So, Buster comes up to me lifts up his shirt lowers his waistband a little and says “what do you think this is?”
Hmmm…I think it might be a hernia, actually. But I’m not sure. I’ve never seen a hernia before, and the illustrations indicate the bump would be lower. :::UPDATE:::Not a hernia – thanks for all of your prayers, which meant a lot!:::
Clearly, a trip to the doctor is warranted, and since Buster is supposedly returning to college in August (one never knows, anymore) a physical is on the agenda anyway.
We have new insurance over here, and it turns out, Buster – now that he is 20 – is no longer able to use this wonderful physician, who has treated him all his life.
Of course, we knew the day would come and we would have to leave the pediatrician behind, but our previous insurance covered full-time students to age 21, so this was an unexpected. It was a blow to realize that Buster would no longer be able to bring his health issues to a doctor he knew and trusted, and that this new concern would have to be looked into by a stranger – someone we would have to select from a pre-approved (who approved?) list. Where to start? I don’t have a GP, I have a hematology group. My husband’s GP (selected because my ever-practical spouse can bicycle to him) gives me nightmares; his practice seems to be about cholesterol, blood pressure and fitting folks out for walkers. His waiting room is always filled with geriatric patients – and maybe that means he is good at keeping folks alive – but he does not ring my bell.
I called Buster’s physician; because I do trust him, I hoped he could make some recommendations, and that someone he thinks highly of will be on our “approved list.” Also, I wanted to say “thank you,” to him for being such a great, attentive, cheerful and very smart healer.
As I waited for the doctor to finish with a patient and come to the phone, I recalled all the non-emergencies and real troubles we had brought to him – the time I’d insisted that Buster, age 4, “must have a hearing problem, listen to how he shouts!” After running a quick test, the doctor chuckled and said, “his hearing is perfect. He’s just loud. Happy kids are often very loud!”
With that specific memory to the fore, when the doctor picked up the phone, I found myself getting inexplicably teary-eyed; this would likely be our last conversation. “I know you must be very used to suddenly having your patients drop off the map as they grow up, but Buster’s my youngest and so this is something like closing a door, for me, in many ways. I wanted to tell you how glad we have been to have had you for our children’s doctor, and how grateful we are to you,” I said in a soggy voice. “With our health insurance changing so often and this whole idea of nationalizing healthcare, I feel like you’re the last doctor any of us will ever have a real relationship with!”
“It becomes more impersonal all the time,” he agreed. “Do you know, almost no one ever says goodbye or thank you any more?” the doctor mused. “Patients are becoming like schools of fish or flocks of sheep; wherever the insurance takes them, they’re bound to turn and follow, and some people find themselves changing doctors almost year-by-year. We’re all so busy that making a real contact – just to say goodbye and good luck – it’s becoming a rare thing. I’ve enjoyed being your doctor; I’m glad you called me and didn’t just disappear, because I actually do care where my patients go – these kids leave, but they’re always ‘my’ patients, to me. And yes, I do have specific doctors who I’d be glad to know were seeing Buster.”
After naming several doctors he thought might be on our insurance plan, our doctor of 20 years said, “I’m sorry I won’t be seeing him anymore; Buster was always an entertaining visit, and he is the only one of my patients I could talk about opera with.”
It was a surprisingly emotional phone call. I realized later that part of my weepiness was sentimentality – the saying goodbye to a trusted doctor, and to my own days as a young mother – the acknowledgment that Buster is a grown fellow, now. But there is a fearfulness there, too, on my part; we stare at a list of “approved” names in a book and step out into a great unknown, with our choices already narrowed-down for us and our options limited. Beyond sentiment, I think the lump in my throat was partly about those limits, that ever-narrowing field of choices and how it portends a narrowing of our overall liberties, here in Middle-Class America.
Nothing feels right.
I gave Buster the list of recommendations and told him to check out which of them are on the “approved list,” so we can get him looked at, and I told him what the doctor had said.
“Maybe I’ll pop by and visit him one day,” Buster mused. “Just to say thanks.”
“I’m sure he’d like that,” I said; “if you do have a hernia, and it needs surgery, you can show him your scar.”
Twenty years flew by like a whirling storm. Another door closes, with no re-entry possible. The future looks that much more uncertain. I hope these doctors are good. The list is not long.
July 13th, 2009 | 2:23 pm | #1
Well, my hope would be that if we went to a public health care system, then you would not have to change doctors because all doctors would work on the same system.
In some ways, it would make some things easier.
But then, some of your concerns about socialized medicine- long wait times for appointments, not being able to get a doctor- are things I’ve experienced under the private pay system. I could not find an OB in my town when I was pregnant with my daughter- they flat out weren’t taking patients with my due date. I did find one in a town close by- there was a month wait for an appointment.
When I was diagnosed with gestational diabetes, it was 6 weeks before I could get an appointment.
July 13th, 2009 | 2:25 pm | #2
I should add- I don’t think that would be better under a public option. But neither do I think it will be worse.
July 13th, 2009 | 3:11 pm | #3
My dentist lives in Texas–I live in California. But I still consider him “my” dentist, and see him for tooth trouble whenever possible.
I grew up playing with his daughter. He and my dad are old friends. In fact, when putting a crown on my dad’s tooth one time, the crown slipped down the sink. My dad got up from the chair, got the toolkit from his truck, dismantled the sink, retrieved the crown, and the dentist finished the job quickly.
He’s the only dentist I know who does not have “happy tooth” posters on his walls–the posters are of Jimi Hendrix, Sergeant Pepper’s Lonely Hearts Club Band, and the Abbey Road album cover.
He’s Catholic, and loves to talk theology with me while working on my teeth (just try talking sacraments with your mouth pried open with dental implements!)
And he’s the ONLY dentist who believes me when I explain that Novocaine does not work well on me–he puts the shot directly into the nerve in my jaw, and I never feel a thing while he’s working.
I miss him.
July 13th, 2009 | 3:53 pm | #4
I’m with an HMO— that makes some things good and some things bad. On the good side, since it’s one of those HMOs that has a staff and doctors on salary (rather than on a per-capita or otherwise piecemeal basis), you don’t have any problems seeing a professional in any department— they can just slot you in.
On the bad side, this does mean you sometimes get shuffled around. I saw no fewer than three OBs during my pregnancy and none of those were delivery doctors, so it was someone else at the hospital. On the other hand, one of those OBs was a last-minute fill-in when the one I’d been scheduled with tore some ligaments in her ankle, so that could be on the good side. And I’ve never had any problems with any of the practitioners I’ve been involved with. On the contrary— I like the care I’ve received, a lot, so…
DON’T TAKE IT AWAY.
July 13th, 2009 | 4:40 pm | #5
I can understand the concerns of people without health care. I recently had to have several tests, including an MRI, a sonogram guided needle biopsy, among others, all on the off chance that I had something wrong with me. My health care coverage is very good, even with not covering 100% of all procedures, but i admit that my jaw dropped when I saw the listed charges from the various providers (even though most accept the plan’s allowance for full reimbursement). In addition to various advances in medical procedures that cause costs to increase (but provide us with good care) much upward pressure on prices is driven by the fact that unless there is a perfect outcome in every instance many people are willing to sue at the drop of a hat. Doctors, in order to protect themselves order yet more tests “just to be sure” nothing shows up. There needs to be reform in malpractice litigation as a way of controlling costs, not reducing reimbursements and denying people access to procedures based on some beancounter’s calculation in DC.
July 13th, 2009 | 4:48 pm | #6
When my husband was laid off a couple years ago, I was scared to death about how to get healthcare (I have several chronic diseases, only God is keeping me alive) since we don’t have medicare or medicaid (not eligible). I don’t go to the doctor hardly ever anymore, but I bite the bullet and pay full price to see the same doctor I’ve had since 1979. Unfortunately, his office staff are new, only been there 5 years or so, and they don’t cut me any breaks or give me any discounts. Since your son isn’t covered by insurance to see his regular doctor, nobody says he can’t see him if he wants to, he’ll just have to pay for it.
[And to be perfectly honest, if we were talking about a strep throat, I'd be willing to pay for it, but I can't afford the surgery!
-admin]
July 13th, 2009 | 6:52 pm | #7
Elizabeth, I am praying for Buster and a quick resolution with an EXCELLENT physician. You know that I work in healthcare and this is such a common story to me.
Stephanie, unfortunately, under a public system, many of the best doctors I work with plan to “go Galt” and take only private pay patients with cash up front. They know how little Medicare and Medicaid pay them and that they cannot earn enough to stay in business if all of their patients are at that reimbursement level.
Signe, I couldn’t agree with you more.
God bless us everyone,
Myssi
July 13th, 2009 | 7:04 pm | #8
Yes Signe,
The costs are very high and doctors are in CYA mode due to our shameful malpractice orgy. My radiologist BIL’s group only collects 40% of what it bills, and every patient in the 60% has as much right to sue as those that pay. The vast majority of lawsuits are settled as doctors’ groups can’t afford to litigate every case AND pay their malpractice insurance premiums as well. Two words solve this: loser pays. BTW, Britain’s tort system uses loser pays. But, is there any part of the Democrats health care reform plan that mentions tort reform? See tort bar campaign contributions for your answer.
One of my frustration with the liberals is, they seem not to have learned one of the facts of life: there’s no such thing as a free lunch (Milton Friedman). There is a cost that comes with our very existence. It is a principle recognized in everything from religious life (Jesus, the Redeemer) to the conservation laws of physics. The US has the most expensive health care system in the world – and the best. I’d rather have our system set up to save lives than money and that’s what it does now.
July 13th, 2009 | 7:21 pm | #9
Signing in from Canada – I will admit that there are benefits to the Canadian system – I do not have to worry about paying for doctor visits etc., however not all procedures are covered so unless your employer has extended health coverage you still end up paying for a lot of things. I am lucky that I have a family doctor (many Canadians don’t because no sane person would do family medicine – the fees provided by the government do not pay for the time spent with any family member – the result is a quick 10 minute visit and if you remember to book 6 months in advance, an annual physical). But if you do not have a family doctor you end up at a walk-in clinic and take what ever doctor is on duty. And you need a family doctor because that is the only way to get access to a specialist – a friend has been on a wait list for 12 months plus for a minor procedure. Our costs are high and there are many, many inefficiencies in the system, plus the great indifference of the staff and doctors in the system. There is no interest in treating you as an individual because they need to move the next person in, and besides – you don’t pay them. On the other hand, my dentist takes time to explain things, his staff are courteous and really $200 for a cleaning, checkup is just something you plan for every year. I would be very afraid of any suggestion by the US government for them to get involved in delivering health care – government is no more effective at creating systems that work than the private sector.
July 13th, 2009 | 8:01 pm | #10
Dear Anchoress,
Yep, I do understand your concern and frustration. I deal with all of this everyday. I am a Pediatric Emergency Physician and I see scared people and their children because they have nowhere else to go. I don’t know what to tell you. . I do the best I can in the face of increasing demand and no hospital beds. I do my best to take care of families and guide them to the best follow up care they can get. What is so sad is that because of the crap reimbursements and the ever growing malpractice payments, we, and our patients are screwed.
Recently finished a grueling 10+ hour shift from hell and I was told that I was “behind.” How am I behind when folks come in- 8 to 10 patients within 20 minutes? I cannot see 10 kids in 5 minutes. I can’t, it is humanly impossible. But somehow it now is my fault- according to administration- because I cannot keep up with the oppressive burden that is given to our inner-city ER. God Help us all.
Lady Di
July 13th, 2009 | 8:21 pm | #11
I would have been sobbing too*. It’s a “good-bye” and it’s hard to do. And it’s happening while your youngest may have a hernia.
Buster (and you, of course) will be in my prayers.
*Sadly, I also cry when watching G rated movies too, much to the embarassment of my younger brother.
July 13th, 2009 | 8:52 pm | #12
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July 13th, 2009 | 9:30 pm | #13
I am on Medicare/Medicaid, the “socialized medicine” that we already have. Theoretically Medicare is 80-20 coverage with Medicaid picking up the balance. As far as I can determine, Medicare sets “allowable” expenses in such a way that the coverage actually comes out 60-20-20 and the doctor is not allowed to bill that second 20% and must write it off.
Those “allowable” expenses bear no real relation to what the care costs the doctor and a doctor is doing well if he or she merely breaks even on me. Most times they see me at a net loss.
I have fairly free choice of doctors, with the exception of the higher priced specialists who lose so much on care/caid coverage that more and more of them simply refuse to treat me or any other Medicare patients.
Where do these insane costs come from? Well certainly not from the little bit of socialized medicine we already have.
I don’t expect most who read here to believe me, but these costs are the direct result of our “free market” medicine. And everything you are experiencing, Anchoress, is also the result of it.
Why? A truly free market presumes two things. First, that the “demand” is elastic. In our case that would mean that we could always choose not to seek care if it is too costly–so Buster gets to keep his hernia until the market drives the costs down.
Second, it presumes that your care choices are always market driven–that you shop for doctors like you shop for a car and drive Buster all over town seeking the “best deal” on hernia repair.
Now when you put it clearly this way it is perfectly obvious that our medical market is not free. What everyone calls “free choice of doctors” is the freedom to avoid market driven choices.
But the demand also is not elastic, Buster can’t wait until prices come down to get his hernia checked. And nobody in their senses chooses a doctor based on how cheaply they can do the work.
Unless they are forced to, which you are being forced to do now. That’s what all the PPO, HMO, in-network, and out of network business is about. The insurers are forcing you to make a market driven choice.
Something a good conservative ought to applaud, right? And they do, until the choice is something really important. Then all of a sudden they want their “freedom of choice” and immunity from the market consequences.
The health care market is a rigged market, not a free one. It is rigged by two separate cartels–on the one side the major, hospital based, medical providers and the drug companies; and on the other the insurance industry.
For the past 20 years these cartels have been in a tug of war over which of them will dominate the market. The pulls on the market have been so violent that we are losing the insured at an alarming rate, usually through the tactic of bait-and-switch.
Employers will be offered a tempting package of below-the-market coverage in the first year, which suddenly shoots up to above the market coverage, shedding dozens of insured employees who can no longer afford their part of the premium, which the company has to raise to afford its part of the premium.
And the major provider organizations are constantly striving to give less care and charge more money for it–forcing the individual caregivers whether independent or in-house to make more choices driven by the market and fewer driven by the need for care.
But you can always get in the see the doctor right now–at the Emergency Room. They’re on call 24/7.
That’s where I went all the time before I was judged worthy enough to get “socialized medicine.”
July 13th, 2009 | 10:44 pm | #14
The issue of healthcare is not a free market issue, but one that has been distorted by history. Tying healthcare to a benefit paid by employers came with unions who were limited by wage and price controls seeking benefits to take to their members. healthcare insurance at the time was cheap and good for employers as it helped keep their workers coming to work.
When the government got involved, they brought in huge amounts of stupid regulations and rules as always. healthcare in 1960 was 5% of GDP and after medicare and other federal and state programs, it started to rise. Because it was based on usual and customary charges, the primary care doctor was locked in at a very low office visit dollar, but when new technology and procedures came about, the specialist were able to get very large numbers for them such as CT and MRI and some surgical procedures. Now, we have few primary care doctors and most of them live their days on a treadmill trying to see enought patients to survive while making half to a third of specialists. The government set up how doctors are paid and so those in government saying paying by procedure makes no sense are the same government that set it up. The same government that pays to fix problems and nothing to prevent them will do nothing to change that unless it comes in the form of rationing. Make sure you understand that the federal government fixing anything the right way will never happen. The same congress that yaps about 800$ toilet seats in the defense department will screw this up. They are the problem. Now I see that to fix helathcare whose main problem is that it costs 2.4 trillion a year, they want to add another trillion to the total cost and you know that this will be much larger in the end.
Anchoress, your post is great and I will be placing a call to my family pediatrician tomorrow to thank him for all he did for the family over the years.
July 13th, 2009 | 10:55 pm | #15
For what it’s worth, I woke up a week ago Sunday (July 5) with a slight stomach ache, so slight as not to cross the boundary from discomfort to outright pain. The spousette and I were spending the holiday weekend with a friend who maintains a vacation cabin in the Sierra foothills, and I spent the Sunday mainly in a folding chair sternum-deep in the south fork of the American River. That evening, rubbing my almost imperceptibly sore midriff, I was surprised to detect a large, hard lump just behind and above my navel.
We returned Monday night, and I called my HMO from work the following morning. They advised me to come in and have it checked out at 3:00 pm. This I did, and the doctor saw me, for a wonder, on time. He checked me out, excused himself, and returned fifteen minutes later to tell me that I should go around the block to the HMO’s ER. This in turn I did, not realizing that I’d be hostage for the next six hours.
I’ll spare you all the details. Doctor #1 correctly diagnosed an “umbilical hernia,” but thought that the inflammation evident on the surface suggested a “strangulated” or “incarcerated” hernia, in which a loop of intestine can be trapped and killed, leading to a cascade of events that can be described in terms that include “necrosis,” “gangrene,” “organ failure,” “septic shock” and “death.” Obviously none of these proved to be the case, and the followup indicated that the far more benign and common instance of umbilical hernia was mine.
I was charged $30 for the initial visit and again for the followup; the ER was $100 notwithstanding my argument that it should be discounted for the first consultation. I pay about $250 monthly (self and family) for health coverage. The premium and the co-pays are both considerably up since the beginning of the decade (partly because I got hitched four years ago), but on the whole the household expenditures are way less than when my future wife was paying for Blue Cross on her own. What, I wonder, is keeping other Americans from this level of health coverage? Could it be — no, surely not — could it have anything to do with lobbying from the insurance industry?
July 13th, 2009 | 11:04 pm | #16
I’m in a managed care system. When we first went to that plan I was a union officer who was in on some of what was going on about our insurance program.
The doctors are screened by the insurance company and if they agree to the contract terms where they receive much less than they bill they are put in the network.
All of my doctors are in our network and I’m very pleased with it. I just dread Medicare in a few years. My husband started on it this month and we don’t know our rear ends from our elbow as far as what supplement to get so we kept my coverage which only covers what Medicare covers most of the time. In other words it’s not going to help us at all except for prescriptions but we still have time to check and shop around once we figure out the system and know more about what we need.
July 13th, 2009 | 11:19 pm | #17
I don’t know how it is now in the military but when my husband was in the Army from 1968-1971 we visited the Army hospital for medical care.
I was pregnant and couldn’t get an appointment for three months. In the meantime, I miscarried the baby. Not fetus, but baby.
Another example of socialized medicine is the Indian Health Services. I had the opportunity to go back home last month and see it in action with family members.
A member who needed a knee replacement had to wait three years to get it. My sister has a back problem they told her will need an MRI but first she has to take dope to see if it helps. She won’t take the dope but got the scripts anyway to satisfy them. She still hasn’t been approved for the MRI and they keep telling her not to lift (she’s a nurse) because she’ll do more damage.
She can afford to get insurance even though she is self-employed and that’s what I told her to do. You should see the dental dept. If you have a cracked tooth instead of putting a crown on it they pull the tooth. Everyone has the same smile there—toothless or with dentures that look like horse teeth. You couldn’t pay me to go there.
July 13th, 2009 | 11:43 pm | #18
Jeanette, IMO Medicare works pretty well, better now than it did 20 years ago. I had to care for both my father and my mother during their Medicare years. My dad had signed up for the AARP supplemental coverage that picked up the 20% of bills that Medicare did not cover. By the time mom passed away two years ago, the premiums were about $200 a month, but considering all the care they needed, and the hospitalizations, it was a bargain.
Doctors billed Medicare and also the supplemental insurance so there was little paperwork for us to do except put the statements we got in a file folder. We were out of pocket only for the annual deductibles, one extra diagnostic test for my mom that Medicare wouldn’t cover (we were warned ahead of time by the doctor’s staff), and prescriptions (before Medicare Part D and then in the doughnut hole). AARP was very competent, had excellent telephone staff to answer questions, and I never knew them to make a mistake.
I never had a problem finding a doctor to see either mom or dad, and they saw lots of them: GP, surgeons, neurologist, nephrologist, urologist, ophthalmologist, cardiologist, orthopedist, gerontologist, and maybe more that I’ve forgotten!
It was pretty confusing when I first started dealing with it, but it turned out to be not so bad after all. Good luck!
July 14th, 2009 | 12:12 am | #19
I’m coming from an uninsured pov. My husband is self-employed and I work part-time. Since his business is in the financial district, it’s been very tough this last year, and one of the first things to go was our whopping monthly insurance premium.
Thankfully, we’ve had no dire emergencies. In spite of the fact that we are now in that magic number of uninsured Obama throws around, I still do NOT want our health care nationalized. We’ve kept our same doctors over the last 25 years – they know us, know the conditions we deal with.
Got teary-eyed over your description of Buster leaving his pediatrician. Felt exactly the same way when our youngest was in that category 4 years ago. Time goes too fast, and you’re right, there’s no turning back.
July 14th, 2009 | 3:25 am | #20
I too am on Medicare because I am disabled and cannot work.I would love to work,being disabled and dependant on Medicare in what should of have been the prime of my life is not
something I wanted.
I do not want Medicare or Medicaid,for that matter gutted in order to pay for a socialized gov’t system.Obama is over his head and just
will not see or maybe just won’t admit that socialized medicine leads to a decline in quality
care and has failed over and over again.If we are extremely fortunate our legislature will not allow the American Health System to become
nationalized.We can only hope and pray.
July 14th, 2009 | 11:12 am | #21
I would gladly sign a waiver to go to mediation instead of suing to see a doctor if it would help contain costs. I’m surprised there are no choices like that available.
I think government mandates for what insurance has to cover have contributed greatly to the rising costs.
July 14th, 2009 | 12:59 pm | #22
Just as I’ve notice many obscure little ways to suddenly realize I’m getting old, I also know with my daughter (one year old last Thursday) that there are many obscure little ways to suddenly realize she’s growing up. And each one brings sadness and happiness to the adventure. She’s not the helpless bean bag we once knew, but instead gets around a little too well on her own and (this week) loves to chant “uh oh!” on our morning walk. Why, I dont know, but she does.
Insurance or no, at some point, everybody stops seeing a pediatrician. It’s a threshold moment–Buster’s a grown up. His life will become more and more his own and while you may always be as emotionally close, you won’t always be as physically close as his life develops separate from you.
This was a beautiful melancholy essay and one day I hope to share your sadness at the loss of a pediatrician (my Janey is much too young for that now). Buster will be in my prayers, I hope everything’s fine.
July 14th, 2009 | 1:28 pm | #23
Anchoress, I feel your pain. I think we have now entered the Twilight Zone.
My husband’s company has Humana. They recently called an office meeting with “great news”. The company was excited because the insurance rates were lowered, but the deductable went from $1,500 to $3,000. Also a couple of his doctors are no longer on the list and copayments have gone up. I have never seen health care in such disarray. Are they doing this on purpose? Can you imagine if we went to Universal Health Care? I shudder to think.
July 14th, 2009 | 1:35 pm | #24
Joseph Marshall makes some excellent points. He enumerates some of the tougher particulars of solving this humanity-wide concern.
I am past the point of affixing blame for the current state of affairs because it is difficult to focus on solutions starting now when staring at the bad actors. I believe we need to remember who are the players in the current disrepair because they do not change their spots–not without a gun to their heads.
In civilized human societies, to achieve the same affect, we the people have to use our government. (We could always use a literal gun to someone’s literal head, but that would be criminal and none of us wants that at all.)
Clearly, I am not alone in my experience of being in the “donut hole” of not being poor enough to qualify for Medicare/caid (providers of which are becoming fewer because of how payment by those agencies is *rationed*– rationing is happening now), not being wealthy enough to afford individual medical insurance (I am not an employee) compounded by having a pre-existing condition.
It is painfully disheartening to hear enough otherwise thoughtful and caring persons opine, vigorously, that unless you buy your own health care you are simply not entitled to any health care. The herd must keep moving and if you can’t keep up, tough.
Are we a civilization, or more like those we choose to worship, or are we trying to promulgate Darwin?
When you fear for your very ability to live a safe, clean, minimal* lifestyle, because you are considered a member of a circumstance-created, market-model exacerbated, medical-community enabled minority, it is not just enough to make you sad, it is terrifying.
*Minimal in that just the bare essentials are donated to you, at great defeat of your self-image; there is a tearing down of your self-respect any time you are in the place of having to accept the kindness of strangers. No vacations, no movie theatres, no concerts. You will live in dangerous neighborhoods, but expect no donations to arm yourself legally.
I do not want a larger still government, populated with people who know how to pass government employment tests, and can wait around for the job to get offered to them, and who will proceed to follow the letter of doing the minimum required, the spirit of the rule be damned.
I continue to seek and explore viable solutions, rather than just denouncing the other side or repeating what I don’t want.
I also pray I, and people like me, won’t be left in the dust.
July 14th, 2009 | 1:52 pm | #25
If I may, JuliB commented about something that brings up an important issue: waivers.
There are many doctors, if not nearly all, who require, they not offer it as an option, they require that you sign, prophylactically, a waiver of your right to access the judicial system.
Under the market-only model, a sick person is then expected to choose, right there, if they are willing to give up a HUGE right. It is called a deal with the devil.
I continue to remind people that if the judicial system were to be moderated in how much market-driven lawyers can charge, not how much can be collected, how much they can charge, a lot of the misuse of the courts would go away overnight. Judges are ex-lawyers, which means they owe allegiance to their brethren and too often allow frivolous cases to go forward in order to keep business flowing.
Yes, what a person charges can be moderated, I’ll give you an example: notary publics.
As long as we continue to listen to defense lawyers trying to convince us that it is everyone’s fault but theirs, the louder we should hear what they aren’t telling us.
July 14th, 2009 | 3:50 pm | #26
Alexa, doctors may require people to sign these waivers, but I’ll be very surprised if any judge agrees to enforce them. I’d bet they aren’t worth the paper they’re written on.
I’m a qualified supporter of national healthcare under the theory that every person’s life is of equal value and therefore should have, to the extent humanly possible, equal access to health. But I am very much opposed to the methods our government is using to make it happen.
Cltinon’s and Obama’s “one fell swoop” massive entitlement nobody understands or has even read, “quick let’s pass it before anybody organizes to block it” method is guaranteed to be a huge disaster.
For me to support it and go out there and argue for it, it needs to be a long (years long) process of public debate, careful comparative examination of the systems of different countries and an honest thorough discussion of the pros and cons of each method proposed.
Until we get that, I can’t bring myself to jump on board.
July 14th, 2009 | 4:33 pm | #27
Thanks for the complement Alexa. Usually the only good point I make here is the one on top of my head.
July 15th, 2009 | 3:04 pm | #28
I shared your loss of a trusted pediatrician several years ago when my youngest turned 19 and the office staff “suggested” that she should be seen by another doctor, even though I was previously told that this office would see her until 21. On our last visit to the pediatrician, we received names of physicians he recommended and I thanked him for his care of my special needs girl. About a year later, I received a phone call from him after he read my daughter’s obituary in the paper. He wondered, first, if it was the same Holly he had taken care of; and then, of course, he asked what had happened. It touched me that he took the time to call. Good doctors are rare, and worth the money it takes to see them.
July 15th, 2009 | 5:01 pm | #29
I literally forgot to say something in my original comment and I’m kicking myself over it: I pray Buster will be ok! I’m also thankful he is young; in these matters, that is a major plus.
Joseph Marshall, you’re welcome; credit where due. I seriously doubt you have a conehead (unless you are from France). (Sometimes, when someone applies a little self-deprecating humor suggesting a pointy skull, I think of Oblio (“The Point!”).)
Tim Maguire, if the up-front waivers are mere fig leafs, then I want to know the stats of how many people have successfully sued a doctor and gone to court, over-riding the waiver. I will bet you that very few. Largely because the naive patient will be reminded that they agreed, they “voluntarily agreed,” to not seek court relief. Game over. Only the truly desperate or truly avaricious will push past it.
I am not arguing for the “government” plan, but I’m not arguing against it, either. I haven’t been able to read the House version of the bill yet (1000 pages)! (The House and Senate version are consolidated.)
I fully expect it will have enough to anger everyone. Consensus births bizarre results.
Time is running very short. If viable alternatives are in play where Congress is aware of them, aside from that by Congressman John Shadegg, then I’d love to know of it.
Long, slow, deliberation *has been happening*, for years, many years, already. What has *also* been happening is lobbying, wrangling, wrestling, stalling, lying, misdirecting, blaming, shaming, back-room dealing, hiding, scaring and denying. By the vocal and shadow extremes of all sides.
That has made me wary and weary.
I wish I could be sure money would not be stolen away by the capitalist opportunists or the socialist opportunists or the bureaucrat opportunists. But humans are a greedy species. Greed will use any method that works, and until we spend more time reducing *greed* in our society, we will continue to suffer.
The only people who do not get their greed fed are the people who just don’t have the energy or resources to pull it off, if they were so inclined, just out of self-defense.
So long as capitalists scream at me that if UHC is foisted on them, they will leave the country, then I will hate them. Because they think I should help them protect their right to get away with anything. While They Scream At Me That My Health Is My Personal Problem Alone. If paying for health care did not include paying for that of a lot of people who didn’t pay their medical bill, then ok. But thanks to capitalism-only, their costs are passed along to me, and you.
Do you have someone to pass along those costs to? Because I don’t. And strict capitalists Never Talk About That, Do They. If passing along costs is good for them, then why isn’t it good for me and you?
So long as socialists mewl at me that if the weight of UHC is not evenly distributed onto everyone, then soon we will see people dying on the streets from lack of health care, I will remember HMOs and the idiocy that created and I will hide the guns they will start telling me are unhealthy for me.
But I also think of the homeless who literally are dying not in the streets, but in the alley. Or under the freeway overpass. Or in flophouses. The tragic life of USMC Pvt Henry J P Landry and nearly anonymous death is heavy on my mind.
At one time Pvt Landry was more than a member of the fittest. But stuff happened. Most of which we’ll have to imagine. Was he, and thousands like him, mentally/emotionally ill due to homelessness (or did he became homeless because he was already mentally/emotionally ill)? He started a member of a good minority and became a member of a not worthy minority. He was not even close to being fit enough to fight City Hall.
Trust me. Those of us on the outside looking in are not “rejoicing” but hoping to heave a sigh of relief. Had the status quo fixed the problems on their own, we wouldn’t be facing a sea change that is terrifying to many because it is not their idea. The capitalist-only crowd had *decades* within which to innovate. Why didn’t they?
I am just learning that the House and Senate bill are integrated and only one bill is in consideration.
I am also having a rueful chuckle over Rep Kevin Brady’s reductio ad absurdum “flow chart” of the bill.
Oh yeah? Compared to the worm mass of holding corporations, sub-corps, shadow-corps, off-shore corps, LLCs, barely brick & mortar corp addressed, tax-evading, asset-shuffling, blame-slippery business “choke charts”?
I am still willing to listen to actual solutions, not refusniking.
(Dang, I can go on. I’m shutting up now (’bout dang time). Thank you for your kind hosting and generous bandwidth Anchoress.)
July 15th, 2009 | 10:38 pm | #30
Yay! Not a hernia, good. Hopefully, something easy to treat with medicine.
July 20th, 2009 | 3:47 pm | #31
[...] decide on the healthcare of patients. I agree; I would prefer to go to free market systems in which doctors with whom patients have histories are able to decide on treatment regimens. Healthcare providers are usually in the business because [...]
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