Saturday, February 28, 2009
Doctors Without (Ethical) Borders
"(Health Care) is a cost that now causes a bankruptcy in America every thirty seconds. By the end of the year, it could cause 1.5 million Americans to lose their homes...It is one of the major reasons why small businesses close their doors and corporations ship jobs overseas...Given these facts, we can no longer afford to put health care reform on hold. So let there be no doubt: (it) cannot wait, it must not wait, and it will not wait another year."
Barack Obama: Address to Joint Session of Congress 2/24/09
Considering that I have lived without health insurance for seventeen years, last week's check-up was pretty good. When I told the doctor that I was excited about the prospect of finally obtaining insurance, he replied that he hoped Obama "wouldn't make him into a federal employee." I would have argued with him, but he was examining my prostate at the time. The doctor knows better than to believe he is about to be drafted into some triage system for the wretched, but he defended his ground because he has been a part of the problem. And the problem has existed for thirty years. Doctors are sort of like truckers: once, a long time ago, they were courteous. Since I am now a "retail" patient, who's insurance cannot be exploited, I have received second-class treatment and taken my seat in the back of the medical bus. I have to enter a doctor's office, hat in hand, and ask for favors and discounts, and thus, have not received the same treatment as an insured patient. Melody urges me to go to the Church Health Center, but I feel I would be taking the place of someone who is truly destitute. I can afford insurance, but the HMOs have determined me "uninsurable." I can't buy it at any price.
Since all the current institutional and infrastructural decay can be traced back to the Reagan administration, that's when the crisis in health care began as well. The nation voted for "less government," and that's what we got. Reagan, the Great De-regulator, was saying it was "Morning in America," but that was mainly for opportunistic capitalists who could see their dreams of unfettered greed finally realized. So the big insurance companies, in collusion with the medical/hospital industry, and the American Medical Association, allowed the formation of the HMO and began herding all citizens into groups of managed care. That was the Conservatives' version of "socialized medicine." I recall having to join the National Council of Jewish Women to get a group rate, but the premiums grew so astronomically that the insurer finally thought better of paying the medical costs for a bunch of elderly, Jewish woman, and dropped the whole group.
Since then, I have been considered an "untouchable." Millions of people take anti-depressants and still obtain insurance. Because mine was initially prescribed by a psychiatrist, I have what is considered a "pre-existing mental condition," which disqualifies me from consideration by the beancounters who decide who's a bad risk for the insurance company. My internist told me to transfer all my records to him and he would prescribe the medication, allowing me the extreme Freudian pleasure of firing my psychiatrist. But when I again applied for coverage, the doctor sent in the same old records and I got the same old answer. So, I am one of those people who fear a catastrophic illness, only more financially than physically. It amazes me that those who can get health insurance are granted it through the workplace, or otherwise have to prove themselves healthy, while others who actually need medical attention are routinely denied. But as long as those papers kept shuffling between doctor's offices, insurance companies, and the government, it was a sweet deal for everyone but the patient. Doctors were so well compensated, they began to think more about Medicare payments and profits than patients. That's why, when you walk into a doctor's office, the first thing they examine is your wallet. And why is it that every time you're in the waiting room, a tight-dressed, spike-heeled, drug representative pulling perks on wheels gets ushered right in?
While the Medical/Pharmaceutical Complex was pulling in huge profits, they failed to re-invest any of it in the upkeep of hospitals. Once the avant-guarde of innovation, hospitals across the country lie in states of decay with antiquated equipment and intrusive devises that are monitored from an understaffed nurses' desk. How could hospitals become the last institutions to embrace new technologies? Confining the ill to be monitored may be a convenience for the doctor, but it has become the equivalent of checking into a seedy hotel for the patient. The last time a relative was at Baptist East, they charged extra for cable on that Motel 6 TV that's been mounted in the corner since 1972. The understaffing is another result of greed within the industry. I'm of an age to have observed several loved ones go through the hospital "system," and their halls are full of only bad memories for me. I only hope that if I'm incapacitated, rather than be hooked up to all that pre-historic shit and left to linger, that I be allowed to go home and die in my own bed. Of course, the technology exists where you could be monitored from home, but where's the profit in that?
I was delighted to hear President Obama announce that health care reform was among his priorities. The Conservatives can scream "socialized medicine" all they like, but that's exactly where we were going with health management organizations that had nothing to do with health, and everything to do with maximizing profits on the backs of the ill. The Right can't tolerate socialistic ideas because they believe they all lead right to Mussolini. But the Bush regime's hands-off, business first policy created no incentive for reform and so health care costs have exploded during the past eight years. Bush's statement that "Too many good docs are getting out of business...Too many OB/GYNs aren't able to practice their love with women across this country," wasn't out of concern for doctors or their patients, he was defending the insurance companies.
Now that we're all in a mid-sociological bungee jump, I wonder how that first big drop is treating everyone's stomach? I first developed stomach problems several years ago and when the doctor asked if I was experiencing any unusual stress, I told him, "I don't know Doc, but it didn't hurt during the Clinton administration." Since then, I've experienced enough invasive procedures to add a wing to his clinic, but they found nothing and since I had no insurance they wanted to spare me the expense of an Ultrasound. Ultimately, the Ultrasound I was forced to purchase turned up an ulcer so aggravated, it even surprised the doctor. It's been treated, but I've been left with a gastric condition that was further enflamed by the stress of no health insurance and no hope of getting it under the previous administration. I can't afford any more "oscopies," so I live with the condition. I have, however, named my pain. So until I am able, and hopefully soon, to obtain some health care coverage, when I am stricken with sudden gastric distress and have to excuse myself, I plan to say, "Pardon me. I have to go take a Bush."