem by buying him a one way ticket back to the Philippines. He told his friends that he didn’t think he’d survive there - and sure enough his prediction came true. He’s no longer among the living.

I don’t know if he would have been treated the same way if he’d suffered his stroke in Canada or in England - but I doubt it. Their systems may be flawed but they’d have to work damned hard for years to come up with the kinds of complications we dream up to "improve" the delivery of healthcare to our citizens..

Fortunately, even though I’m a senior, I don’t have to try to understand the Rube Goldberg Medicare drug "assistance" bill that is currently sending seniors to psychiatric centers in droves where they very likely are being refused coverage because Federal Stupidity isn’t listed as a known disease. I have coverage through my wife’s employment. But for other seniors? Over 40 different "plans" - run by - and probably designed by insurance companies. With this secretive administration, you never know who is dictating what. Remember the closed door energy policy meeting run by that old lawyer shooter Dick Cheney?

The business of insurance companies isn’t healthcare or the delivery of healthcare - but to make money. So naturally the "plans" are virtually impossible to understand unless you are a graduate of the aforementioned Rube Goldberg graduate school of convoluted thinking. My brother, who - as I’ve noted before lives in England - takes any prescription his doctor writes for him down to the local pharmacist where, as I’ve also noted before - it gets filled without him having to have joined any "plan" and without him having to pay anything. No co-payment. No payment of any kind. He’s managed to live to a senior age and his government, with its national health plan so despised by our planners - takes care of his health needs. There’s nothing for him to try to understand. An idea that our bureaucracy couldn’t begin to understand.

I’ve written here before about the burden that the cost of prescription drugs places on all of our citizens. Seniors are probably hit the hardest - but unless you’re wealthy or lucky enough to have the kind of drug coverage that my wife’s employment provides for us - you could be faced with a choice between buying your medicines or one or more of life’s other necessities. Like food.

What sets me off on this day’s particular dissertation is not so much my personal increase in medical expenses that I mentioned with my opening words - but the coincidence of the introduction of Medicare’s cockeyed drug coverage plans for seniors and the rash of television commercials from pharmaceutical companies - not pushing their products - but telling you how much they care about you!! You’re what’s important to them - not making money. Finding the drugs that will keep you healthy. There’s even one company that says if you can’t afford their drugs, they have a program to provide them to you without cost. Sure. Can you imagine the demeaning means test you would have to go through to qualify for such largesse? It wouldn’t apply to the very poor who have been on Medicaid and getting their drugs paid for by that program which now will pay for the new Medicare coverage . Obviously it wouldn’t apply to the wealthy. So who is left? The middle class- people who probably would never qualify for any drug company’s benefit program and who most likely would never lower themselves to apply for any kind of welfare program anyway.

The drug companies could help - as could our government. The companies could help by quitting their self praising ads to the general public and their out of public sight costly P.R. campaigns to get doctors to prescribe their drugs - and stop the annual price increases they attach to medications that already cost patients one, two, three, four or more dollars per pill!! And government could help by allowing itself to negotiate the cost of drugs on behalf of Medicare enrollees - just as the Veteran’s Administration does for the people it services at VA Hospitals. Why do you think we don’t allow such negotiation? Why are insurance companies running the new Medicare drug program? The second question answers the first if you stop and think about it for a minute.

If you can think of anything more disingenuous than the current crop of self praising pharmaceutical ads or the government’s assertion that the Medicare drug program was designed just to help senior citizens and not pharmaceutical companies and insurance companies - please let me know .