Welcome to the Death Panel, You're Already Paying for It

I got a phone call from my oldest friend yesterday. We've been friends since nursery school, stayed best friends in grade school, high school, college and beyond. We were the kind of friends that had hundreds of "in jokes" and we passed notes and talked on the phone more than we should have, and drove our parents crazy. We survived Mrs. Nemchek's geometry class together. We liked the same music. Neither of us were the "popular" girls, but we didn't want to be. We marched to our own drummer. We had each other, and we made each other laugh and we were always there for each other without reservation. We got a kick out of the fact that people would routinely ask us if we were sisters, when we looked absolutely nothing alike.

So, it wasn't unusual to get a call from her. There are times when we talk every other day. Sometimes we seem to go for weeks without a call, but we're always there in spirit.

"I need to tell you something," she said. I wasn't sure whether this was going to be good or bad, but "I need to tell you something" is always important. "I went to the doctor, and there's something wrong with my heart."

I wasn't expecting that one.

My friend has had a series of health problems -- a bad car accident resulting in two painful spinal surgeries, asthma, a breast cancer scare, but this was different. Her matter-of-fact tone quickly dissolved into tears of fear and vulnerability. "I can't believe this. I'm only 43!" This wasn't supposed to happen.

After her breast cancer scare, the doctor recommended a preventative regimen of tamoxifen, a drug which would help ward off the risk of cancer that her condition indicated might be a problem. But before they started her on the potent drug, they wanted to make sure she had a good healthy heart. A family history of heart disease put her in a high risk group, so the cardiologist insisted on a stress test.

She's been living through multiple problems with her insurance provider so she wasn't surprised when they refused to pay for the test. She was surprised when the doctor decided to call the insurance company himself. He explained why it was important, and that he felt very strongly and in no uncertain terms that it needed to be done. They still refused to pay for the test. And then the cardiologist did an amazing thing. Outraged at the insurance company, he said that he would pay for the test himself, out of his own pocket. It was important, too important to cow to the insurance company representative whose job it was to deny claims just to increase the profits for the company.

My friend wasn't even able to complete the stress test. After a few minutes on the treadmill, they stopped it and wouldn't allow her to continue. Shortness of breath. Chest pain. She'd been experiencing these symptoms lately. She was mowing the lawn this week, and had to stop half way through because she couldn't catch her breath. She chalked it off to asthma. But it was, in fact, a coronary blockage that was keeping one of the chambers of her heart from getting enough oxygen.

So, instead of starting a regimen of tamoxifen next week, she will be getting a stent in her heart tomorrow. She's home right now, trying to "do nothing," and trying not to get too stressed out by the thought that she'll be in surgery in just a few hours, and never even knew anything was wrong.

If her insurance company had gotten its way, she would never have had that test. The next time she was out mowing the lawn, it could have killed her. "He saved my life," she said, just as I was thinking the same thing. Yes, doctors are in the business of saving lives from disease, and illness and injury, but they shouldn't have to be in the business of saving lives from business. "He saved my life from the insurance company, she continued. "The insurance company... there's your Death Panel."

I didn't even ask her his name, but I'm grateful to that cardiologist in the kind of way it's difficult to express in words. He saved a wonderful, beautiful life. But how many people are not so lucky? A recent study found out that 45,000 people every year die because they are uninsured. And each one of those 45,000 has a story, too. They are someone's husband, or wife, or parent, or best friend since nursery school.

But my friend has health insurance. She pays $600 every month for it, and yet her coverage denied a test that saved her life. How many fully-insured Americans die every year because we allow the insurance industry to be a for-profit enterprise, making money off of people's lives? How many die because our current system says that the money made for salaries and bonuses for insurance company executives is more important than they are? More important than your mother. More important than your son. More important than my friend. How long will we accept the harsh reality that the insurance company looks at human beings and sees nothing but a spreadsheet?

"We need a revolution in the health care industry," my friend agreed. "We should not allow them to profit from our own illness."

Until then, if you have insurance, get in line. Because whatever you are paying them, it's only a matter of time before your number is up, and it's you or someone you love that gets to stand in front of the Death Panel and plead your case. And guess what? They'd much rather pay politicians than pay to save your life.

It's cheaper.

Follow AKMuckraker on Twitter: www.twitter.com/Mudflats

Comments

[MaggieH2]

It amazes me how smart people wish to destroy what works, for an illusion. In America we have the most advanced health system in the World.
We have been suckered into believing a sociological utopia. “Quality healthcare for all”, which is equivalent to “Maximum Social Security for all” or “Lowest Credit card Interest for All”. Why not “First Class seating for all”.
We have grown to believe that every time there is a problem, someone else has to be blamed. The average annual insurance premium is now close to $100,000 for obstetricians and neurosurgeons”. What this means is that you have to pay a premium to protect your doctor.
We have grown used to the jibes of “Big Oil” and “Big Pharma”, which is easier to accept than searching for the truth. Why don’t we say “Big Air” or “Big Store” - Walmart comes to mind.
If you really want to get close to your Utopian idea of “Quality Healthcare for All” why don’t you get “Big Government” to deregulate the Health Industry - allow Insurers to cross State borders and introduce Tort Reform. Just those features would reduce the cost of healthcare by nearly 40%. With such savings “Big Government” could even mandate pre-conditions and expand Medicaid to include “Basic Healthcare” for those 5 million uninsured that actually want it.
Maybe we should ignore common sense and forge ahead to have a healthcare system as advanced and efficient as “Big Post Office” or “Big Amtrack”.

[wildedge]

Part of the tragedy of the Republican/media collusion to bury healthcare reform has been that the intereference with healthcare that the right charges may be in the reform bills - and they're not - are all already in operation in private sector insurance companies.

[joanmhe]

It's ridiculous that the insurance company would not pay for a stress test in those circumstances, but it's not a recommended test for women who do not have symptoms - she actually did but her doctor did not probe for those in order to get her test. (again ridiculous to have to game"the system).
I had some mild chest pain, was sent to the ER, then sent for a stress test. The stress test had an irregularity, so I had to get a nuclear stress test. Turns out that women have a high rate of false positive on the stress test, and also false negative. The nuclear stress test showed the same irregularity, but could show that there was actually nothing the matter with me. So you can see why the insurance company want sto avoid unnecessary tests, but they are not good at figuring this out. In a culture where doctors order tests whenever a patient demands them or defensively - there are a lot of unnecessary tests going on.
The chest pain turned out to be a spasm caused by stress - but no md wants to risk not sending a woman to the ER for atypical chest pain.

[homas]

Why doesn't MADD (15,000 car/alcohol death/year) change to MANI (Mothers Against No Insurance) and triple their impact (45,000 deaths/year from no insurance)?

[Imago]

Great point!!

[1smartcanerican]

It is insane that a county such as ours allows for-profit organizations to make decisions on who is eligible for treatment. If you are turned down for a procedure that could save your life, that org has effectively signed your death warrant - ie: the death panels in action.

How people who fail to see that we need health care for all that is run by the medical community, not for-profit organizations, can sleep at night is beyond me.

Health care should be a given for all citizens of the US, along with legal immigrants who are paying taxes and contributing to society equally with citizens.

Let's do what is right and pass public option at the very least or a single payer plan that truly will change the health care picture. And let's make it effective NOW, not four years from now.

[hoobit]

Just received two accountings from socialized medicine (Tri-Care/Champus) for lab work done at a local hospital.

For the first, the hospital charged $61.9. (The price non/under-insured are charged...would HAVE to pay out-of-pocket.)

Through the socialized medicine plan, the allowable charge is $5.24 for this lab work. The socialized medicine plan paid the hospital $3.93; the remainder, $1.31, is still due the hospital. (The hospital "adjusted"­/wrote-off $56.67.)

For the second billing, the hospital charged $584.04 for (more extensive) lab work. (The price non/under-insured would HAVE to pay out-of-pocket.)

Through the socialized medicine plan, *this* bill comes to a total of $92.16. The socialized medicine plan paid $69.12; the remainder, $23.04 is still due the hospital. (The hospital "adjusted"­/wrote-off $491.88.)

Because of "socialized medicine," $645.95 worth of charges (from the hospital) were 'adjusted' to $97.40. Of that amount, the socialized medicine plan paid $73.05. Out-of-pocket comes to $24.35.

Yearly deductible is $150.00. Yearly Catastropic Cap is $3,000.00. I can live with that.

Why can't ALL citizens have the SAME "socialized" medical care plan?

Why, other than for the benefit of for-[mega]-profit insurance companies and big pharma, are we even *having* this ridiculous 'debate'?

Single payer for ALL.

NOW!

How simple is that?

[Freedom of Logic]

"The insurance company... there's your Death Panel."

Well...Duh. You deny some one the money to fund the care they need, you will eventually lead to their death. So what good is insurance if they are never going to be there when I need it most? So where does all the money I sink into the never ending hole go to? Certainly not in my best interest.

[SelenicMagick]

I find it absolutely horrifying that the 45,000 who allegedly die due to lack of insurance (something which can NOT be proven other than as something that MAY HAVE CONTRIBUTED to their deaths) but NOTHING is said about the 106,000 who are equally dead because of the side effects of the medications that they take.

WHY is it "more tragic" that 45,000 "die from lack of insurance" than that 106,000 die from medication?

What EVERY person who is screeching like a fishwife about those 45,000 deaths is saying is that THOSE deaths are MORE IMPORTANT than those who are murdered by medication are. You should ALL be ashamed of yourselves.

[SelenicMagick]

ARGH... that SHOULD read:

"I find it absolutely horrifying that the 45,000 who allegedly die due to lack of insurance (something which can NOT be proven other than as something that MAY HAVE CONTRIBUTED to their deaths) are "tragically dead" and being screamed about but NOTHING is said about the 106,000 who are equally dead because of the side effects of the medications that they take."

[mdlw]

Thanks, AKM, for sharing your friend's story here.

Those opposed to a single payer health care plan scream that the government will interfere with the doctor/patient relationship. Yet, the insurance companies have been doing it for years.

[billhodges]

The Washington Post published a story in November 2008 pointing out the hypocracy of Obama appointed registered lobbyists to administration positions, after pledging he wouldn't.

Transition spokesman Dan Pfeiffer told the Post Gaspard would "recuse [himself] from the fields of policy or agencies [he] lobbied in the previous 12 months."

It is laughable to suggest the Office of Political Affairs in the White House would be AWOL in attempting to foist a $1.5 trillion health care plan on the American people.

Liberal author and commentator Bill Press has identified 10 Democrats in the Senate that "are reluctant to embrace the public plan option" pushed by SEIU, ACORN, and others.

He cites an article from The Hill, in which the Healthcare for America Now coalition is spending upwards of $23 million on TV ads targeting senators on the Finance Committee.

And just when you thought there would be ‘equality?’ Bloomberg.com reports SEIU and the AFL-CIO want union-negotiated health benefits exempt from the reform.

So not only is any sort of healthcare reform a giveaway to Obama’s liberal allies, but it’s an opportunity for organized labor to seek key exemptions that will hammer everyone else.

[CalBearinIllinois]

Sad as it is, this is the natural state of affairs wherever cost-shifting is the primary focus of medical care. Even a public option won't change the problem that insurance providers, by nature, are cost/risk averse. I'm not an advocate for socialized medicine, but if we truly care about healthcare then we need to find a way to make the decision less about whether the test in question is costly relative to likelihood of detection (current model) to how much more likely the test is to determine what course of treatment is warranted relative to other indicators. That's a big part of the movement for medical best practice panels, to ensure that all doctors (and the paying party) are doing what is best for the patient and therefore avoiding unnecessary expense.

[JillBond]

AK, I am wishing the best for you and your friend! My doctors usually try to work with me on things like tests and medications because my insurance doesn't pay for a lot of things either. It is great that the doctors go out of their way to help us get through the criminal health insurance programs, but they shouldn't have to. We all need to make those phone calls and make appts to see our representatives. The more noise we make the more likely we are to be heard.

Again, wishing a sucessful outcome for your dear friend!

[Dianethegardener]

My neurosurgeon paid for me to go to a neurosurgeon in Washington DC and a pain clinic there for a second opinion. He knew the MD there and knew he would get a good opinion. He wanted another opinion for doing surgery.
My insurance would not pay for it. Since one appt. was on a Fri and one on a Monday, he paid for our motel room for the weekend. I had been out of work and had no pay. My son had just started college and we had 2 others at home. He knew that we would not be able to pay for any of it.I have never heard of such generosity.
I don't have many problems with my insurance co., but that trip saved me from another back surgery.

It has been recommended that I have a spinal cord stimulator implant. The insurance Co will not pay for it unless it works for me, but I don't know if it will work unless I have it implanted. The hospital demands $20,000.00 in cash in case the insurance Co. will not pay.

[ericmiami]

My story is similar enough I won't post the details. My emergency room doctor told me the insurance company (UHC) would rather see me dead.

[onegandolf1]

As I noted here on HuffPo several months ago when the "Death Panel" hoopla began, all insurance companies employ "Death Panels".

Be it a Health Insurance Company, An Auto Insurance Company, Homeowners, Life or whatever; they all employ a "Death Panel".

They don't call it that, obviously, they call these folks Actuaries.

They access risk (the chance of a given policy to cause the company to experience "adverse risk", otherwise known as a loss.

[SCmommy]

These people must be stellar human beings.


(Isn't that what Ben Stiller's character was in Along Came Polly?)

[alumcreek]

I am smiling broadly at the last few statements in the article.

It has been my contention for the past few decades that purchasing legislation via legal donations to campaign funds is a crying shame. America will slowly slide into 3rd world status if this is allowed to continue. It is essential that we stop letting the rich and powerful buy legislation that benefits them and harms the citizenry as a whole.

We will profit by having publicly financed elections rather forcing legislators to spedn a 3rd of each day begging for money. Lobbyists write legislation and give it to an elected Representative who then passes it off as his own work, most probably without having read it or even understood the implications of it.

Americans must protect themselves from those who see nothing wrong with harming the nation and the world just so long as they can keep making a few millions each year.