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FEEDING EACH OTHER
01/04/2010
Health care reform will remain in the news over the next few months as Congress decides if they will pass a meaningful bill. Progressive Democrats will most likely be disappointed that the bill does not contain real reform, the kind that would guarantee health care to all. Conservative Republicans, on the other hand, are doing all they can to scare citizens into believing the bill has an assortment of horrid provisions that will kill Grandma, take away choice of doctor, and give the government control over your health. Of course, the current bills in the House and Senate do none of those things. Nevertheless, fearmongers will continue to make false statements about the Democrats’ attempt to bring about at least some needed reforms.
One new talking point was provided recently by Rush Limbaugh, after having been treated for a chest pain emergency while vacationing in Hawaii. When he emerged from the hospital, having been told he had not had a heart attack, he declared health care alive and well, and in no need of reform. Because he had been treated well, he opined, Congress could just leave health care the way it is. Wow! That’s amazing logic. I could apply that logic to many things. Because I have a car, there is no need for public transportation anywhere in the nation. Or because I have a house, everyone else has adequate shelter. Or because I received a good education, all of our schools must be just fine.
Let’s be clear. Rush Limbaugh makes hundreds of millions of dollars each year. He can afford a Cadillac policy, so of course he will get good care. First of all, I imagine he has an expensive PPO rather than a less expensive HMO, that would put limitations on what doctors he could see and what hospitals he could use. He isn’t like the rest of us. He can afford the best. It doesn’t matter to him that most health care premiums went up 30 to 35% this year. It’s not going to deprive him of anything.
Let’s compare that with my situation. My husband and I are insured through his company. Last year, we paid a little extra to have a combination HMO-PPO. We did this so that if either one of us had a catastrophic disease, such as cancer, that required special care, we could go wherever we wanted and wouldn’t be stuck here in a medical no-man’s land where there are no decent services for such diseases. Most of the time, however, for simple ailments and our annual physicals, we accessed care through the HMO, with any special services requiring approval by our primary care physician.
I needed surgery last year, and my doctor referred me to a surgeon who was in the network. I was not allowed to have the surgery where I wanted to have it. Instead, I was referred to a local, inferior hospital. I could have chosen to use the PPO portion of the insurance and gone to a better hospital, but 30% of the bill would have been my responsibility, after an initial deductible of $3000. Since the hospital bill alone was $45,000, I would have had expenses well over $13,000. So I took my chances and used the HMO, but I wasn’t comfortable with the limitations the insurance company put on me. When people tell me they are concerned about government workers making decisions about their health care, I laugh. Some employee of an insurance company already does that. And the reason has nothing to do with my well-being. It has to do with how much the cost of my care will cut into profits.
In December, during open enrollment, we learned our premiums went up 35%, and our co-pay per visit raised from $10 to $30. While we could tighten our belts and pay the extra for the more flexible PPO-HMO, we opted out this year, and went with the straight HMO. Now, if one of us needs specialized care, we will be out of luck. So while Rush Limbaugh’s health care is just dandy, ours isn’t. And we are among the lucky ones. At least we get some care.
My son’s situation highlights another problem with health care. He is currently unemployed, having quit his job to go back to school full time. He will survive on student loans and his savings, but currently he has no health insurance. He is looking into COBRA, which is available to those who lose or leave their jobs, but it may be prohibitively expensive. He might opt for a lower cost, high deductible policy while he is a student, but he will have to go through an application process, and if the company finds anything they deem a pre-existing condition (something as simple as allergies, for example), he will be turned down. If health reform passes, that discrimination will end, but if people like Rush Limbaugh have their way, it won’t, and millions of people who are self-employed or unemployed, and have less than perfect health, will be denied health insurance.
I had a conversation today with someone who is on Rush Limbaugh’s side of the debate. She began by saying “What scares me about ‘socialized medicine’ is that some bureaucrat in Washington will make decisions about my health care.” I corrected her misimpression by first telling her that the health care bills in Washington do not create “socialized medicine,” that they maintain our private, for-profit, employer-based system, and that in fact, they will probably not even contain a small public option for people who cannot afford private policies. I then told her that pencil pushers in the for-profit, corporate arena are already making decisions about her health care, as they are mine – telling us what doctors we can see and where we can have surgery. I informed her that Medicare, the government health insurance program for Seniors, is wildly popular, and doesn’t deny care to people the way private insurance does. In fact, six months after the deaths of both of my parents, I am still fighting over hospital bills, not because Medicare didn’t pay, but because the private supplemental policy is not paying.
In fact, everything that conservative Republicans fear about the imaginary “socialized medicine” they have conjured up is already happening in the private insurance industry: rationed care, denial of insurance, denial of care, decisions taken away from patients, increasing cost of premiums, increasing co-pays, etc. Furthermore, insurance companies do one thing all the time that Medicare never does: cancel your policy.
We really must ask ourselves what kind of a social contract we have in this country. Can we all agree that everyone who lives here ought to have access to health care, or are we going to continue acting on the belief that health care must be earned? Will the mantra be “No job, no money, no medicine,” or will we finally grow up and admit that if we really care about our fellow citizens, we will put people over profits, and finally demand that everyone have access to health care, however we decide to structure it?
I’m reminded of the story of a man who died and was escorted to the afterlife. The escort took the man to a banquet hall where all sorts of sumptuous dishes were laid out in the middle of a wide table. Each diner was allowed to eat as much as he or she wanted. A long fork was permanently attached to the left hand of each diner, and a long spoon to the right, so that they could reach the food. “Surely this must be Heaven,” the man told his escort. “Watch and see,” the escort replied. Soon, he saw that while the diners could scoop up the food, the long, unwieldy forks and spoons made it impossible to maneuver the food to their mouths. They were miserable, and the man realized this was Hell. The escort then took him to a second destination, one that looked remarkably like the first. The diners had long forks and spoons attached to their hands, and they, too could not reach their mouths with the implements. “You have fooled me,” the man said. “This is also Hell.” “Watch and see,” replied the escort. The man looked on in amazement as each diner scooped up the food and fed it to the diner directly across from him. “Now I see,” said the man. “This is Heaven.”
The basic flaw in Rush Limbaugh’s logic is that if he – a multimillionaire - is doing okay, then the system is doing okay. But he knows better that that. He just doesn’t care. Rush Limbaugh’s words reveal his ugliness as a person because they tell us what he really believes: as long as he is doing all right, then no one else matters. This also reflects the weakness in conservative ideology – that each person is responsible for himself, and that no one is required or obligated to help anyone else. “I’ve got mine, and that’s all that matters,” is what Limbaugh is saying, and he couldn’t be more wrong, or less humane. In almost every arena of life, but most especially the health care arena, the idea that we are a nation of rugged individuals, each capable of taking care of himself, is absurd considering how the corporate cards are stacked against us, especially in the health insurance industry, and how vulnerable each of us is to the vicissitudes of life.
It is time to determine that we are here, not just for ourselves, but also for each other. It is time for generosity and open-mindedness and compassion. It is time to be a society of human beings who care about each other. It is time to reform health care, so that we might honor those sacred words in the Declaration of Independence, that all men and women are endowed not just with the right to liberty, but with the right to life – a right that will only be theirs if they have access to the medicine they need when they are ill.
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