Thursday, March 12, 2009

This is my rant

I am so tired of the American health care system. We spend an incredible fortune on it and get really bad medical care in return. All three members of my family have been sucked into the system for some annoying, but non-life-threatening, reason in the past year, and all three of us are being driven crazy by wishy-washy, drug-pushing doctors, or their underpaid, overworked, and therefore, incompetent office staffs.

We make appointments, we rearrange our lives to accommodate these commitments... and then the rescheduling begins. Yeah, sorry -- your insurance doesn't cover visits to that office -- we're going to have to reschedule you for our other office. Yeah, sorry -- we just found out the doctor's not going to be in that day -- we're going to have to reschedule your appointment again. You don't mind, do you?

We go to the appointments, which now cost $25 for 10 minutes with a specialist, and don't have time to tell the doctor any more than you'd share with a stranger sitting next to you on the bus before you hear her telling you that she's sending you to yet another specialist and then she runs out of the room. Wha? Wait! Are you not interested in any details?

You throw out your back -- oh, this one was a real kicker -- and call the doctor immediately -- and still have to wait 15 days before getting any medical attention. Why? Because, even though you explain to the appointment clerk that you've thrown your back out and can't get up off the floor without being in excruciating pain, she says the doctor doesn't have any openings until next week. And you can't get in to see anyone else without first going through this doctor. This is what they call "primary care." HA! Then once you do finally see this "primary care" physician, she says, "Oh, yes! You've hurt your back! You need to see a physical therapist!" But please don't let the fact that I look like a question mark give you any sense of urgency in pushing that referral through, doc! I can wait a few more days -- three or four, even! And then, when the referral is finally in hand, I'll only have to wait a few more days for the scheduled appointment. Sheesh.

And I'm grateful that no one in my family has any serious medical problems. I can't imagine how people struggle through this system when something has gone horribly wrong. I think I'd have to look into hopping a bus to Canada, or taking a boat to Cuba. Anything to get out of here.

Now, to be clear, I don't think these physicians are uncaring. I just think they have to keep up with so many patients in one day that they can't afford to spend any time thinking about any one person. And they can't afford to properly train their over-worked, probably underpaid, office staffers. All this because the insurance companies are running the show -- not the doctors -- and it's those suits who set the pace, the premiums and the prices.

And that, my friends, is a stupid way to run a health care system. And you know what? I hear conservatives shrieking over and over again that we shouldn't make any changes to this system -- or that the changes Obama wants to make are wrong (not that they have any ideas of their own for fixing this mess!). At this point, I would love to see our nation's health care system go socialized -- anything to get it out of the hands of the insurance companies and their profit margins! Single payer, universal -- let's do the whole deal. Because I'm tired of spending a fortune on crappy medical care and nobody's come up with a better idea. And it works pretty well in lots of other countries -- at least that's what the people living there say.

Plus, I don't think Zach Freakin' Wamp should be the only one getting the good stuff.

:::sigh::: OK. Thanks for reading. I'm done now. :::deep breath:::


Keera said...

Don't forget to breathe. ;-)

Contrast what you say with what I experienced today (as one of those people living in another country - thanks for the linkage!):

I've been feeling overwhelmed at work and took a sick day off yesterday to see if that would help. It didn't (bad sign: wanting to cry today because someone asked me a question). So around 9:30 AM I went down to my doc's office and asked if my doc could see me at all today. Oh, joy, he could, at 1 PM (he was on time, too!). They set up their day in such a way as to leave about an hour free for emergency consultations. For like when you throw your back out.

Anyway, left his office with a 100% sick-leave for what's left of this week, and 50% sick-leave for all of next week. If I had needed a referral, then I could risk experiencing the appointment-rescheduling dance and it might be weeks before I saw the specialist. But for primary, emergency matters? I see the doc immediately. And he answers to only one "insurance company": the government itself. Total cost for me today for my 10 minute visit? NOK 160 (it's actually co-pay; the government foots the rest of the bill). In spending power that's the equivalent of $16 (current exchange rate: $23). If I get more than NOK 1780 in medical visits for the year, the government starts paying me back. Howzat? :-)

Sandy on Signal said...

Zach shouldn't be getting any free stuff. Especially after how he votes against everything for the rest of mankind.

You had to wait three weeks in order to see your doc when you were in excruciating pain. My God. That is so wrong but common. We do need better care for medical help, Zach has it, so why not us?

The insurance companies are the first thing that needs to be removed from our healthcare. They are of no value and make the situation worse. Government is not the problem, insurance companies and middle men are the problem. We need a solution where those who need health care (pre-existing problems) are given health care. That is not too much to ask for, nor is it a privilege.

Thursday afternoon head cold link blogging at Tête-à-Tête-Tête said...

[...] Nice healthcare rant from my good friend Alice who I haven’t seen in a long, long time. [...]

alice said...

Keera, howzat is pretty cool. It makes me ache for a system that works here.

Sandy, thanks for the heads-up on the incoherent spewings of our embarrassing representative in DC. I can't believe this guy wants to be our governor. I just don't think our state can take that much abuse and neglect!

fletch said...

Just take a look at the monstrous palace, which I call Temple of the Gods, up on Cameron Hill if you want to see where the problem is, and they are non-profit! And like you said in a way, contribute nothing to society.

JoeSchmoe said...

If the American health care system is so bad why do folks who live in countries with socialized systems flock to the USA for medical care?

alice said...

I've seen no credible evidence that they do.

Sandy on Signal said...

Joe Schmuck, I just read some of your link. You have a big error in the first sentence, so why don't you re-do your stuff before posting it elsewhere for us to try and muck our way through it?

1st question for you, schmuck, is: why is medicare okay for you but not S-chip? Children never had a chance to earn a buck in this world, but seniors have, so why not put the onus of paying on them instead of children? Perhaps, you don't want to peeve the "socialist seniors" because they vote 100% of the time and kids don't have that right. Mighty nice of you to put the screws to our children. No doubt you are a Rethuglican.

Secondly, medical malpractice is a big farce too. This is not driving the costs up especially in your state of GA where there are caps on lawsuits. Your state protects doctors at the expense of patient care, here it is, in black and white for you:

Georgia—while ranked 4th in medical liability environment (meaning caps) is ranked 44th in the nation for access to care and only 37th in the nation for quality of care and patient safety.

What does this mean? It means to some that Tort Reform does not protect patients. What it may mean is that the lack of accountability afforded to the ER with caps and the gross negligence standard that exists in this state may actually harm the patients of Georgia.

here is the link because I don't think you can find it on your own, Mr. Joe Schmuck:

I could go on and on with you, Joe Schmuck, but I can't do this to my dear friend, Alice. This is a comment section and I would need a whole blog to deal with your insufferable ignorance.

Keera said...

Alice, I've heard that myth about the US, too. However, anyone from out-of-country getting medical care in the US is likely paying for it with a platinum card or has had the procedure donated (Reader's Digest has countless stories of third-world kids getting medical help in the States thanks to eager white people with connections). This has nothing to do with the lack of timely and affordable medical care the regular citizens of the US experience.

alice said...

I suspect that there are a lot more medical procedures that are only available abroad, than those that are only available in the States (though that might change during the Obama administration). And for anything that is not exclusive to his country, why would anyone come here and pay our prices, when medical care is cheaper pretty much everywhere else in the world? The only reason I can think of is the one you give: someone has offered to pay the bills.

Keera said...

Third world kids get help in all the industrial nations. And there are cases when I am so proud of Norway, for example, for donating time and expertise and a hospital bed to give someone a humane life (a new limb, proper burn treatment). But, again, that has nothing to do with what is offered to the people who actually live here.

About procedures not offered here, but are offered there: Thanks to the EU, it is now getting easier to go to another EU country for a medical procedure that is OK there, but not in one's home country. Some Norwegians have had back surgery done in Germany when Norwegian hospitals have refused. (This is a source of argument, mainly over who pays the bill, but it looks like the patients are winning that one.) But all the way to the US? The doc there had better be good AND the financing had better be in order. I'm sure that was the case for the girl who went to China, too.

It is odd that medical care is cheaper elsewhere, isn't it. And we're not even talking about who foots the bill (individual vs. insurance vs. government). Norway has some of the most expensive health care in Europe (we're trying to figure out why; for example, our system matches Sweden's), and yet the US's health care costs more per capita than does Norway's!

Keera said...

I found this "researching" my own blog post: An article explaining why the current US system doesn't work (in support of nationalized health care).

Keera said...

How about a link that works:

Beep said...

I was ranting to someone just yesterday about how frustrated I am about having had to stay in poverty during the entire length of what should have been my most productive years in order to qualify for government-paid health care, since our beloved health insurance companies are allowed to cherry-pick and exclude people with serious chronic illness. Why can't they arrange to share the burden instead among each of them? Or get out of the health business and stop blocking HR 676? They have been horrific stewards of our health care delivery. We do pay more than twice as much and yet let at least 18,000 die each year due to having no health insurance. This doesn't include all of the people, such as certain friends of mine, who died WITH insurance because the insurance was busy denying and delaying instead of treating.

We should have medical care other than emergency rooms available at least some evenings and weekends. Our Medicare program should be opened to all which would get Medicare out of the business of only insuring the elderly and the disabled, the most expensive population! And Medicare should be allowed to negotiate for better drug prices! The pharms should not be calling the shots the way they do and selling the drugs for which we paid for the development to other countries cheaper than they sell here...ok I'll stop because this is my main rant topic and you don't need to hear the whole lecture ;)

But we have been sold a Big Con. And anytime anyone tries to fix it, a bunch of dittoheads scream "socialism!" since that is what they have been programmed to do. And the industry puts lots of scary ads on tv. Like we don't already have health care rationing and waiting lists and all the other things we supposedly don't have that national health care systems have to put up with.

What we don't have is affordable care for everyone. If we did, I would be trying out a home-based business, and so would a lot of other people. Startups would be really good for this economy right now. And our already exisitant businesses might just find themselves more competitive in the global market. But noooooo...Rush Limbaugh would never let this happen!

alice said...

Amen! You say it, sister! ;-)

Beep said...


Unfortunately a passionate "private is ALWAYS better" ideology is restricting our nation's choices right now, all the way from solving the lending crisis to fixing health care.

If we spent what we currently do on health care in a single-payer system, we could afford to pay for much more oversight than other nations have done, because we spend more than twice as much as they do per capita! Private health insurance has had numerous problems. One is the loss of economies of scale, including duplication of paperwork and review procedures. One is the profit-first motive, which doesn't always deliver the appropriate health care to our citizens and instead chooses to pay for things like luxurious office buildings and executive perqs. One is the cherry-picking which ends up leaving those who are most ill stuck on the government's dime, leaving the government having to pay for expensive care without collecting the premiums from the healthier and younger population. This also is letting many of our citizens die before their time. We taxpayers deserve better than this.

Even Adam Smith, the author of the "invisible hand" quote so often used to justify "free" market capitalism as the best of all possible economic systems, warned against the power of large corporations skewing the market. We have large insurance companies as well as large pharmaceutical companies who are set up to look out for their shareholders (although those who invested in bad mortgages haven't been able to do even that) rather than the patient population. And by setting up our health care system this way, like our financial system with little regulation or oversight, we have let the needs of patients become more and more unmet over decades now.

Btw, Medicare's administrative costs are estimated at about 4%, private insurance about 35%. It's tough to get away from that difference no matter what you might try to do to compensate for it.

Unfortunately our largesse to our insurance companies at the expense of our citizens who need health care has enabled these companies to pay for very expensive lobbyists and media time whenever they feel the American people might suddenly desire to have all of their citizens covered, and covered well, for the greatest-cost-in-the-WORLD per capita they are paying for health care.

It is also unfortunate that in recent years the division of our country into "liberal" and "conservative" camps has made it easy to whip up passion with a few short tv ads...and since Americans are working more hours than workers in any other country are, except if they have joined the growing ranks of the unemployed, they don't have time to do their own analyses. Many are voting against their own self-interest. We also don't have the choice of candidates with many different points of view. The fact is that most of us have both "liberal" and "conservative" leanings; we are human beings with many different needs, not cardboard cartoons caricatures.

Oh and attacks against me may be conveniently made at :


Beep said...

Oh and PS...I totally relate to your experience with having to wait for acute care...I learned from a blood test result on Dec 24 that I had diabetes...took me a month to see a doc to begin treatment for it. In the meantime, I had blurred vision, fainting spells, the works. Why did it take a month? Not enough docs treating it. We are starting to get doctor shortages. Having formerly done insurance billing in a doctor's office, I know why. They are being beaten to death by the insurance companies and by Medicare having to always bow to the pressure of conservatives who want to lower, lower, lower doctor reimbursement rates. Instead of letting Medicare cover some of the less expensive population or the insurance companies trimming their executive compensation. Docs have to hire extra people to fight with the insurance companies both to get treatment for their patients approved (drugs, procedures) and also to get paid by the companies. Some claims require resubmission five times! It pays the insurance companies to delay payment as long as possible, and since so many patients really don't have much of a choice for their insurance provider there are no consequences to doing this. In the meantime the docs who are not the highest-paid specialists are going under from the increasing costs of med school and loans for school and these blood-sucking insurance practices. They aren't making ends meet and are getting out.

But believe it or not, a conservative friend of mine told me we are losing doctors "because they are afraid of nationalized health care." Everything gets twisted to fit an ideology which has bankrupted the country and yet is still going, like an Energizer bunny on crack.

A Free Man said...

The American health care system is f*%ked. I have first hand experience with the American, British and Australian systems. One of the reasons that I plan to be a permanent expat is that I can't imagine being at the mercy of health insurance companies for life and death issues. I can't imagine going bankrupt to pay for what is, by our own Declaration of Independence, a fundamental right - life.

I hope y'all (we) get it fixed, but to be honest I think that the system won't allow it.

alice said...

If things get bad enough, the system won't have a choice. I just hate that we're going to sit around and wait for it to get however bad that is first.

Gah. I wish *I* could get the hell out of here...