Wednesday, February 25, 2009

Health Care

We received an unexpected surprise in our mailbox the other day. I suffer from a vocal chord disorder called Spasmodic Dysphonia (SD). It is a neurological condition that causes my vocal chords to over contract causing portions of words to get lost. I also have very low volume. For several years I have gotten botox injections to partially paralyze the chords which has given me the ability to speak more clearly for 2-4 months. However, I have not had a successful injection in quite some time. I even stopped getting the very expensive injections for awhile.

Out of desperation I decided to try again last fall. The last two injections I had were done with the aid of a camera threaded down through my nose. It appears that I am now botox resistant which leaves me with no other alternatives for treatment.

Normally, we pay 20% of the cost. Each injection has run $1100 to $1400. My husband also has to go back and forth with the insurance over each bill to get them to pay it. It often requires a call to the company insurance agent. My husband is very involved in the procuring of insurance for the company he works for and has more pull than other employees and is also very familiar with what is covered. It is always very frustrating. Especially when the injections do not work.

The surprise? The insurance is not paying for the last two injections. The last two injections that did not work and were close to $1400. The injections that were done in the office and took around 30 minutes. Apparently, it is now considered a surgical procedure and being applied to our deductible. My husband doesn't know if he'll be able to fight it.

When we've complained about our health care costs to friends and family we've often been met with the... "Well, that is why we need universal health care." Really? There seems to be this belief that if we have universal health care that everything needed will just be covered... no hassle.

I actually wrote the above for a post yesterday and did not finish it. I got frustrated and had to walk away. Last night, watching the State of the Union address, the high cost of health care and the need for health care reform was mentioned...

Universal health care sounds nice... in theory. The United States is the only wealthy industrialized country that does not have it.

In Canada, health care is mostly publicly funded with most services being provided by private corporations/enterprises. Doctors do not receive an annual salary and are paid a fee per visit. Interestingly, many Canadians have private health insurance to cover services that are only partially covered or not at all, such as prescription drugs, dentistry, and vision care.

In my experience, socialized medicine opens the door to a myriad of problems. There is not a limitless supply of money to pay for such programs. There are so many restrictions in place by insurance companies already. However, they are still working within a free market system and have to sell their packages to employers. If the service isn't acceptable or it gets too expensive, the employers go looking for a better deal.

The real problem with health care is trial attorneys. Malpractice insurance is outrageous! There is some sort of expectation that doctors are in control and can fix anything. If a mistake is made, people sue. They sue for BIG money and often get it.

When I was in labor with our second child the catheter for my epidural cracked. They inserted another one. Soon after our daughter was in distress and I was rushed to a delivery room. I was in excruciating pain and scared. Our daughter had moved down into the birth canal so they couldn't do a C-section, the vacuum extractor didn't work, they got another, the cord did not reach the outlet, they put something more into my IV, I had a seizure and stopped breathing, our daughter was in respiratory distress and they were beating on her chest... and my husband got shoved out into the hall. When the bill came... there were dozens of charges that were bogus and many of them duplicated.

My husband did go see an attorney. I had hot needly sensations in my back for 8 months. He went to see him when we were worried about there being long term problems with either our daughter, myself or both of us. He said we had a case and was willing to take it on a contingency. The problem was... we didn't know what the lasting effects were, if any. We just wanted to make sure we were taken care of if there were. He told my husband that we had a year so we decided to wait. We were both fine. I sometimes think about that. The attorney seemed to think we could get some money out of it. It bothered us then and it bothers us now.

How often are you watching TV when an attorney comes on to tell you he'll got to bat for you to get you what you deserve... and then show someone holding up a check for a large amount of money? How many commercials are there for class action lawsuits for medications?

Ugh. I'm just going to post this as is. There is so much to consider but people just don't. We have insurance... but our health care costs are way and above many other people we know. When our son gets sick, one trip to the doctor costs us usually $100-$250 between the co-pay and all the prescriptions (he has asthma). We have health care in place for those that can't afford it. Sure, we could tweak things and something should be done to bring down the costs. I personally know a family that pays $5 per doctor visit, $5 per prescription and $5 to go to the dentist for their kids... and they complain because they have a ton of kids and it adds up. Okay... I am backing away from that one.

Where is the money going to come from? Who is going to set the standards of who receives care and who does not? What kind of availability/access to doctors will there be? What choices will we have? Where will the cut off be for those that automatically get care for their children (I recall seeing somewhere $80,000 a year). I want to know exactly what is being proposed... not just "change."

I want to hear from you. What do you think? What do you know that I don't? (uhhh... probably a lot...but, limit it to health care for today) If you have experience or know of other's experiences in countries with socialized medicine... please share!

11 comments:

Roland Hulme said...

Brilliant post - when Boo was born, we had about 600 or 700 added to our bill that we didn't actually receive service for.

I am divided about this issue - when I came to America, I was STRONGLY against universal health care. Now... Well, it's pretty damn tough for the little people like us to pay our bills and medical costs just go UP and coverage shrinks.

In what other business, too, could you be given a service without knowing if you were going to be required to pay for it or not?

It strikes me that medical billing is an enormous, ineffective waste of time and money.

Health care reform has got to happen one way or the other.

Two Dogs said...

The way that this ridiculous trend is reversed is for you to work out cash terms with your doctor prior to services. Every single doctor has FREE sample packets of drugs, too. Remove the insurance from the equation, too.

I got a broken tooth fixed for 200 bucks last year by paying cash. It would have been 1800 if I filed on my insurance.

Refuse to capitulate to the government intrusion into everything. Seriously.

Coffee Bean said...

It is interesting that you would say that about working something out ahead of time Two Dogs...

Our son got really sick last month. We caught it early at a regular lung check and were able to jump on it. Our doctor regularly gives us free samples... even with that our expenses are incredibly high. Without me even saying anything they asked what our co-pay is... it is $50 for specialists. They made a note for the front desk and cut it in half.

My brother does not have health insurance and was in a bad car wreck in August and lost a bunch of his teeth. By paying cash he was able to get some new ones for a lot less money.

The thing that concerns me most about the government getting involved in health care is having them decide who is worthy of treatment and who is not. That already happens to a certain extent through coverage standards through insurance companies, Medicare/Medicaid and other state sponsored health care programs.

Think about it...

We've all heard about New York's trans fat ban. Is it out of the realm of possibility for certain medical procedures to be withheld from someone that is overweight? Of course, if someone's BMI is above a certain number and the procedure would be risky... yeah. But, what if they decide to go by the standard weight charts?

What if a pre-natal test shows that a baby has a birth defect?

What if a couple has a high probability of having a child with some sort of genetic abnormality?

What if they have a board that sets a standard for what quality of life is?

Believe me, I would like some relief from our health care costs. But... what is the real cost of universal health care or socialized medicine? Just what would we be giving up to get it?

Two Dogs said...

CB, you are ignoring the reality of things here, sorry. Who do you think is going to get the asthma medicine? The white kid with the married parents or the illegal immigrant kid with no daddy? Which is the VICTIM?

Your answer will bother you more than the cost of the medicine.

One Salient Oversight said...

Universal Health Care in other Industrialised countries ends up saving money for all concerned.

The US spends around 15% of GDP on health care costs. Nations like Germany, France, Canada, Australia, etc average around 10% of GDP. Yet the extra money spent by the US has not led to any better health outcomes.

The free health care system we have in Australia is far from perfect - but it's not as if we're trying to create a utopia. It is, however, very comforting to know that when you're sick, you can get a doctor and not have to pay.

BTW - no country actually has 100% government funded health care. Here in Australia, along with all other industrialised nations, we have a combination of free government healthcare paid for by taxes and a private health care system paid for by insurance premiums.

This means that if we're rich enough, we can choose our own doctor and speed up the procedure.

It works.

Coffee Bean said...

Two Dogs,

I'm not ignoring the reality at all. We are the people who pay and who will continue to pay regardless of whatever reforms are made. You have to live by your principles and do what you know is the right thing to do. Life isn't fair.

Two Dogs said...

OSO, not to call you out on your WRONGNESS, but the reason the US costs APPEAR greater is that the RESEARCH costs for the US was figured into the WHO report. No other country's research costs were included. Actually, France pays 13% of their individual INCOME in medical costs versus less than 8% in the US. So, WHICH is actually cheaper? You know, NOT to ignore the little fact that the US makes 48k v. France's 36k, that is about the ONLY way that you can compare dollar for dollar.

So, as usual, you are incorrect based on FACTS.

Coffee Bean said...

Good to hear from you OSO! I was hoping you would chime in. My experience is limited to my life here in the United States and I can only read about the health care systems of other countries. You live in one and know better than I how it works.

I have some questions for you:

1. Can you get in to see a doctor when you need to or do you have to wait days or weeks?

2. Do you know what your infant mortality rates are and how they compare to the United States?

3. Is there a point where the elderly are no longer given treatment?

4. Do you know the percentage of money citizens have to pay in taxes to cover health care for all?

5. Do y'all have programs for those that can't afford the additional insurance coverage for things not covered?

6. Do y'all have problems with malpractice lawsuits?

BLBeamer said...

OSO, please indicate how universal health care would improve the health outcomes in the USA when the biggest contributing factors in American's unsatisfactory health outcomes are caused by:

1. diet
2. smoking
3. obesity
4. stress

Improving one's health is available to every American right this minute and it doesn't cost a penny. In many cases, it saves money.

Roland Hulme said...

OSO wrote: "Yet the extra money spent by the US has not led to any better health outcomes."

I'd have to disagree, moving to America from England. American health care is light years ahead of ours.

Two Dogs said...

Roland, give it up, you are one of US now.