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Donna Smith

Donna Smith, American SiCKO, is executive director of the Health Care for All Colorado Foundation

December 24th, 2009 9:10 AM

A Patient’s View of the Senate Christmas Healthcare Gift

So, all the great fanfare and all the king’s horses. The great and almighty U.S. Senate has spoken. I will have to buy private health insurance – forever, amen. The defective product that has left me wanting for real healthcare for all of my adult life is now a step closer to being the law of the land.

A lump of Christmas coal all polished up with sparkling rhetoric.

Here’s what the Chicago Tribune said this week, and I agree:

On Sunday, the Chicago Tribune published an exhaustive front-page analysis by Northwestern University's Medill News Service and the Center for Responsive Politics of how it was done. The main culprit: "a revolving door between Capitol Hill staffers and lobbying jobs for companies with a stake in health care legislation."

The study found that 13 former congressmen and 166 congressional staffers were actively engaged in lobbying their former colleagues on the bill. The companies they were working for -- some 338 of them -- spent $635 million on lobbying. It was money extremely well spent -- delivering a bill that, by forcing people to buy a shoddy product in a market with no real competition, enshrines into law the public subsidy of private profit.

As we approach the end of Obama's first year in office, this public subsidizing of private profit is becoming something of a habit. It is, after all, exactly what the White House did with the banks. Just as he did with insurance companies, Obama talked tough to the bankers in public, but, when push came to shove, he ended up shoving public money onto their privately held balance sheets.
This is not just bad policy, it's bad politics.

Now, back to my own thoughts as a patient:

I went broke while carrying health insurance, a disability insurance policy and a small healthcare savings account. And if I get sick under this mess of a plan, it will happen to me again. Little has changed except that millions more of my fellow citizens will join my ranks.

How does it happen to insured people under this plan? Easy. Step-by-torturous-step. Slowly. Like water-torture.

1. Buy health insurance at work or on the new exchange;

2. Avoid using insurance due to co-pays, deductibles and out-of-pocket maximum exposures – not to mention lost work time and the worry about losing one’s job in a tough economy;

3. If symptoms are noticed, treat by internet medical site suggestions and over-the-counter drugs until no other option but going to a doctor are available;

4. Attempt to make appointment with doctor but first find one who accepts both new patients and your insurance;

5. Go to doctor and pay co-pay up front before ever speaking to anyone about medical problem;

6. Sit in outer waiting room for as long as required, missing work and worrying;

7. Sit in exam room waiting for doctor for as long as required;

8. See doctor for five or six minutes, if lucky, during which time you will either be prescribed some expensive drug to fix a problem the doctor isn’t sure you have, referred to another doctor who may have a month or two wait for appointments, be directed to get some tests done you aren’t sure your insurance will allow or pay for, and do it all sitting in your underwear or less;

9. Leave medical office owing more than what you thought your insurance and co-pay advertised (and never get an explanation for how that is possible) and never sure if this experience was much different than being to a used car lot where the sales folks have assessed your financing mechanism before showing you anything at all and then only show you what fits the financing not what you need or want;

10. In the alternative, if you collapse or wait until symptoms get so severe that going for an office appointment is impossible, go to an emergency room – repeat steps five through eight – and either be admitted to the hospital if your insurance is adequate and you have any available sick-time from work (if not, beg for drugs and to be released) or go to number nine.

11. Need a dentist? Too bad. Have dental insurance? Still too bad. You might get a cleaning and some x-rays, but getting the care you may or may not need will be again totally related to your ability to pay whatever portion of the dental work is not covered (and amazingly, every penny of what dental insurance will cover will be eaten up by whatever problem you may or may not have) – in the alternative, avoid dentists or just pull teeth as they go bad;

12. When the bills roll in, try to pay some after trying to find out how you can possible owe hundreds if not thousands more than the insurance policy you have indicates is possible;

13. When the collectors call to collect all of the balances due, try to negotiate payments but endure threats of lawsuit, garnishment and worse as the collectors report back to the doctors you saw for a few moments in number eight;

14. Try to get your meds – if too costly, go without;

15. Try to get well – if you cannot, go back to work;

16. Try to act like this is all wonderful and you are grateful to have any insurance at all;

17. Get sued by a collection agency for a doctor bill or hospital bill you cannot cover;

18. Sell your house and use whatever proceeds you have to try to pay some of the debts;

19. Collectors for the doctors and hospitals are not happy if you don’t pay it all in full and up-front most of the time;

20. Feel stress, fear, anguish – but don’t gripe and don’t show it at work – buck it up, chump;

21. Sell keepsakes and anything valuable to try to stay afloat;

22. Stress, more stress. Fear to answer the phone. Friends and family fall away as they don’t want you to ask to borrow money;

23. Keep working – sick or not, keep working or you’ll lose that damn insurance if you cannot pay the premium – or you’ll be back out on the exchange trying to buy another policy that is cheaper and even worse;

24. Watch your elected officials claim victory and history as they work to make sure your kids and grandkids must suffer the same fate if they need healthcare in America;

25. Have a Merry Christmas, so says your U.S. Senate.

Don’t think this can happen to you because it hasn’t yet? Count your blessings this Christmas.

I'd really like the gift of healthcare. Medicare for all, single-payer healthcare would remove so much of this awful process. That would be a gift.

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