by Lowell Grisham

 

printed in the Northwest Arkansas Times, Fayetteville, AR

August 17, 2009

 

My mom had cancer last year.  After surgery, radiation, and chemo, she's doing great.  Her energy's back, her color is good, and her hair grew back with some attractive extra curl. 

She got great medical care.  She used her choice of physicians, clinics and hospitals.  Happily, she's in her 70's.  That means she's on Medicare.  Some people wrongly call that "socialized" medicine.  Our family thanks God for "socialized" medicine, if that's what you call Medicare.  My mom is well, thanks to Medicare.

Because of the nature of my work, I'm with a lot of people during their illnesses.  I almost never hear of problems or anxieties related to Medicare.  I think we'd all be better off if Medicare were expanded to cover all Americans.  Lots of people breathe a sigh of relief when they reach 65.  They're covered.

On the other hand, I regularly witness the medical problems for the under-65 folks.  The problems are common and abundant.  Lots of people have no access to insurance.  Fewer and fewer employers offer medical insurance.  More than one-fourth of Americans under-65 have no insurance – and those are old 2007 numbers, before the recession.   

I've watched uninsured patients get sent home from the hospital earlier, get screened from access, be charged far more than insured patients for the same procedures, choose between mortgage and drugs, and lose life savings into medical bankruptcy.  It’s tough living without insurance.

Even if you have insurance, if you get ill, you may then have what insurers call a "pre-existing condition," and you may never qualify for insurance again, say if you change jobs.  Some people stay in bad jobs only because they can’t lose their insurance. 

Recently a friend in his early 60's, who has worked all of his life with barely a sick day, had to quit work temporarily for his cancer treatment.  He promptly lost his insurance when he needed it most. 

I see the stress when people are ill.  I've waited with patients as they argue with their insurance company about what their doctors can and can't offer them for their care. 

I'm lucky.  My church pays $14,400 a year for medical insurance for me and my wife.  Not many employers can afford to do that for their workers.  Even at that, my insurance company gives me a list of doctors, clinics and hospitals that are "in-network" and preferred providers.  I've had to choose between hospitals and providers.  My insurance would not cover my preferred providers with the same coverage as their preferred providers.  I have to pre-approve surgery and some other procedures through the insurance company.  Not everything my doctor recommends is covered.  My insurance is about as good as it gets, but my medical care is managed by bureaucrats of an insurance company.

The cost of bureaucracy and paperwork in the private insurance system is 20-31% of the total cost of medical services.  Medicare does their paperwork for only 3-5% of costs.  Who says the private system is more efficient than public systems?

In fact, the U.S. regularly ranks highest in costs and very low in outcomes when we compare our medical care to that of other nations.  We spend 40% more per capita on health care than any other industrialized country.  We are last among them in preventable mortality according to the Commonwealth Fund.  All of those countries have some form of universal coverage.  Among all nations, rich and poor, the U.S. ranks 23rd in infant mortality, 67th in immunization coverage, and low in life expectancy:  21st for men, 20th for women. 

Yet people are screaming at their legislators out of fear that our underperforming health care system might be changed.  Yes, some of it is simple fear.  Some of it is a bias against government, even though there is widespread satisfaction with Medicare. 

Some of the fear is manufactured hysteria for political gain.  Some politicians are willing to sacrifice a rational discussion about improving health for a chance to attack President Obama.  There is no good spin for Sarah Palin's misinterpretation of proposed coverage for hospice planning.  She either violated the 9th Commandment against bearing false witness, or she is astoundingly ignorant. 

We can do better.  We need a better healthcare system.  We need healthcare for all.  We can learn some things from other countries.  And we need a rational discussion.  It is a complicated subject.  It calls for mature study and debate.  Not screaming.  Not political sabotage.  Nobody has a perfect plan.  But right now we pay more and get less than other industrialized country on the planet.  We can do better.