27 September 2009

Wherein I Say Some Things About Health Care

As Jane at Seagull Fountain knows, I've been meaning to write a post on health insurance for a long time. It's not a secret that I despise politics. But I see something brewing that gives me so much hope. Every news source that I actually look at has brought up the subject constantly in the last few years. And though we like to cling to our ways and say that things are working how they are, it seems like a lot of America has finally gotten to the breaking point, to the point where people are realizing that America's health insurance system can't go on like this. For those who don't want to change a thing, I invite you to open your mind for a little while. It's hard to see how good things can be until we try them.

Let's start by taking a look at this map:


(Image found at www.nocaptionneeded.com.)

The orange is Iraq and Afghanistan's universal health coverage provided by the U.S.'s war funding.
Gray indicates countries with no universal health care system.
Blue shows countries with some type of universal health care system.
Green is the countries attempting to implement some kind of universal health care system.

This map seems unbelievably tragic to me. The U.S. is grouped with countries largely considered to be underdeveloped. If you are a modern, powerful (despite the negative sound to this word, let's face the facts), example-setting country, you don't go around with uninsured citizens. Even if you do not fund health care through the government, you make way for your citizens to be healthy. I think this reason to have insurance (as a matter of pride) is probably the weakest reason, which is why I had to get it out of the way. Now on to the real stuff.

The following things sadden me more than any map where countries try to impress each other. American nurses have told me that patients needing emergency care aren't getting it because the emergency rooms are full of the uninsured who go there in order to get some kind of care. That's sad for both sides.

Also, my own parents have spent hundreds of hours, often yearly, filling out paperwork to apply to change insurance companies because of increased costs that they can't afford. There were days of panic when I had appendix and Crohn's Disease problems as a twelve-year-old. My parents have also been denied coverage because of pre-existing conditions--conditions they couldn't take care of because of the money they'd have to pay out-of-pocket. These are problems that really get to me. Why should you be paying for a service that doesn't serve you? Doesn't everyone deserve to be healthy and happy? Doesn't everyone deserve coverage they can afford?

My whole life, I've heard about socialized medicine and its evils--how the doctors have no motivation to be the best, how expensive it is, how it limits insurance companies' competition, etc., etc. But then I moved to Germany and I've found the story to be different than I imagined.

In order to get my student visa, I had to be signed up for health insurance. I walked into DAK, and ten minutes later, I walked out with a piece of paper saying I was covered. No one asked me if I'd had Crohn's Disease when I was 12. No one asked me if heart disease ran in my family. No one even looked to see if I walked like I was healthy. I went in, signed a paper with my bank account info on it (for automatic monthly payments), and left knowing if some crazy health issue were to come along, I'd be taken care of.

It took me a while to understand the ins and outs of the system--how I have to pay 10 Euros each quarter of the year that I want to visit a doctor, how doctors have hours when you can just show up and see them, how I must have a transfer form from the last doctor I went to. But guess what happened? I did have a crazy health issue. In the form of a ridiculous toenail that wouldn't let me sleep or walk normally. But I was covered and could go to any doctor I wanted (meaning I went to the doctor suggested to me). When I wanted to go to the U.S. in the middle of this problem, I only had to pay an extra 8 Euros to have travel insurance, and I was able to visit a doctor while I was in the U.S., who gave me an enormous amount of relief and told me how to deal with the problem probably for the rest of my life.

And then came a whole plethora of crazy health issues. First the never-ending throat pain. Then the sledding accident that did a number on my knee. Then back pain that crippled me. And my chronic neck and shoulder pain reappeared. And I had two cases of carpal tunnel. And hayfever. And skin problems. I needed nose surgery. And my tonsils out.

Having grown up where insurance was something you had but that couldn't really help you anyway, I tried to survive through everything, but I learned that wasn't the brave thing to do, that was the stupid thing to do. And then I started being informed about all the options available to me through my insurance. I started physical therapy and voice therapy. I received a wrist brace. I learned about prevention classes for motion and relaxation and back health. And though I'm still fighting through these issues, there is hope. Instead of feeling discouraged because I don't know how to help myself, I am lifted to know that there are people who can teach me how to live a healthier and pain-free lifestyle, and my insurance, which I'm paying for, will guide me to those people and cover most of the cost of their services.

The contrasts between what I grew up with and see my parents dealing with and my experience in Germany has allowed me to do a lot of thinking about the health care issue. A lot of people automatically criticize Obama's plan without even listening to what he's saying. It seems to me that people are very biased when it comes to presidents. They either hate or worship every little move of the president for four years, when in reality, there have to be some things that you like and some that you don't. Regardless if you like Obama or not, please be open-minded. And besides, some of what he is suggesting is coming from candidates you supported. These changes could be fabulous for you and for my peace of mind. I found this video very informative. It outlines the basics of Obama's health care plan in four minutes; I would suggest it to everyone.

In short, here's the plan:

  • If you have insurance you like, you are welcome to keep it!
  • There will be no denial because of pre-existing conditions (tears of relief)!
  • There will be no dropped/lowered coverage when you're sick and need it the most.
  • There will be no yearly/lifetime caps on coverage.
  • There will be caps on how much you will be expected to pay out-of-pocket.
  • There will be required coverage for preventive care. (Instead of waiting for you to become miserably sick, let's help you stay healthy! What an idea!)
  • There will be competitive prices in an insurance marketplace.
  • There will be low-cost coverage for individuals and small businesses.
  • For individuals or small businesses who can't afford even the most inexpensive health insurance, there will be tax credits.
  • No one will be forced to take the public health insurance option--there will also be a private option.
  • No dime will be added to the national deficit; it will be paid upfront.
  • Medical experts will work together to identify waste.
  • Waste will be eliminated.
  • The prescription medicine "Drug Hole" will die a horrible death. (Okay, so I added that last dramatic part. The original phrase was "be eliminated.")
  • Medical malpractice doohickeys will be reformed.
And though I'm not sure how everything will work, I trust that because of the benefits being aimed for and because other countries have accomplished these things, it will work. I suppose most people's argument with me would be that putting the plan in action won't work as smoothly as is thought. But was a big change ever easy?

One person I talked to said that it's not fair to tell health insurance companies who to cover, because that's telling them how to run their business. Letting something so trivial get in the way of people being able to be healthy and more able to enjoy their lives seems wrong to me. He said that he didn't want to pay more so that other people could be covered, but that's what's happening now. People with insurance are paying more and more because they have to cover those who show up at emergency rooms. I asked him, if people were to suddenly be diagnosed with a horrible disease and unable to pay for medical bills, if they should be left to suffer and even die without help. He hemmed and hawed, but in end effect (something my friend Bryan loves to say), he said yes. Then I made it personal and asked if I were the one in that situation, what would he do? More hemming and hawing. Where is the charity?

The concern about competition for insurance companies is ungrounded. With the option of private insurance, insurance companies can still lure richer people to wait in special waiting rooms, have their own hospital rooms, have their own hours, etc. And I don't really care about this difference as long as I'm covered.

I want to know, that if I were to be suddenly sick and unable to pay for care, that there would be hope for me. I want to know that someone would be able and willing to help me. Being on the other side of the world, I worry about my parents. I worry about my siblings and cousins and aunts and uncles and friends. And though the German system isn't perfect, it's comforting. I want to know that the same hope would be available to my loved ones. Being suddenly sick is stressful enough without having to worry about how to pay for care.

Some more items I'd like to add:

Yes, things may be more bureaucratic. But I think a bit of paper-pushing is much better than the fear that the day may come where I'm desperately ill and unable to find relief because of money.

Doctors aren't less motivated. They still get more money if they have a good reputation, because more patients go to them.

Of course, we all know that even when things improve, we still find things to complain about. Please just weigh all the benefits of such a change--America will measure up to the times, you won't be denied care or expected to pay amounts you can't afford, every suffering father, mother, and child in the country will be covered, and you won't have to fear going without care if you were to suddenly become sick.

And now the statement that frees me from attacks and never-ending arguments in my comments: I'm not here to debate; I'm just giving light to my personal observations. Please don't take your frustrations out on me.


  1. Don't take frustrations out on you? :)

    Of course not. I'm not the best person to comment on the system as I've never been denied, being healthy and young. I can't imagine being in that situation and how scary it would be.

  2. Being sick or injured without coverage is scary. You go from being a hard-working productive member of society to wondering if this is going to be your ruin and you'll be living in a cardboard box the rest of your life.

    This is where I'm at. I've been worried about what's going to happen to me if universal doesn't go through because I was cut from my position due to the budget and while I had insurance through that job, I had a bunch of conditions that need long-term care diagnosed. These are now pre-existing conditions...

    Everyone should have the opportunity to be happy and healthy and be taken care of.

  3. Well-argued!

    The US health care system needs fixing, there is no doubt. But do we want someone (the government)running it who can't keep a business (the country)in the black? Inefficiency is the illness of every government agency.

  4. Thanks for sharing, Michelle. It's refreshing to be reminded that real people's lives are at stake, and not some "other" group of "lazy poor people."

  5. I agree that SOMETHING needs to be done. I have two brothers in med. school and another one in a Masters of Health Administration/MBA program... so we talk about this a lot.

    One documentary that I thought was particularly informative -and very interesting!- was the one at this link: http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/

    If you ever get the chance (and want to), you could check it out.

  6. Glad you posted even though you fear ridicule. I recommend an article in the September Atlantic called "How American Health Care Killed My Father." I like it because the author identifies the true issues and thinks way outside our current system.

  7. great post michelle.

    it's honest and thoughtful.

    be well.


  8. Michelle,
    I really want to leave a post for you, but I am such a dork, I wrote a thesis-comment and it won't let me post. So, I'll just go ahead and make a new post on my blog if you'd like to read.