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Let’s Treat Our Patients, Not Trick Them with Private Insurance


#1

Let’s Treat Our Patients, Not Trick Them with Private Insurance

Emily Kirchner

A few days ago, I was studying a medical diagram in a coffee shop when a man in his mid-forties walked in. His face was red, he was sweating, he looked upset.

"Please, can anyone help me?" he asked. "My daughter is at Children's Hospital for seizures and she needs medicine. My credit card is maxed out. I need $16.50."

A few weeks ago, I was listening to a friend describe a Pennsylvania Insurance Department hearing on proposed rate hikes for marketplace health insurance premiums.


#2

Lets hope and pray that Emily Kirchner and the other medical students' confirm that their actions are in sync with their words by voting for Jill Stein on November 8, the only POTUS candidate who shares their values.


#3

I love to see the enthusiasm of young people, medical students in this case.

HRC famously said that single payer will never happen. Here's a good goal for activism: just as the DNC forced HRC down our collective throats, we should force single payer down HRC's throat, by securing an overwhelming congressional majority that can override a hypothetical presidential veto.

Look up Brand New Congress and get busy.


#5

Its less about murkins working harder and more about murkins loading up on drug and insurnace company stock so they can pay for medical services and drugs with the dividends from those stocks.

Canadians need to also load up on drug and insurance company stocks, seeing how Canadian single payer medical insurance and negotiated drug prices will be history when corporate tribunals enabled by the revived CETA, TTIP and TTP sue Canada.

Canadians have a lot more to lose than murkins do when these regulatory capture schemes disguised as trade deals are passed.

luv from murka


#6

Single payer champion Dr. Margaret Flowers is running for US Senate as the candidate from the Green Party, and got forcibly dragged out of the televised debate yesterday. Reject the parties that refuse to debate candidates outside the duopoly.


#8

Pharmacies and insurance companies will feed themselves while they exist; we had might as well harbor large carnivores in a nursery.

Healthcare's not apt to come together in the States soon. We had a moment, but Obamacare more or less inoculated the system against any sort of socialism for a generation or so by providing a bogus socialism set up to fail. The effect is not apt to go away as the IRS begins to collect penalty fees and as insurance fees rise and service predictably falls to government-guaranteed payoffs and collection and clear-as-mud industry regulation as interpreted by industry lawyers.

As the rulers have left things, the array of other likely difficulties--faltering of the now-inflated stock market, progressive energy hikes leading into peak oil, increased poverty and displacement related to erosion and poisons and climate change, increase in crime and abuse with a steepening hierarchy and the disabling of electoral options--are likely to deflect energies from healthcare as the population slides down Maslowe's hierarchy and the sick and aged start to feel like a smaller sacrifice, relatively speaking.

I won't go so far as to call this a saving grace, but an interesting perspective is provided by the fact that Western medicine is not really all that good. In some cases, what we will be denied will be service sorely needed, but in many others, we will simply dodge a bullet without knowing that it existed.

My father's recent hospitalization and death provided a somewhat spooky example. He had paid for insurance over many decades, and the insurance companies did cover most of his hospital expenses. I would have to be an expert to know whether they did so as promised, and I am not; but they at least did well enough that the old man was not kicked to the curb like a pauper, and the resultant bills to the estate were modest. The hospital was not only well equipped but eerily well landscaped, with considerable decor and accoutrement for the care of various next-of-kin--that meant me, and not once did any of these fine people start to shoo my ragged tail from the building, a fact that I set down strictly to the influence of this accumulated insurance money.

The staff was quite competent, too. They X-rayed him, found a lung filled with fluid, poked a hole and inserted a tube to drain it, found that it would not drain, suspected and confirmed that he could not swallow for reasons that were probably neurological, stuffed another pipe up his nose and down his throat to feed him, scheduled and then canceled surgery to have another feeding pipe stuck into his belly, counseled his non-paying relative (me), brought him into hospice, jammed a catheter up his urethra to drain his bladder, and finally gave him an IV of morphine so that we could all wait in the fine environment with the advanced xeric landscaping while he took his time to die.

At each and every action, every single hospital staffer looked to the non-paying relative for the decision: that was me. I assume that is because my father was dying, and that left me as the Person Most Likely to Sue. After deciding to go to the hospital that he had previously said would kill him, he made not one decision regarding his life or death or well being that he did not have to pass through his son.

As nearly as I could tell, the morphine helped. As a subjective judgment, I would say that it helped quite a lot. And there are other stories, of course: cancer caught early, bypass surgeries, times when antibiotics and vaccines actually did work, diabetic medication, and so forth. We will miss a lot of that, and badly.

Most of the world's opium products today derive from product exported from Afghanistan by US military and paramilitary personnel working with and against local Afghanis under the Karzai regime. My father was US Army 1943-5 and defended them mayhem and monkeyshine all his life, but imagine asking in a private California hospital in 2016 that he should therefore get a cut of that.

The poppy itself grows quite readily and reseeds itself easily in many locations across California and across a pretty good band of the rest of the union. In many places it would need nothing so incriminating as irrigation.

As I was told a good while ago, "Summer's almost gone."


#9

A Hippocratic Hallowe'en


#10

Without a doubt, there are healthcare providers who are dedicated to providing the best medical care possible to their patient.

That being said, the level of care that is being provided isn't the issue at this point in time ... it's the cost of the care. There are three major components that dramatically affect the cost of healthcare (other than quality care) in the U.S.:

  1. Malpractice insurance for medical care providers is a huge expense for them. The legal tort system doesn't provide as many benefits to patient citizens as it does to the legal profession in filling their financial coffers.

  2. The "red tape" generated to process insurance claims and meet the requirements of the insurance companies is absolutely ludicrous. Standardization has been attempted for years with only marginal success. Even a small practice requires the medical provider to have at least one full-time insurance processor.

  3. Let's be honest, while the vast majority of medical providers are caring and competent professionals, they aren't business people. Medicine is their specialty ... not business. As a result, there is inefficiency in their operations that adds cost to the medical services they provide. (I realize their are some exceptionally well-run offices, clinics, etc.)

Simplicity and efficiency drives down costs. Unfortunately, the current system is filled with complexity and inefficiency that keeps adding costs to the medical care provided. As is apparent, "planned complexity and inefficiency" produces profits to those outside forces (insurance and legal) who shouldn't have a presence in our healthcare system to begin with.


#11

Making money off of misery and sickness is a miserable sickness.


#12

You reference a comment out of context from early in the primary race and get up on your high horse. There's no reason to believe universal health care needs to be "forced down HRC's throat," though certainly, even without the need to override a presidential veto the cause will need a different Congressional orientation. Why not just take it from the positive? And why not provide a link to BNC and the information that they're focused on the 2018 midterms? Why not talk about relevant Congressional races this year?


#14

What state is this? And what were the terms (which she certainly knew) to participate in the debate? She certainly got herself some attention, though I doubt it won any hearts and votes, or attention for the cause at issue here.


#15

It's called next of kin. My impoverished brother, who had let even his Medicaid lapse, recently died at home, had his body revived by EMTs and treated in intensive care for several days in a public hospital in Virginia. The decisions were left up to his wife, who has vascular dementia and is only half with it at best. If I'd had any say, I would have called the coroner instead of EMTs, but there you go. I'm not as cynical as you are.

And I don't believe the native California poppy makes opium. I'd think Californians would have made something of that long ago.


#16

Agreed. But it's more about price than cost.


#18

Excuse me, Mr. Rude, but did you notice that Kirchner is a member of Students for a National Health Program? I'd guess she mostly agrees with you about what doctors have contributed to the rise of the cost of health care. But let's not try to paint the insurers as heroes. It's the profit motive that has ruined health care for all.


#19

Emily Kirchner, I'm with your main purpose and applaud the witness you'll be making, but you undermine your argument by starting with unsupported anecdotes. I did take a look at Children's Hospital of Philadelphia (CHOP), and found, among other things, a financial assistance program. I've been around enough hospitals to know (and I think you do too) that no one receiving inpatient services is going to be denied ordered medication for a $16.50 copay. This was indeed a fairly creative panhandler. I understand "marketplace health insurance premiums" to mean private insurance, and your problem (though the anecdote is hearsay) is with the PA Insurance Dept. I'm sure there must have been some reportage of that hearing. And note that your surgeon was certainly describing elective surgery, and you didn't say whether it might have been cosmetic or what.

Yes, let's have health care, not just profit-based insurance. But let's not make the argument through trickery and costumes either.


#20

When I ask for the cost or the price of a product or service I am inquiring about the amount of money I have to give to that person for the product or service I will purchase. Example: I ask a clerk in a store what a bottle of Coke costs. I am asking what the price of a bottle of Coke is as it relates to my potential purchase.

I am not inquiring about the cost of the product or service to the provider of the product or service as the margin of profit is not included in the cost of the product or service to the provider/seller. It's a given that any expense (whether originating externally or internally within the organization) is a determining factor in the cost of the product or service to the provider/seller.

As a result, the offering price of a product or service will reflect the expenses (costs) associated with a product or service to the provider/seller that a buyer must pay ... a cost to the buyer.

  • The expenses of a product or service (wholesale price of merchandise, supplies, overhead, payroll, insurance, etc) are the costs to a provider/seller.

  • The price of a product or service is the cost to a buyer.

After owning and operating a business in 32 years, you will just have to take my word that I understand costs and prices.

Why must you make communication so tedious when everyone else reading the post knows exactly what was meant without going through the all the mental gyrations that add nothing to the content or understanding of the post?


#21

I generally try to be subdued in my tone (go check my comments and you'll see), but when the topic deteriorates to HRC, I can't avoid some hysteria and deep sadness, hence the 'high horse' effect. Sorry if I offended you. Voting for HRC means either that you will have the enormous responsibility to agitate against the many wars she will initiate, starting with poor hapless Syria, or become criminally complicit with those nefarious activities. I sure hope you are not descending into that kind of moral abyss, given that we have an excellent choice as an option, that being Jill Stein of course. Worse thing that can happen if you vote for Jill Stein is that the buffoon wins, which would signify a dark period in US history, but at least it would not result in a nuclear confrontation with Russia (secondary the the no-flight zone craziness over Syria that HRC is promising to deliver).


#22

It is Maryland. If you click the tweet, there is a link to her longer statement, which includes:

"I was initially told that a decision would be made on September 16. At that time I met all of the criteria and would have been invited to participate because there had not been a poll that included me. When the organizers learned that a poll was going to be conducted, they pushed the decision date back to October 14 to see if our campaign would meet the arbitrary 15% threshold that was set by the Maryland League of Women Voters. Given the intentional lack of coverage of my campaign in the commercial media, and without the millions of dollars necessary to gain paid exposure, the 15% threshold is impossible to attain. Conducting polling before the public has been informed of their choices is putting the cart before the horse."


#23

Actually, the difference between costs and prices charged to the consumer (patient) is one of the elements of our health-care system that's least understood. Check the big increases by Pharma on particular products recently: How do they justify jacking the price when the cost has actually gone down as R&D is amortized over the extending life of the product? Or how about the recent revelation that Pharma spends more on marketing a product than they do on developing it? And very, very few understand that their insurance premiums (not even just health, or even doctors' malpractice insurance) are not used to pay benefits, but are stashed away, out of the economy, in "reserves" that generate interest income that is used to pay for everything an insurance company does. That assures an ever-growing principal and corporate valuation. The companies then adjust what they spend out of the interest income and where they spend it to assure their measurable profits, from which they also pay dividends to shareholders.

When you buy that bottle of Coke, you know that the bottler and the merchant are making profits from the price you pay. If a merchant builds in too high a margin, you can say, 'Nah, I'm not that thirsty.' You don't get the opportunity to make those decisions about your health care or your insurance. (A national lab that I used regularly, as chosen by my doctor, started asking me to write what amounted to a blank check, giving them a credit/debit card to which they could charge the copay, though they couldn't tell me until after they'd billed my insurance company what the copay would be. Would you give your regular Coke dealer a blank check they could charge whatever they and some 3rd party decided your Coke should "cost"?)


#24

Seems to me the vital charge here is

That should be proven before you start stamping your feet, and well before you try to muscle into an event whose parameters you knew. But now we're veering off topic.