Tuesday, April 10, 2007

The Young Invincibles

New York Magazine has a fascinating, and depressing, story about health care in the United States:

The article is about young Americans who are under-employed, and can't afford health insurance, living in New York. They include a young man with titanium pins in his back who can't afford the twice yearly checkups, or the carpenter who carries his own suture kit, the woman who walked around for days with a bad cough only to eventually head to a walk-in clinic... and discover she had tuberculosis.

The story about the young man with appendicitis is particularly alarming. Not only did he get sub-level care, he was looking at a staggering bill until he was forced to use the "m" word — malpractice.

Alana and I have to deal with health insurance issues ourselves. We really can't afford the $500+ a month we're paying for insurance for us and Logan, but we can't afford not to have it, particularly since Alana is now on insulin. I thought about dropping off insurance myself, but Alana won't allow it. Probably just as well, as insurance companies penalize you when you finally get into a plan if you haven't been insured for 6 months prior to signing up. (This happened to me; they wouldn't take the fact that I was covered by Ontario's government-sponsored plan as "insurance".)

Our insurance company, Vantage, is no longer offered to State of Louisiana employees in this region. The replacement, Humana, is available elsewhere in the state. It's less expensive than Vantage, which is good. Unfortunately neither of our doctors takes Humana (although Logan's does), so we have to find new primary care physicians. I like my doctor well enough, so that's a pain. Alana is unimpressed with her doctor, so she was in the market for a new doctor anyway. The trick is going to be finding one in this area. There aren't that many that take this insurance plan, as it's fairly new.

Having an insurance company dictate your choice in doctor isn't exactly what you expect from a country that prides itself on liberty. At least we have a choice; the uninsured do not.

I have a friend in Canada who bemoans the state of Ontario's health care. He heard an earful from me. Having lived under both country's systems, I can say that the Americans get woefully bad health insurance coverage for the money.

I don't think it will change, though. There is too much money at stake, and too big a fear of "socialized medicine". I suspect the only thing that will change the system is if the number of uninsured becomes vast enough that a fast-moving spiral takes hold. Prices shoot through the roof, more people drop their insurance, resulting in higher rates for those left behind, which causes more to drop off. Then maybe something will be done, given all the doctors and hospitals who would be unable to collect a growing number of hospital and visit bills from the uninsured.

This is assuming that the economy survives such a catastrophe.

Unfortunately, we'd be among some of the earliest victims. It's the sort of thing that keeps you awake at night... and feeling not the least bit invincible.


Michael said...

Geez, I really feel for you guys. That has to really inhale.

I'm convinced that most of the people who "fear" socialized medicine would have dramatically different attitudes were they to actually spend some time in a place like Canada or France or Sweden. Most of the "fear" is, I think, deliberately manufactured by the insurance industry as a way of protecting a lucrative business.

This isn't to say publicly funded health care is flawless: there are doctor shortages in Canada and waiting lists for many forms of treatment.

But I know people across a broad range of the income spectrum, and nobody I know has ever had to go without medical care when they needed it. And that's the bottom line that more people should be paying attention to.

Allan Goodall said...

But I know people across a broad range of the income spectrum, and nobody I know has ever had to go without medical care when they needed it. And that's the bottom line that more people should be paying attention to.

That's a very good point.

There is a real fear of the term "socialized medicine" down here. There are those, I'm firmly convinced, who believe that universal health care would somehow diminish the country and send it down a path toward socialism.

Of course the people most likely to be adversely affected by socialized medicine, the wealthy, are also the ones with the most political clout.

Alana sees many people in her job who complain about what a crappy job the government does in helping seniors with their medical bills. Sometimes it's all she can do to refrain from yelling, "Why weren't you paying attention all those times you voted for people who created the health care system in place today!" (Okay, Alana's rant would have been more succinct, and probably with an expletive or two, but you get the point.)