#56 – Dick Bernard: Health Policy Sausage Making
This post is the first of thirteen on the topic of Health Care and the need for its Reform. The rest are at July 26, 27, 29, 30, 31, August 1, 2, 5,6,7,10,15. More will likely be added.
Yesterday my coffee shop friend and I were discussing the issue of Health Care. I mentioned a major (and, I felt, excellent) article I had read in the New Yorker, and when I went home I e-mailed it over to him. ( The article remains accessible at http://tinyurl.com/q5krj3.)
This morning he said he’d read the article and found it useful. “Is the New Yorker liberal?”, he asked. The question puzzled me. I didn’t know, though I guessed it probably was. The reason for the question came out: his spouse is a very liberal activist, and he didn’t know if she’d like the article. Some conclusions at the end might not be exactly what she wanted to hear.
We went our separate ways. But the short conversation between a liberal (me) and a (likely) moderate conservative (my friend) dramatized the huge dilemma faced by anyone hoping to tackle the health care mess in this country: the sides have been chosen, and unfortunately, they’re far more than simply two sides. There are infinite special interests, biases and points of view, and the reluctance to negotiate towards a common ground makes potential resolution extremely messy.
The same day President Obama had his news conference on health care reform, I learned that my 7-year old grandson, a Minnesotan, had been injured and was hospitalized after being thrown from a horse he was riding in a distant state. (He’s still hospitalized, we hope soon to be released.)
Parker is hospitalized in a large children’s hospital in a major U.S. city, but it is 500 miles from his own large city and large children’s hospital.
A neighbor – a nurse – wondered if that other state would have as good medical care as Parker could receive here. Parker’s uncle, whose daily work is with a group of physicians here, told his colleagues what the physicians in the other state were doing, and they backed what their colleague doctors were doing at the other hospital. It was as if there needed to be some local validation of the work by other people with the same qualifications elsewhere.
(We just returned from a trip to Canada. It is odd how one feels a certain sense of relief when finally crossing the border back into the USA, and then into Minnesota, even if some kind of crisis would be as well handled, if not even better, if it happened in Manitoba. It’s how we’re wired, I guess.)
Of course, Parker’s release from the hospital will only begin the adventure for his parents. They have, I think, very good insurance, but then will come the matter of dealing with bills from what is almost viewed as a foreign land. At least they have the insurance. What if Parker had no insurance, or his parents had no money? What then?
Meanwhile, back in the public debate, the sides are reacting basically as could easily be predicted months ago.
The medical industry long ago announced a $100 million war chest to at least control the debate. $100 million is not small change, and can and is being utilized in small and large and diverse ways to successfully disrupt and confuse the public: to bother our minds.
Entrepreneurs are positioning to cash in: medicine is lucrative if you can keep the “public” out of “public health”.
A singular Republican win in this debate will be planting the perception that the President lost, no matter the consequences to the public who elected them. (Their talking points back home, and some responses: http://tinyurl.com/n9qq23)
The 47,000,000 or so who are uninsured, and are the real victims of this charade, won’t be strong advocates in their own defense. A great share of them are young children, and the bulk of the rest are probably poor, whether working or not. They don’t have the luxury of doing all of the things that are required of a citizen lobbyist. Their concern is survival from day to day. Little details like falling off a horse in a distant state are pretty far from their minds. Getting outstanding medical care if they did fall off that horse would be a very iffy proposition.
Meanwhile, the rabble that is all the rest of us, the middle class who will bear the consequences of bad policy or no reform at all, tends to run around in circles, unable, even, to agree amongst ourselves what might be necessary in some reform initiative. For example, for years I have watched the attempt to resolve the issue of merging multiple insurance contracts into a state-wide single system for public school teachers. It is the teachers with the supposedly better policies who have harpooned the efforts for greater efficiency. Other well-meaning people have done and will continue to do the same.
If only we could get our act together and simply speak out to policy makers and shapers “from the heart”. But that is tough to do. Giving up is a common option for us. We are lied to, regularly, by pious sounding people. We tend to take our belief towards supporting our personal bias, whatever that is. We don’t help ourselves in the process.
The President and his advisors know all about this sausage making process and are more than willing to play the game, and a game is exactly what it is – a dangerous game, granted, but a necessary game nonetheless.
How this conversation will actually end, I have no clue.
I am pretty certain, however, that one way or another, putting the issue on the table, and demanding debate, will result in some kind of substantive and important change that will positively impact on everyone.
President Obama knows what he is up against, and it is not pretty. But he deserves acclaim for forcing the issue. At some point, and in some substantive way, there will be something good resulting.
Write that letter, make that call…just do something! Every day.
For those of us with the access to health care because we’re insured, it can be hard to appreciate the plight of others.
As parents of young adults we have always been hyper-aware of and preached the need for being insured. At times that has meant paying COBRA premiums for them.
Our oldest son, TJ, was born with an enzyme deficiency that we knew would some day require the only cure available – an organ transplant. Even knowing that, however, our son could be pretty cavalier about maintaining insurability. When he began to have symptoms of liver disease and other organ involvement in his late 20’s, we were very glad that we’d been able to keep his insurance coverage constant even as he changed jobs or was laid off.
His best insurance coverage came as a trucker with union membership. When he became too sick to continue employment in November 2007, his union covered him for the balance of the year.
Fortunately for him, he’d also gotten married in April 2007 and was able to have continuing coverage under his wife’s policy for about half of the cost of COBRA.
TJ was under the care of the Mayo Clinic transplant program and received excellent care. In April, 2008, however, he died at age 36, while in surgery to receive the liver that they’d been trying to locate for many months.
His wife and step-children were left without a husband and step-father, and we were left without a son, but his medical bills were paid. I can’t imagine our grief compounded by unpaid medical bills.
Single payer health insurance would have reduced much of our anxiety and would not have left such a high degree of “chance” for our son’s medical care.
Perhaps it would also help everyone who can be an organ donor to become a donor. It would significantly reduce the medical costs of those needing transplants if they didn’t have to wait so long for a match. Are you a donor? In Minnesota you only need to say “yes” when you re-new your drivers license!