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.
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Thank you Rep. Shakowsky for your important and timely article.
I am the practice administrator of an internal medicine practice in the midwest. Most of our patients are working or retired middle class. I deal with medical horror stories on a regular basis. The most infuriating ones are those where a retiree loses the health benefits that were supposed to be provided under their pension plan. A couple of years ago it was the steel workers whose pension benefits were halved when their company's pension plan was taken over by the Pension Benefit Guaranty Corporation. Now, we have heard from retired auto workers that their pension-guaranteed health benefits are going to be reduced or eliminated. These are people who took care of their families and lived their lives honorably. People who got up each morning and worked long hours in factories or who, literally, roasted in the steel mills. This country was built on their backs and shoulders. Yet, the top executives of their companies, who mismanaged their pension plans, walk away with golden parachutes while the workers lose their health benefits at a time when they need it most. This is not right!
cont: The retirees who are Medicare eligible, lose their supplemental insurance when pension benefits are eliminated. This means that the retiree is, then, responsible for the Medicare yearly deductible
cont: Recently, we had an employed patient who requested refills of prescriptions to treat low thyroid hormone, anemia, and diabetes. All of these conditions require that a patient's blood work be monitored on a regular basis. The patient had not had the lab work done that the doctor had requested, so the nurse called the patient to advise that we needed the lab results before we could refill the medications. The call was transferred to me because this married couple had lost their health insurance and they advised me that the labs that the Dr. had requested would cost over $400.00, which they could not afford. I had to advise the patient that since we do not do lab work in our office, the Dr. could not jeopardize his medical license by not following standards of medical care, so I referred the patient to some non-profit agencies in our area to see if they might be able to help with the cost of lab tests! Frequently, physicians find themselves between a rock and a hard place because they are torn between providing compassionate care and protecting their medical licenses from malpractice. Further, despite the ever increasing staffing and supply costs of running a medical practice, with the yearly decreases in insurance reimbursement, primary care physicians have limited resources to provide indigent care. This adds another layer of emotional stress onto an inherently stressful profession.
Would not Jesus agree that universal healthcare is the Christian way to go? Would not a healthier people mean Country First?
Interesting to see mythology make its way into the discussion
Interesting how? Like interesting that people have faith that they are willing to profess, or like interesting that people actually say things that you don't believe in?
Sounds like politics to me.
I can't speak for Jesus, but I don't think he'd support forced charity.
Actual charity, like the hospital mentioned in the article, yeah, he's probably down with that.
If you can't speak for Jesus, then don't.
As you did you must see yourself with god like powers.
Actually he did, he said if you want to get into heaven sell all you have and give it to the poor. Sounds pretty socialist to me.
The situation you describe about our health care system displays even more of the problem that it appears on the surface.
The main reason why the US pays more money (either per capita or as a percentage of GDP or even as a percentage of government spending!) yet has terrible life expectancy statistics is that we are forced to put off things until they are a crisis and then hope that the safety net kicks in. In any other industrial country she would have been able to go to the doctor at the first sign of problem and no doubt had one or two small problems taken care of early.
The bizzare thing is that this even applies to those with insurance. My insurance won't pay for ordinary doctors visits for a non-critical problem or routine tests but WILL conver emergency room visits.
The thing is that with our private health care system the insurers would rather put it off, because by the time the problem gets really serious you may be on medicare and not their problem, or lost your job and not their problem, or changed jobs and not their problem, or they can concoct some flaw in your application to call it a pre-existing condition and have it be not their problem.
The reason they will put it off has to do with stock value [and the option that CEO get]. Why pay today for a procedure that will effect stock prices, when you can put off that procedure until after you cash in your profits?
CEO these days never seem to look beyond 3 months out.
You want a health-care horror story, Rep. Schakowsky? Hold hearings on the AARP. Ask them how much their "non-profit" organization takes in every year by administering those horrible, confusing Medicare Part D "plans." AARP is the reason Part D passed Congress. Why didn't this powerful lobby object to the "donut hole" in coverage? Why didn't they fight to include more medications in the formulary list? Why do their "discount" cards suddenly provide much less of a discount on vital medications?
AARP was vehemently against Medicare Part D. They lobbied against it but the Repubs in Congress passed it anyway.
Talk about revisionist history. AARP lobbied heavily against medicare part D.
Get a job and then buy a clue.
Healthcare is breaking the back of our economy along with every other stupid mistake we make.
Its the price we pay for market-driven for-profit health care. Making a huge profit off sick people is ugly and wrong! However, it is the conservative way and since Americans keep electing conservatives don't expect change anytime soon.
Ah yes, but the well is running dry. The day is quickly coming when they will no longer be able to blame hispanics and others because it won't matter. The system will cease to function just like russia in the 90's.
"Thus, one would think that a massive overhaul of our completely dysfunctional health care non-system would be a no-brainer
“you'll find that people in those countries live longer, have lower infant mortality, and overall get more bang for their buck.” They don’t live longer when one factors out car crashes and homicides (the US goes back to number one). Do their healthcare systems provide better driving instruction? The US is number in overall cancer survival rates (an actual health care statistic.
"Medicare for all" The “Medicare for just the elderly” is on the verge of insolvency. Could you at least attempt to fix that first?
easy to fix. First you quit balancing the general budget by taking Social Security payments and medicare payments and useing them in the general budget replacing them with IOUs. Amazing what you can do if you also lift the social security caps for the wealthy.
Who is borrowing against Social Security (along with external creditors) to help finance their deficit spending? Could it be the same people you want to control my healthcare?
How about you get your "easy fix" applied first? Then we can talk about giving more responsibilty to the politicians.
Government did not create "our completely dysfunctional health care non-system
I've been reading them. 44% of all health care spending is by the government. There is a huge tax advantage for employer's to provide health insurance. Purchases of health insurance across state lines is prohibited by federal law. You don't think the federal government has anything to do with our health care system? You think this is free market? Imho, this is why we have such high costs. All of these lead to distortions in the market price.
Yet another redistribution of wealth scheme to further enrich the allopathic oligopoly. I have yet to see any so-called "elected official" establish even the most basic grasp on the underlying problem with the domestic healthcare system. A lack of access to care, exorbitant costs of care and the continued acceptance of incompetence and malpractice in the field stem directly from the implementation of the non-scientific segments of the Flexner Report. Even the most cursory study of economics would help put such in its proper light. Fixing the broken domestic heatlhcare system starts with breaking the back of the allopathic oligopoly when it comes to controlling the allopathic education system and when it comes to the assignment of whole swaths of the field of healthcare to themselves.
Tee-Hee
"Whole swaths"?
You mean, the 20% of you policy that actually goes to doctors for payment of their services?
I won't even go into your quotation from the Flexner report. That's a study that was published over 100 years ago in an attempt to standardize medical education, before health insurance was invented, BTW. You apparently don't know what it's about.....
Is your argument allopathic v. osteopathic? Or allopathic v. homeopathic? Because the medical community does not ignore homeopathic-it's just not scientifically supported, and, yes, there is ongoing research.
I find it fascinating that homeopathic mythology is okay by you, but spiritual mythology is not. I guess you like to pick your fav hypocrisy
The Flexner report was the first of the scams fun by the AMA and big Pharma but certainly not the last.
And yes, there is an oligarchy in the US.
All of that aside, do you have a point.
How about this horror story from the future:
I get sick, and I can afford to pay a doctor for treatment. Unfortunately, I can't get in to see a doctor because of all the other sick people who can now afford a doctor because I'm being forced to pay for their care.
Wow. Rush? Is that you?
First of all you aren't being forced to pay for anyone, including yourself. Second, the likelihood of their being a long term or even short term shortage is minimal. I own a medical clinic and like many of my colleagues I have space in our schedule.
You sir are a parrot of a straw man. Your fears, which I suspect is how you live your life, in permanent code brown, are unfounded at best and radically sociopathic in all likelihood.
I'm not being forced to pay for anyone? Taxation is voluntary?
And of course you have space in your schedule, that's because your service is provided at a cost to your patients. Once it's perceived as ''free", you'll see an increase in patient load and the tax dollars taken from me by force will be spent on people who otherwise would stay home.
It's a great deal for you and your colleagues
How about instead we just force all doctors to perform their services for no charge?
I hope you're better at medicine than you are at economics.
How about THIS horror story from the future:
You (who seem to think the current system is just peachy keen) lose your freakin' job, can't find another one for a long time, your unemployment insurance runs out, and you lose your continuation coverage.
NOW you can't "afford to pay a doctor for treatment". So even if your made up situation (which is B.S. anyway) WAS valid, it wouldn't even matter because now, pretty much without fault on your part, you CAN'T afford to pay a doctor for treatment. I.E., you discover you have colon cancer or any other type of serious illness but (A) Can't get insurance coverage because you have a pre-existing condition, and can't afford out of your own pocket, the $250,000 or some such amount that the treatment would cost.
So in our glorious present health care system YOU. ARE. S. O. L. Welcome to our PRESENT health care system.
Let me get this straight. You say that (in your version of the story) my inability to pay for healthcare isn't my fault? Whose fault is it then?
I've read your story several times and in your scenario it'd be my fault if I couldn't pay for my own healthcare. The difference is that I accept that responsibility and you want to force your responsibility onto others.
Why do you think that my inability to pay (in your contrived situation) is the fault of anyone other than me?
Anyway...
That's it for me. I'm through even responding to people with your kind of attitude about this topic.
Done.
Those medicare and medicaid dollars come from the magic money tree fairy. They are not collected under say... the threat of the implied use of force. Party A thinks that Party B should have [insert need of the day here, which seems to be increasing on a yearly basis] and and instead of Party A paying for such, en toto, from their own pockets, they extort Party C.
Ha! Funny you would say that.
My mother works for the federal government, is not given insurance by her employer (i.e. us), can't afford it, and isn't old enough for medicare.
She probably has (don't know, cause we can't see a doctor) rheumatoid arthritis. She can't pick up a coffee cup in the morning. She just quit her government job because she is no longer physically able to get in to and out of a car.
By the way, no one else in my immediate family has health care either. Luckily we're all doing a lot better than my mom.
So you in the future would be much better off than my mom now.
Thanks for your position on this issue, Jan.
The insurance industry has had its run, now it's time to put them to bed!
I do not want ONE MORE PERSON to hear that they are not entitled to health care because they are already sick. It's just absurd.
The current health care, drug, and insurance industries have a pre-existing condition.
Status Quo DENIED!
When has is ever been said that someone can't get healthcare because they are already sick? It hasn't ever been said. Hilda can go to any doctor she wants and get treatment.
The problem, for Hilda, is that she can't pay for the care she needs, because the mean spirited and selfish doctors want to get paid for their services. What she wants either for someone else (you and me) to pay for her bills, or to find a doctor who works for free.
It sounds like Rep. Schakowsky has helped her connect with one such doctor, hopefully she'll find another.
Payment for health care isn't a right, people. The sad stories don't change the fact that it's a service you buy, just like any other. Any government involvement is just a handout provided by the taxpayers via the politicians that lord over them (like Rep. Schakowsky)
My wife has lupus. When we received that diagnosis my insurance company dropped us. Now I cannot obtain private insurance because she has a "Pre-existing condition" three days worth of my pay a week goes for medications. "Let them all die". That is the sum of your logic. "If you can't afford it, you can't have it"! I assume you have never been jobless, or homeless. You sound like you are well off, spouting ditto head talking points. You have lost your humanity in pursuit of your selfish greed.
A "Medicare for all" is the only fair and humane way to go. Every citizen deserves good and equal healthcare. Our healthcare insurance should not be tied to our jobs. I'm more than willing to pay more in medicare taxes to have good worry-free healthcare. IT'S TIME!
I have worked in Canada and had health care through their system, far better than the US and much more responsive. This spring while in the UK my husband became ill. He saw a surgeon within 3 hours, saw a urologist in 6, was in the hospital with outstanding care, Thank you Blackheath Hospital, he was seen by experts who did the required tests and delt with the situation swiftly, For 3 days in the hospital with specialists, scans, drugs and care we paid $6300.00 This was because we were not covered. What was telling was both his surgeon and urologist were American expats. They had moved to the UK to practice medicine. They were highly skilled professionals who in the US spent most of their time fighting with insurance companies to get approval for needed care, their malpractice insurance regularly chewed up 1/5 of their income. Both of them have been in the UK more than 10 years and say they wouldn't come back. Their income is very good ( the surgeon drove my husband to the hospital in his Mercedes) but what both of them treasure is why they got into health care, to be doctors with no one deciding that an insurance company knows better than they what the patient needs. I would love to have doctors in the US who are allowed to do their job.
If we don't get universal healthcare there is a silent movement within the medical community to fix this problem in a way. At my clinic and others, Doctors are moving away from billing any insurance. That doesn't mean that insured patients cannot see the docs, but rather that the patient is responsible for getting reimbursed.
I suspect that if every patient HAD to get money out of their insurance company and then followed up THAT call with one to their congress critter then the phones in Washington would be permanently crashed. Something would be done if we all just demanded it.
In the meantime our clinic is looking at Canada to relocate and not billing insurance right now.
Great, now we make people who can't understand their ARM loans trying to navigate and fight insurance companies.
Insurance companies are already refusing to pay for care, they find anyway they can to get around it and no amount of fighting by the patient/customer makes that happen. You have to get a lawyer you can't afford to fight for the reimbursement. Why do you think so many people are going into medical bankruptcy?
Insurance needs to be regulated, they cannot refuse to pay for medically necessary and life-saving treatment. Insurance should be non-profit eliminating the prime motivator to deny care.
I started out in election 08 as a healthcare voter. I am healthy and my family has insurance. I am also for ending the war, pro choice and support many democratic efforts. I think as important as universal healthcare is the need to face our energy needs. I think we should drill, go nuclear if needed and yet try to consume less and promote green energy.
I wanted to vote for Hillary but I will never vote for Obama. I think he smeared Hillary with falsehoods, fabricated his stances and pushed himself forward in the primary with the help of Pelosi, Dean and Brazile. It has been the worst thing I have ever had to witness on the political stage.
I now consider him to possibly be a grave security threat for our nation and have lost all respect for the Democratic Party.I will now place my vote for McCain with a very heavy heart and pray ( although I do not pray ) both for Hilda and that I am never in her situation.
Good luck, you'll need it, because you're cutting off your nose to spite your face!
Head.
Chopping block.
And was what Obama supposedly did worse than any of the Repub smears? I think not.
Oh well. America has the government it deserves and people like you are the reason.
Obama is "a grave security threat for our nation".
Yeah, right.
Geez, it takes all kinds doesn't it.
So your stands are the same as Obama's but you will never vote for him because your candidate didn't win. Thus you will vote for the guy that wants to make out health situation worse. Doesn't women to get equal pay,is against green energy whose only response to the war is more of them because that is what McCain wants. All because your chosen candidate hired inept personnel (Penn thinking it was winner take all) Blew through her money carelessly, paying 10 million to Penn, who was inept. Lied at least as much as Obama (under fire in Bosnia, lied about Obama supporting Nafta, while she actually did) and had a different persona every day. She lost because she didn't get enough votes, he got more so you are willing to have the court stacked against women, in favor of war, and against decent health care. I doubt you were support Clinton you are just a paid McCain troll serving up lies and trouble.
Here's my health care horror story: I learn more about the merits of single payer from Business Week Magazine than from any other single source (and both they and I know that what Obama is talking about in public ain't it). The strongest constitutency in this country for single payer (albeit one that is reluctant to really go on the radar screen for many reasons) is big business.
Yeah, they save a ton of money, and you could call that the wrong reason to go along with the right answer. But one reason why many politicians won't go for the real deal is because they think that the opposition is still too strong. Now, however, the business community is deeply divided on this point and opposition from the money side of the political spectrum would be far less than at any point in the past.
In fact much of the strongest opposition might well come from organized labor, though that shouldn't be the case. Current Union workers would find their medical benefits diluted, but retired members would now, or certainly in the forseeable future, find their circumstances improved over the status quo.
Over on the right, small business should sign on to single payer in a heart beat.Compa
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