Friday, October 3, 2008

Health Care Sinks to Low Priority in Debates


The anticipated VP debate has ended and both candidates held their own, but there was barely a mention of one of the most pressing issues in the United States…health care. Health care inequities and the rising costs have been a concern of Americans for a long time. I know the Wall Street meltdown has eclipsed most everything but I once you describe the “orgy of Wall Street and the greed of big business” for the 10th time, it’s time to move on and talk about your policies for change.

Palin touched on the subject by mentioning the $5,000 tax credit McCain would give for people to buy their own insurance. Biden countered with a long winded (but accurate) explanation of how $5000 wouldn’t really be enough to cover a policy that now costs $12,000 and is currently subsidized with tax breaks to employers.

That was it…end of discussion. What wasn’t said is that McCain’s health proposal would eliminate the tax benefits employers now get so more people would be dropped from work based health care. It would be every man for himself on the open market trying to qualify for insurance, figure out what is covered and purchase policies on their own (with $5,000 credit).

For anyone who has dealt with their insurer and tried to find out what is covered, what their share of charges would be, how to get their doctors paid, how to battle denial of care when they are sick, the McCain plan puts more control (and money) into the hands of insurers. There are no provisions for universal coverage. There are no prohibitions on insurers refusing to cover sick people.

Here’s how it works now in the free marketplace. If you try to buy insurance yourself you must disclose all health risks as well as prior treatments. All past medical records are reviewed by underwriting. I’ve had patients refused coverage for pink eye, prior abnormal (but benign) pap tests, sinusitis, depression, anxiety, abnormal (but benign) mammograms, urinary tract infections, and hair loss. If you have had cancer, diabetes, hypertension etc etc etc you will pay enormous rates or be refused outright. This is called “good business underwriting” and for companies whose goal is to produce profits for shareholders this is the way it should be done.

Is this what we want for our U.S. health care policy?

I will be watching the next debate and I would like to see health care covered in detail, just like they talk on and on about drilling for oil. Everyone knows that is not a solution for our energy policy but that doesn’t stop the discussion. Lets bring health care back into the dialog.

6 comments:

My Prostate's in a Mason Jar by the Door said...

If the discussion on health care had continued:

Moderator: "Governor Palin, please explain your party's health care proposal."

Candidate Palin: “When John McCain was a prisoner of war in Vietnam, they asked him if he wanted to go home and he said no not until those who came before me go home. Well he didn’t get very good health care in the Hanoi Hilton, dontch know, and I think the McCain-Palin ticket will provide some purdy darn good health care when we go to the White House next January, by golly, because every soccer mom knows her young soccer players get twisted ankles and stuff.”

I am not a Joe Biden fan, but Sarah Palin just avoided answering the tough questions.

Comedy Writer Jerry Perisho

Healthnut said...

I don't think either candidate will do much to improve the health care system. When you think about it, it's the government that created the health care mess. By subsidizing corn & sugar, the government essentially created "mass production" of Type 2 diabetes, obesity, and a host of other health related issues.

Anonymous said...

Just to add to the free market insurance problems:

If you have ever been treated for depression, you will be denied mental health care coverage of any type, and you may be denied any kind of medical coverage.

My DH's employer only agreed to put him on the payroll if they didn't have to insure me because I have bipolar disorder. I don't think this is legal, but we agreed to the demand because the job paid well and there were no other opportunities available at the time. It seems providing comprehensive group coverage to one person with mental illness significantly drives up the cost of premiums for the entire company. Apparently, this is a problem for small companies.

PookieMD said...

Last year, my family and I decided to buy our own health insurance as my husband's new company only offered a certain HMO. We are now paying $2500/mo., after being told that my 48 y/o husband was uninsurable because he had a tubular adenoma on colonoscopy, and my daughter who has "mild intermittent asthma" was "uninsurable" as well. I felt like I was living the movie "Sicko". It was enraging, especially because I am a physician myself, and felt if anyone could navigate these waters it would be me. (Ha, not true!) Health care in this country is a disgrace. We are rushing in to save Wall Street tycoons, but leaving behind working class Americans. Physicians should learn all they can about the America's health care system, and lead the charge to change it.

Anonymous said...

I worry about Obama's plan given what has happened to Mass. However, you and anon are correct. HMO's will continue to practice good "business" sense by refusing all but the healthiest in our country. McCain appearsto be completely oblvious to this issue. Additionally his tax "credit" at 5K is not nearly enough for those with significantly higher premiums (ie all those who are not on an employer plan). I personally think the long term answer lies in converting for profit HMO's to strictly non-profit enterprises. This would leave something beyond the single payer system but (hopefully) cut out the gross inefficency and waste of the HMO system. Some mechanism (either government of private) whether it be a high risk pool with government involvement or private needs to be inplace for those with significant comorbidities that preclude typical insurance. Also, catastrophic coverage needsto be in the equation. The top reason for bankruptcy in this country is medical bills. Lastly, to pay for this, americans are going to have to understand that you can't get the moon that your request. Real talks about rationing care will have to be started (ie 90 yo's getting CABG's or dialysis. Outrageous treatment in the last months of ones life, etc). Any of us docs or patients who has ever had significant involvement with HMO's know's that they are not a long term option.

Toni Brayer MD said...

Anon 6:65AM: I couldn't agree more. We do need rational rationing and a complete overhaul of the system. Neither candidate's plan will get us there and they are just perpetuating the dysfunction. Health care profits should not go to wall street. Non-profit organizations make money, but the money is poured back into the community rather than the feeding of the wall street beast.