I’m going to build this guy for you, right here, right now. I’m going to create him out of dust and return him when I’m through. I have my reasons.
He’s in his mid-50s, and middle management. Good job, 28 years, worked from the bottom up. Nice salary, not stunning, but very workable. Benefits are pretty good, all in all.
And then the job is gone, poof. Bought, sold, downsized, outsourced — there were rumors, then inklings, then suddenly that was it. Some severance. No more health insurance.
Two weeks later, he tries to stay busy, not to think about what he doesn’t want to think about. He’s got resumes out there, messages left. He doesn’t want to do what others do, give up, get depressed, pass the days with Oprah and bourbon, so he tackles those chores that have been hanging around for a free afternoon. Paints some walls. Repairs a fence. Tidies up. Lifts some firewood and frees up some plaque that’s been just hanging around, waiting for an opportunity to get loose and occlude a coronary artery. Blood flow to a part of his heart suddenly slows. That section of the organ begins to die. This hurts like hell.
How could this happen, you ask? Me too. I created a good guy. Exercises regularly. Never smoked. Eats well. Everything is done in moderation. Sort of the opposite of me.
My bad. Forgot to create his ancestors while I was at it. Genetics will mess with us.
Cardiac catheterization is full of surprises, including three arteries that are 90%-plus clogged with crap. No stent for this guy; he passes Go and heads for the OR, where they cool his heart to stop it, take sections of saphenous vein from his legs, and put in little detours for blood flow, avoiding the congestion and keeping traffic moving. He does OK, no major problems, and in six hours his hospital bill has gone into six figures.
OK. I’ll stop now. There are imperfections in this story, but I’m lazy; I could have covered those, too. I just wanted to construct a situation in which none of you good people could say, “Well, it was HIS fault…” because some of you seem to have a tendency to do that. Or maybe not you. But people I know. Hear, read.
And you know the rest. Retirement savings, house, chance of actually getting new health insurance, etc., all gone.
Sixty-percent of bankruptcies in this U.S. are directly related to medical costs. Surely some of those people did all the “right” things. You can’t blame them all, right?
For over a hundred years, people have been trying to fix this. That amazes me. Over a century, and that’s only if you trace it to Teddy Roosevelt. We do certain things as a group, as a nation — everybody has access to public education, as imperfect as that is. We get some nice roads, and some not so nice. We aim for clean water, sewer systems, electricity. We pay for it. We expect it.
But unlike everybody else in the freaking world, pretty much, we don’t have universal health care. Surely they can’t all be communists.
Yawn. You know all this, or you don’t care, or you have a peculiar world view, or you live in FOXLand. No need to explain. I’m so bored myself that only pretty good coffee is letting me continue right now.
Here’s the thing: I know more about this than you do.
(I’m guessing here; it’s possible you’re some sort of health care policy whiz, but I can’t imagine one of those reading this blog. Maybe, though. Still.)
This doesn’t mean I’m smarter; I just know more. I’ve worked in this industry for a long time, so have members of my family, I have a passion for it, I have an interest, I like to read about it, blah blah blah. It could be comic books; for me it’s health care.
And here’s what is going to happen, I’m real sure — we’re going to get universal health care, but we’re going to have to revisit the cliché first: We can do this the easy way or the hard way.
President Obama has said repeatedly, campaign and in office, that this isn’t about philosophy; this isn’t about the idea that health care is a right, although I’m pretty sure he feels it is. Like education and clean water. What it is about is economics. The system is broken, and eventually it will stop, and then talk about a public option and health exchanges and preexisting conditions will be moot. It will become an infrastructure issue, like water pipes and bridges. A critical mass will be reached, enough cars will tumble into the river, enough people will run out of water, pick your analogy; it will happen. And we will be SO BROKE.
The easy way you know. This is my world — I wave my hand and Blue Cross is now in the alternative energy field. We all have something that looks like Medicare, with gold-plated programs for people who want and can afford them, and bare bones for the least among us, but our friend up there isn’t living with his kids and working at Wendy’s. We pay slightly higher taxes and no premiums at all. We save LOTS.
Real world? No idea, except you start at the beginning and work from there. What do people, poll after poll, want the most when it comes to health insurance? Dump the preexisting condition clause. Everyone knows this. Republicans know this, which is why politics are going to get interesting here pretty soon. Because you just can’t eliminate preexisting conditions; people would wait to get sick before they buy insurance. People funny.
No, we have to go to Insurance 101 – Get everyone in the pool. Spread the risk. Mandate health insurance for everyone, subsidize the poorest, do everything you can to eliminate waste and inefficiency. See what happens, fix what doesn’t work. This is, pretty much, what the bill that the Senate passed in December looks like. If you simplify it a lot.
I know. I know. Still. The rubber is going to meet the road eventually.
That’s it. Felt like writing that, is all. I could give you 10,000 more words, lots of data, lots of proof. I could give you personal stuff, tell you what it costs to provide for a disabled child. And I’m sure you could give it back to me. Or you could scream about socialized medicine and tyranny and Hitler and death panels; scream all you want. I know more than you do, sorry. And although I have absolutely no idea how this will play out, and very little confidence in our bought-and-paid-for professional politicians, and suspect we will go harder than easier, I can add and subtract.
In the meantime, we have some very nice emergency rooms. Good luck.