Why Hilda Needs Universal Health Care

A week doesn't go by in my district offices without some constituent, often several, calling in a panic about a personal health care crisis. These calls come not only from people who aren't insured, but increasingly from those who are -- or think they are. Most of the time, they are shocked and furious that, now that they actually need the coverage, their policies don't seem to apply.

I know my office is not unique among Congressional offices. Thus, one would think that a massive overhaul of our completely dysfunctional health care non-system would be a no-brainer. Maybe in an Obama administration it will be, but I doubt it. There will still be those defenders of the insurance industry, mostly Republicans, who think the system is just fine, with maybe a few tweaks. Even with a supportive President Obama, it won't be a cakewalk to take on the pharmaceutical companies, insurance companies, HMOs and all those who profit handsomely from sick Americans while contributing generously to political campaigns.

Hilda is an example of one of the common, everyday stories we hear. She lives in my district, is uninsured, and too young for Medicare. She grosses about $1,300 a month as a home care worker for an elderly woman. If you think about that, it's easy to get really mad. She works full time at an important and difficult job taking care of another human being, but can't afford the care she herself needs.

Hilda has severe pain in her stomach and also in her neck. A doctor told her she needed an ultrasound in both places in order to make a proper diagnosis. Because of her situation -- uninsured and low income -- she could only afford one. She picked her stomach. It hurt the most.

The doctor discovered a large fibroid tumor on her uterus and a cyst in her ovary. She was told that she needed a hysterectomy. This was financially out of her league. So, she continued to work while in severe pain, this time knowing why and what to do about it but unable to afford the surgery. Meanwhile, Hilda's neck was still killing her but in this case she didn't know what was causing the pain because she couldn't afford the ultrasound.

Because my office was able to get a local hospital to examine her and perform the surgery at a 100% discount through their charity care program, Hilda will have the operation this week. It's unclear how long she will be out of work, and, as if this whole ordeal weren't a big enough pain in the neck, she still has the pain in her neck.

My office has been trying to enroll Hilda in the Medicaid program, but today we heard from the Illinois Department of Human Services that she is not eligible for Medicaid or any other state program because she didn't prove that she is disabled. Who is her employer that can't offer any health coverage? The Illinois Department of Human Services.

This common to us story would sound strange in most first-world counties. Every other industrialized nation in the world considers health care a right and has figured out a system to make it available to all of its people, some more effectively than others, and all at considerably less cost. Japan for example spends half of what we spend and has much better outcomes. Compare the U.S. to the United Kingdom, Germany, Switzerland and Japan, and you'll find that people in those countries live longer, have lower infant mortality, and overall get more bang for their buck.

I myself favor a single-payer system, a kind of beefed up "Medicare for all" system as the best way to go. I like the Obama plan because it moves in that direction. Under his plan, consumers may choose to enroll in a public plan (like Medicare), or choose a private insurance plan that meets the high quality standards set by the government. I think the public plan in the end will prove itself to be by far the most efficient way to finance a health care system.

Until the United States joins the rest of the world in providing universal health care, families will continue to muddle their way through as best they can. Some people simply won't make it. The Urban Institute estimates that 22,000 people died in 2006 because they didn't have health insurance. Many other people will face bankruptcy, stick to a job they hate to keep the insurance, cut their pills in half, or pray their kids don't fall off their bikes. But I hope some of them - maybe you - will take the time to contact their member of Congress and demand an American health care program that guarantees everyone accessible, affordable, quality health care.

If you have a health care horror story to tell, I'd like to know about it.

Comments

[hagreen]

Below is the answer for all the nations health care ills...

http://www.pnhp.org/news/2008/february/what_government_does.php

[FreedomBeforeDemocracy]

Is there any progressive out there who thinks that maybe, just maybe, even a 1% chance that giving more control of our health care to the government is a bad thing? If so, could we try this grand solution at a state level first? Even Michael Moore admits that some of the socialized systems have flaws (that we can of course learn from and fix.) Can we learn at the state level? That way, if by some off chance the government gets it wrong (I know it's totally unlikely and yet to happen once), it will only be affecting a subset of the citizens. In fact, the citizens most affected will have more control (assumes citizens have a bigger say in state matters than federal).

We could even let different states try different things (I hear Massachusetts is giving insurance mandates a try). California could go to single payer, New Hampshire could be completely free market, and Colorado could let individual counties decide. The states could see how well the other systems performed and adjust their own accordingly. We could call it federalism.

[optech007]

Massachusetts passed a universal coverage law back in 2006. Already it is projected to cost the state almost twice as much by 2011 than what they originally projected it would.

[BlackWidowPilot]

And I'm confident that the GOP and its corporate masters in Massachusetts have been very diligent in their efforts to make sure the system fails as miserably as possible to prove their point that government never gets it right.

This also begs the question regarding just how the Mass. system is executed, how insurance companies and their partisans operate within this system, and how much influence their allies in the state government have over disrupting the system on an operational basis. All of these factors will affect costs.

Nice anecdotal oversimplification, but it still remains a rather large red herring.

Leland R. Erickson

Citizen

[chinohillster]

I lived in Connecticut for six years, mostly in Hartford, pretty much the captial of the insurance industry.

I worked for Travelers, CIGNA and MassMutual, and I knew people at The Hartford and Aetna.

Every insurance rate payer should take a trip to Connecticut and see: (a) the campuses (and I do mean 'campuses' - many of these places would put a college to shame! (b) the data centers (c) the executive suites of many of these insurance companies.

As long as profit is a part of the healthcare equation, we will have the kind of medical care that we have.

[wolfgangmo]

"Follow the money." - Phillip Marlow

[BlackWidowPilot]

It never ceases to amaze how so many that come to these blogs are so willing to defend so vociferously putting monetary profits for multi-billion dollar corporations over human life, and argue that the opposite - human life trumping monetary profit- is somehow morally repugnant and unacceptable.

Leland R. Erickson

Citizen

[rwe]

and what would are health care costs be without supporting illegal aliens ?

[wolfgangmo]

I would respond to what I think your post might mean but I am just not sure, sooooooooo­o....

... What?

[UnbiasView]

Everyone needs to watch I.O.U.S.A. and see how well medicare and social security is going to work in 20 years . . . the unfinded liabilities is going to make the 9 trillion dollar debt look small.

Then let me know if you think government runs a good system in any phase.

[wolfgangmo]

I could not agree more,

Let's cut the militaries budget by at least 90%. We'll still have the largest military in the world.

[wolfgangmo]

And I say let's cut the military budget first because when an intelligent person budgets they look at the big ticket items first.

Anything else is nickel and dimeing.

[mmogu77]

Rep. Schakowsky's blog seems to have drawn an unusually large number of comments for Huffpo from people claiming to oppose the government helping guarantee universal healthcare. I'm wondering whether AHIP, the insurance company lobby, isn't beginning to orchestrate a campaign. It will take a mass movement to help courageous Congress people like Rep. Schakowsky and Rep. Conyer's pass meaningful health care reform

[wolfgangmo]

On the other hand this could just be a byproduct of decades of underfunded public education.

[apexfork]

Or citizens who don't want the government taking over yet another aspect of their lives.

[mmogu77]

Rep Schakowsky: You’re one of the most courageous progressives in Congress. We need to get Obama elected. But then please don’t give up your support for single payer and Rep. Conyers’ HR 676 for a weak compromise with the insurance companies, just because that’s what Obama ran on. Backed by a mass movement, Congress can pass a stronger bill than Obama first asked for and he will sign it. An optional public plan cannot compete with the private insurance industry which will offer low-cost stripped down programs with high deductibles and co-pays that will siphon off the young and healthy. The optional public plan would become the private insurers’ dumping ground for older and less health people, thus making the public program increasingly unaffordable and busting the federal budget by raising the cost of federal subsidies. If you have a chance, please reread the talk I gave on the panel with Rep. Conyers which you attended at the Take Back America Conference at:
http://www.huffingtonpost.com/miles-mogulescu/why-not-single-payer-par_b_94239.html
Thanks again for your great work.

[Emmagoldmanbabe]

The only way to fix this situation is through single payer health care for everyone. I haven't heard Obama say that. He's still in the pocket of the industry..­...

[UnbiasView]

Government is never the only way to fix something, if you believe that try Russia or China . . . they are big on government being in every aspect of your life.

[mmogu77]

Also try France, England, Canada, Germany, Taiwan and virtually every other democratic capitalist country in which the government guarantees universal health care to all citizens at half the cost and with better health care results than under America' profit making private insurance system.

[Andman0121]

Your China and Russia example is far faaaaaaaar oversimplified. No one is saying we want the government to take over everything thus becoming a tyrranical state like your examples, we just want to be afforded with the dignity of healthcare. Simple as that. Just because we call for universal healthcare does in no way mean we want a communist, centrally planned economic state.

In the end you are right about one thing though, government is indeed never the only way to fix something. However, you must also agree that the point of even HAVING a government is to make sure its people arent getting the short end of the stick daily by these greedy businessmen and downright filthy HMOs.

[FreedomBeforeDemocracy]

Actually, over the last few decades, China has become freer and freer, while at the same time becoming richer and richer. Coincidence? No doubt they have a long way to go, but about 1.5 Billion people are starting to enjoy Capitalism after suffering so long under Communism (or Socialism, Collectivism, Progressivism. Whatever you want to call it.)

[Dunque]

Perhaps an important law to consider as we ponder new legislation is the law of unintended consequences. The impact of more "free care" is going to lead to the same type of lawsuit prevention medicine practiced now that results, for instance, in doctors prescribing MRI's and X-Rays for the same injury (I've experienced that one personally). As well as perpetuate the ongoing insurance fraud where the MRI provider (for instance) charges $1,400 for the MRI and accepts $800 but if one were paying cash will accept $450.

Is this the type of health care system we want? It's easy to take personal experience and extrapolate it to policy but it feels more like the 4 blind individuals who are certain they know what an elephant looks like depending on which part of the animal they felt. Can't we ask more of our government than ill-considered knee-jerk policy recommendations? Shouldn't we?

[wolfgangmo]

X does not follow A in the alphabet any more than "lawsuit prevention medicine" follows "free care."

You connect to unconnected items in your argument and then supply a worst case scenario to it. It is not logical and it is not true.

In fact there is less "lawsuit prevention medicine" practiced in countries with universal care largely because the main expense in US lawsuits is removed, that is the cost of ongoing medical care.

With this large factor removed from the equation, there are fewer lawsuits and much lower settlements. Don't believe me then check out the phone books for Vancouver, Canada [population 600,000] vs. Vancouver, WA [population 150,000] Despite the fact that the canadian city has 4 times the population the american city has 4 times the number of lawyers in their yellow pages. And comparing personal injury attorney's is even more lopsided.

There has to be a simple economic reason for this. Perhaps personal injury attorney's in America, under our current broken medical insurance system, have found a lucrative market in suing the insurance companies.

So perhaps you should consider the law of unintended consequences [which is a libertarian piece of wishful thinking and not a law at all - life and the law change to suit changing circumstances - your so called law assumes that nothing ever changes and that once a law is put into place that it never gets changed or modified] in your case. In other words, ya cain't fix stupid.

[harveyr2]

Neither socializing health care nor socializing health insurance is the solution to our current problem as we're already too socialized. What? How can that be? Quick, name the best doctor is in your local area. Next name the least expensive doctor. OK. That was too easy you say, so answer these questions for pharmacies and hospitals. If I asked you these questions for gas stations or supermarkets you'd respond immediately. Should be the same for the health care marketplace.

In reality you probably can't name the best or least expensive doctor, pharmacy, or hospital in your area. This matters because today's medical market is neither efficient nor transparent.

Finally, ask yourself why your doctor (hospital and pharmacy) has a retail price list and the insurance company negotiated price list (which they will not share with you until you make a claim). Why can't you buy medial insurance that's available in a different state?

Our medical industry is by far the best in the world. Unfortunately, the ability to gather relevant information such as price and quality is opaque at best. We need to make this market transparent and eliminate as much friction as possible. This will lower costs and improve outcomes.

Socializing health care is not the problem. We need to free the health care market from today's friction.

[bamilt0]

So what you're saying is, if I have a heart attack, I should consult my spreadsheet to do a cost/quality comparison to see where I should ask the ambulance to take me? No, that's none sense, obviously. As is the idea that, given any opportunity to profit off of human suffering, a semi- or complete free-market system will provide anything but the lowest quality for the absolute highest price possible. That's what's been happening; that's what will continue to happen.

Look, this is a human rights issue. Quality health care is a human, inalienable right. To be able to successfully pursue life, liberty and the happiness, we have to have our health. Our health should not be a commodity to be bought and sold. No. Period.

Now, that being said, throwing around the boogey man of health care "socialization" (scene opens on gray, perpetually overcast sky covered post-industrial wasteland where lines of dour, unhappy citizens slowly amble toward an imposing factory-like building with the word HOSPITAL painted in Soviet-style lettering) is a scare tactic that belies the truth of what we need: a single-payer universal health care option that provides the highest quality care on the planet, alongside a robust private medical service sector that offers care to those who opt for insurance. That's it.

[Dunque]

"Quality health care is a human, inalienable right."

I must have missed that day in school.

"To be able to successfully pursue life, liberty and the happiness, we have to have our health."

And what else? A car? Money? A job? Do those all now get legislated as well?

It's not being hard-hearted. It's thinking through the implications of mandating policy based on trying to right every hurt we see.

[optech007]

"Quality health care is a human, inalienable right."

When I was hired, my employer told me it was a benefit.

[BlackWidowPilot]

Nice little lasse faire fantasy, but until the hammerlock of the insurance industry racketeers around the throat of America's healthcare system is broken, we'll never even get to try out your little "libertarian" fantasy to see if it will actually work.

What we have is a *corporate* healthcare system, not a capitalist one. Either way you swing it, I agree with G.B. Shaw;

"Capitalism has no place in medicine."

Leland R. Erickson

Citizen

[UnbiasView]

So you expect drug companies to just magically invest and work towards cures because it is a nice thing to do?

Capitalism is the carrot that spurs innovation.

[georgiaR]

The problem is I have a niece who has a $100.00 a month cell phone bill and a nice car, but has no health insurance. She says she can't afford it. Oh I forgot to mention her $100.00 a month cable bill.

[RightWingMarine]

So your niece as a grown adult woman decided for herself what she should spend her own money on? And she chose not to have health insurance? This is further proof that we need Mommy government to come in and save us from ourselves. Clearly this woman doesn't know how to properly spend her own money and it needs to be taken away from her and spent on her behalf in a more progressive manner.

[BlackWidowPilot]

I happen to be one of the 47 million (and counting) whom the insurance industry racketeers have judged 'not profitable enough" (I'm quoting a Blue Shield/Blue Cross broker off the record).

I enjoy the unique privilege of paying for everything out of pocket.

Thank you for your service to our country. Sorry to see that you didn't learn any compassion for your fellow Americans.

Leland R. Erickson

Citizen

[Annette]

Yup, if she is injured or seriously ill, who will pay. The doctors who provide the service, the hospitals who care for her, that is who. She will almost certainly declare bankruptcy due to high medical bills. That leaves the doctors and hospitals picking up her bills. If she "cant afford" insurance she certainly can't afford $150,000 in medical care.

As for buying insurance, it is expensive because over 1/3 of your premium does not go to health care and administering but for profits to sharholders. .

Before you squawk about the care in socialized countries. It is better than the care in the US. We have had care in Canada and the UK. (We had to pay for it because we hadn't paid any premiums there,) it was efficient, effective, the doctors spent all the time necessary to explain everything to us, it was also relatively inexpensive compared to the US even for us foreigners. There is a reason why They have a higher life expectancy than the US and why ours id falling. They get better medical care.

[moreupnorth]

Your point? If the government took the money needed for health care coverage from her in the form of forced payroll deduction, before she could waste it, then it wouldn't be an problem.

[FreedomBeforeDemocracy]

"before she could waste it" But what if the new socialized medicine is so cheap that she still has some money to waste. Wouldn't it be better if the government took all her money, and then gave her cable service, a car, and a cell phone that weren't so wasteful?

[wolfgangmo]

Yah Georgia,

That's the problem. If only we could get rid of your niece then everything would be OK.

[Chavez08]

Rampant industrialization caused many of the life-threatening and expensive medical conditions we are seeing today. Since industrialists and global bankers got wealthy poisoning the people and the environment, shouldn't they be responsible for the lions' share of the responsibility for universal health care?

Does the establishment expect us to die quietly now that we are less productive so they can make room for new slaves? Is that what's being discussed in corporate-sponsored "think-tanks" and Bilderberg meetings? This government, under Republicans and "Blue Dog" democrats, has redefined "Democracy" to mean unchecked Capitalism. It's "Democracy for the Few".

South America is systematically dumping this perverted version of "Democracy" and they are reverting to Socialism. Democracy used to represent peace, good will and prosperity for all and what it stands for in the past 30 years is war, slavery for the profit of a few.

Please tell me that Washington is finally going to start working for *the people* and eliminate Neoliberal "Free Market" economic and foreign policy from the agenda. 98% of us desperately need hope right now.

[robinhood2]

I think things will come to a head soon after the oldest baby boomers start getting their Medicare cards in 2011. If Medicare funding is not a big issue in the 2012 election campaign, it certainly will be by 2016. An acquaintance of mine recently had heart bypass surgery at a cost of over $800,000. Medicare paid for most of it, his supplementary insurance paid for some and he had to come up with a few thousand dollars on his own. How many heart bypass operations does it take to bankrupt the US @ $800,000 + a pop?

[UnbiasView]

Easy answer, they will just ration them.

[BlackWidowPilot]

As if they're not already. I'm one of the 47 million whom the insurance racketeers have declared "not profitable enough." If you can't pay under the current system, the docs and hospitals increasingly won't play.

I'd rather take my chances with a triaged system where everyone has access to healthcare under a single-payer plan, than the for-profit chaos we have right now.

Leland R. Erickson

Citizen

[mayzebra]

My youngest son was very sick his first year. We ended up in over our heads... To the tune of about 40K (btw we had insurance, but try to get them to pay when it's not through your work). One of the FDA approved medications (new research now says it causes non-hogkins lymphoma) cost us nearly $1000/mo. He's 5 now and much better. With any luck, he'll stay healthy.

While visiting friends in France, I mentioned that I had filed bancruptcy for medical. She had difficulty comprehending the situation. When she got it, she exclaimed, "What!!! Your country doesn't take care of it's people!" And that from someone who grew up in a third world country.

It's simply unfamthomable for people who have not been conditioned to this. And it is shameful that any parent (insured or otherwise) should not have the best medical for their children that their country can probide. We were "lucky" to have had the incident before the bancruptcy laws changed. But now I'm thinking it would be safer to move to a more modern country... one that takes care of it's people.

[ProgressiveChange]

As a healthcare consultant for almost 30 years, I concur that Obama's plan is better than McCain's, which is no plan at all. I believe that a single-payer plan has the potential to cover all Americans without any additional tax revenues. Obama's plan initially includes many of the elements, which have enabled special interests to trump the public interest. The public simply has no clue of the breadth, depth and scope of abuse, fraud, waste, and egregious business practices, which siphon off billions in unnecessary opeating costs, executives' compensation, and shareholders' dividends, within the current non-system. It is unfortunate that those with platforms and media attention do not tell the story to the American public. Unless and until the story is told, incremental 'reform' will continue to be an illusion of change. The real deal requires biting the bullet.

[UnbiasView]

"I believe that a single-payer plan has the potential to cover all Americans without any additional tax revenues"

I highly doubt that. When something is free, people always consume more. You are also asking the people that currently pay to pick up the bill for another 50 million. Obama also hasn't came out against covering illegals.

[BlackWidowPilot]

Start by having the Pentagon justify it's so-called "black ops budget," and stop paying $435 for a $9 claw hammer, and we'll go a very long way towards covering those costs.

Leland R. Erickson

Citizen

[hippynanainblingland]

UnbiasView Please check this out: truemajorityaction.org/oreos. I don't know if this link is still active, but if it is, you will get a very interesting view of how our tax dollars are spent, and you will realize that if the Pentagon's annual take were lowered by half, we could easily afford universal health care without having to raise taxes, and we could afford much else besides.

PS I just checked it out again, and the link is active, though not from my post. Just type it in if you want to check it out... but you won't, will you? It looks like you'd rather believe that universal health coverage is an impossible goal. Go ahead, prove me wrong!!! Check it out!!!!!!!!!

[Annette]

"Consume more," such as getting adequate medical care? Or do you assume that Americans will take up medical proceedures for fun.

Americans have a falling life expectancy. In countries where there is adequate medical care they live longer.

In every country where they have adequate coverage, everyone pays into the system. The few who are unemployed still get coverage. Your notion that only those of us who currently have medical insurance will pay for everyone falls apart. There are over 45 million employed Americans who for a variety of reasons do not have insurance. They would be paying their fair share. You seem to be of the opinion that we are not currently paying for their care. We are. A hospital bed in the US costs to much because everyone is paying for those who are forced to declare bankruptcy, who walk away without paying, and even yes even the "dreaded illegal aliens" they get care now but all of us are already paying for their care.

[woodchips]

It really not that simple. For instance, if preventative care is available for free, many conditions that now don't get treated until they are critical, would be diagnosed earlier or prevented altogether.

If the insurance company profits and administrative costs incurred in dealing with insurance and billing issues were removed, health care costs would be reduced. Write-offs from services rendered to uninsured patients and underpayment for services causes hospitals to jack up rates for those who can pay.

Take this and more into account before you conclude that costs will increase. Also keep in mind that a large number of people in the US are already covered by Medicaid, Medicare, the VA and other "socialized medicine". Administrative costs for these programs is on the order of 2-3% vs 30-35% for "for profit" health care.