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Friday, September 04, 2009

A Guest contribution

As of this moment, 324 people have visited this blog this morning, making a total of over 3500 since Monday, which I am pretty certain is a record by a wide margin. Most of them, sadly, have come here thanks to an anonymously written right-wing email that some one attributed to myself last spring. Because the hysterical campaign against the President is growing in volume, the circulation of the email is growing as well. (You can read the full history of the email here.\\

Meanwhile, however, the increased traffic has in one way or another brought interested people to the site, people with something to say about health care and other issues. One such just posted a comment--and I would like to ask everyone who gets here today to go ahead and read it and ask yourself if you are really satisfied with the health care in this country.

My thanks to the author, whose story is far more eloquent on this topic than I could ever be.

"Re NHS services in the U.K: Our daughter spent six months (2002-2003) as an undergrad student at Pembroke College in Cambridge. We were urged to purchase student health insurance coverage for her despite the presence of NHS in England, and we did so. It was a waste of money. She had one brief illness while there and did consult with a physician. As with David's experience above, she found the NHS the way to go, and also found that her "insurance" was more of a hindrance than help.

"We are a blue collar couple in our late 50's. My husband is clinging to his physically demanding job despite severe rheumatoid arthritis that leaves him in pain at the end of each work day. Every time he sees his rheumatologist he's told to quit. He stays because our health insurance is tied to his job and because I also have a chronic condition that would go untreated without insurance. We have a profoundly autistic son who was just kicked off our insurance arbitrarily at age 22, despite our repeated compliance in providing physician's forms certifying that he is never going to be able to care for himself. If his care defaults to Medi-Cal, he will not be able to see his present neurologist for care of epilepsy and our area has no other neurologists who will accept Medi-Cal as payment. He will also be refused dental care (but cannot speak to tell us when his teeth hurt). We lost our home years ago as a result of having to pay childhood medical bills for our son during the very early years of the explosion of autism--years when insurance companies classified autism as a non-covered mental illness. Doctors in every specialty including family practice who accept Medi-Cal are all but nonexistent in our area. I'll be spending today working to again prove our autistic son's disability to the insurance company.

"Meanwhile, our grad student daughter's (History, U.C. Irvine)insurance comes & goes, entirely dependent on when she is actively working as an instructor as opposed to periods of fellowship work on her PhD. She is the poster child for starving student; she's done it all on her own because she had to, but she is also only one serious illness away from losing all she has worked so hard for.

"Our oldest son followed his father into a service trade and has a wife and two children. While the trade is one that blessedly has not yet experienced deep layoffs, our greatest collective fear as a family is loss of that all important job--not because we could not eat or pay the rent (we'd figure that out) but because we'd lose our health care.

"Something must change, and I voted for change. I pray that President Obama hits this one out of the metaphorical park. We need it.

"I arrived here as a result of that awful forwarded email. I'm glad I found your blog. I'm not a regular on any blog, but I enjoy your insight and will return!"

In response I am going to share a story of my own.

William Strauss, as many of you know, was my college classmate, close friend, adn the co-author of the theory of generations and turnings upon which so many of these commentaries is based. He actually earned his living for the last 25 years or so of his life as the producer of the comedy troop, the Capitol Steps. He and his co-owner provided a health plan to all the members of the troop--about 25 of them I think.

In 1999 Bill got pancreatic cancer. Fortunately he was a candidate for a new procedure that initially restored him to full health and left his pancreas cancer-free for the rest of his life. However, within a few years the cancer was in his liver as well, and between 1999 and 2007, when he died, he had several chemotherapy treatments that required significant hospitalizations. The interesting part of the story is that just a couple of years after his operation, as I recall it, the insurance company informed the Capitol Steps that there was going to be an enormous increase in their group premium--more than 100%, as I remember. It was obvious what was happening: they wanted to recover the money they had had to pay out on Bill's treatment! Since the enterprise could not afford the increase, Bill dropped out of the plan--fortunately he was able to get insurance through his wife, a public servant. Otherwise he would have gone bankrupt, died years earlier than he did, or both.

Yes, readers, there is a very serious health care problem in America that needs--I will not shrink from the word--a radical solution.


StV said...

One of the significant differences between US and other Anglo cultures (I am an Australian) is that the US seems to have been established by various religious (and other) groups seeking freedom. They basically established their own communities and established strong local laws so that their communities could live free of state or federal oversight.

One of the unintended consequences of this trend was less identification with remote government and with the greater community in general.

Your reader's story is common across the entire country but the attitude of those without serious illness in their lives is "That's your problem" or "That's your choice". It seems very easy to divide this country by appealing to "freedom of choice", in part because of the historical roots.

This desire to isolate one's own self/community from the rest of the country scarcely exists in the UK or Australia or Canada and may be one of the key impediments to reform.

Anonymous said...

My question regarding health care reform is based on my own misfortune. After months of hospitalization for a chronic condition, my finances took a beating when the insurance would not pay.

While the lure of more universal health care for all may seem attractive in that everyone would have coverage, the debate continues whether that care would be at a higher standard. Also, a "socialist" ideal such as it is, is repulsive to most conservatives. Therefore, my question is this: What "radical" change in health care would you suggest to adopt that would maintain a high level of care at affordable prices while maintaining our traditional mindset of democracy over socialism?

Connie Cuellar said...
This comment has been removed by the author.
Nur-al-Cubicle said...

What we need is an Aneurin Bevin and we ain't got one. It's so comic when opponents to US NHS moan about the price tag. The UK instituted NHS when it was dead broke.

Anonymous said...

I am one of those who found your blog through that obnoxious letter. BTW, I saw it on a discussion board, where it was quickly rebutted and mercifully forgotten; so ends that story.

However, the two compelling accounts in your current post notwithstanding, I must oppose the current healthcare reform proposals. My reasons have nothing do do with any alleged “death panels” or other scare tactics from the right, but hopefully will be appreciated even by those who may disagree.

First, as a career civil servant (a term merely two-thirds as untruthful as the name “Holy Roman Empire”), I have an unbounded faith in the Federal government’s ability to mess up any good idea, to smother it in paperwork, to grind all progress to a halt, and to do so at at least 200% of current costs. I could give examples, but I need to retain my employment. I am sure (and say with only moderate sarcasm) that this is not the case in Great Britain, etc., however the sad truth is that our government’s track record shows that nearly any major intervention into any industry by it is ultimately a financial disaster.

Second, I think that without a significant tort reform component, any attempt to control costs through a Federal scheme is failed before it begins. Frankly, I would venture that a large fraction of any additional public outlays would simply go to line lawyers’ pockets.

Third, I have seen no indication that the proposed reforms would in any way reduce paperwork, lead to greater transparency in medical billing, or help decouple health insurance from employment. (Aside: why IS my health insurance tied to my job? My car insurance isn’t, my home insurance isn’t. Apart from a poorly-designed leftover labor practice left over from WWII, why is health insurance the exception?)

Fourth, I am profoundly suspicious -- no, absolutely resent -- that the Congress, under intense pressure from the current administration, tried to force a half-baked bill through before a scheduled recess. It is all too reminiscent of the PATRIOT Act, where the urge to do something now overcame rational debate, ultimately leaving us with a giant mess to clean up over the next few decades.

Fifth, I sincerely doubt our country’s ability to afford the programs, judging by cost estimates I have seen so far. Yes, doing nothing would be incredibly shortsighted and costly too, but let’s not go jumping ot of the frying pan into the fire. In these days of trillion-dollar deficits, I think it is absolutely unconscionable that the Congress is contemplating yet another massive spending program.

Now, having said all this, I do agree that healthcare funding is long overdue for a complete overhaul. The specifics are for another time and place, but let me conclude with this: the current calls to rush out and blow yet another fortune on yet another ill-though out program fill me with twin senses of impending doom and creeping poverty.

In closing, thank you for an excellent blog, and I will be sure to visit on a regular basis.

Nur-al-Cubicle said...

Career civil servants, enjoying a government-funded healthcare cocoon, may not have a clue what it's like for the rest of us, who are obliged to fling ourselves on the mercy of our private sector employers' P.T. Barnum heath insurance schemes until age 65, when we are all jettisoned on Medicare.

As to "nearly any major intervention into any industry by it is ultimately a financial disaster." Pardon me, but I just have to bust this myth.

What about the commercial aviation industry? For starters, the Federal Government funds every airport in the country and pays the tab for baggage inspection and air traffic control for a vast network. And then there's the maritime transportation industry (the Government's plays an essential role in maintaining infrastructures of all kinds). The heath care industry: CDC, National Institutes of Health. The pharmaceutical industry: FDA. The Internet? Didn't the Government just save our collective necks from financial wipeout? (Acutely aware of this b/c my well-to-do grandparents lost everything in the Great Depression.) I don't think such roles (to mention only a few) played by the US Government are being ridiculed or considered unnecessary and wasteful.

Our government is already heavily involved in our lives and I think it's doing a good job in performing the role required of a modern state. Government-sponsored health insurance is as welcome as rain in Texas in my book. It's plain to see that the costs of private health insurance are skyrocketing and that within a few years health insurance be unaffordable for most Americans.

Anonymous said...

>> Career civil servants, enjoying a government-funded healthcare cocoon, may not have a clue what it's like for the rest of us,<<
As the former V.P. of a small company, I very much am aware of healthcare costs. And to repeat: I do agree that healthcare funding is long overdue for a complete overhaul.

>>As to "nearly any major intervention into any industry by it is ultimately a financial disaster." Pardon me, but I just have to bust this myth.

What about the commercial aviation industry? <<

Ah, you mean like when the Carter administration largely deregulated the industry? Yes, that was one of the few things they got right, and air fares dropped precipitously while services improved over the next decade.

Enough about airlines. Staying on the subject of transportation though, if you want to have a general idea of how a government-run healthcare system would function in America, take a look at Amtrak.

And having written the unholy name of “Amtrak” to get a point across, I’m going to invoke something akin to Godwin’s Law and move on from this pig-wrestle.

Ben Burned said...

What you are looking at being proposed as health care reform, as well as cap and trade, is not about
reforming anything. It's about more government control and intrusion into everyone's lives and just another way to raise taxes which will promptly be wasted. Wasting money is the only thing that government does efficiently.
If you want to improve health care then (1) permit people to get insurance from any company, regardless of where it is being issued from, not just in their own state and (2) tort reform would bring down health care costs to manageable and affordable levels for everyone.
No question that our health care system needs some "refining", but it does not need to be crushed under governmental controls. The fact that so many people are rebelling against this proposal is a testament to people waking up and getting involved, which is exactly what we need. Americans can solve their own problems without the intrusive intervention of a bunch of socialist/elitist politicians.

kingpinbravo said...

Although a legal US resident in that I vote and pay taxes to the USA, I work and live in New Zealand . I do have private U.S. based health insurance which costs me $1600.00 a year. Here a 1/2 hour consult with a GP costs $10.00 no fee for small children . Typically prescription medicine costs less than $15.00 . I had to have an MRI . Had to wait 17 days but there was no charge. USA seriously needs health care reform.

Anonymous said...

I have to agree with Anonymous 9:13. I would add that we're approaching the nadir, or lowest point, of the American cycle. Our era is equivalent to the precivil war years, and to the time when the gilded age started teetering toward the crash and the great depression. I'm afraid we may wind up comparing Obama - a man who might have been our Lincoln, our Roosevelt, our Washington - to Coolidge or more likely (and especially if he gets a second term) to Hoover. The cycles aren't quite so precise of course but I do feel that any "new deal" program we try to enact now will be torn apart by opposing forces.

The ability to move the country toward vast sweeping reforms will come later. That time is not now.

I appreciate your blog and The Road to Dallas was brilliant.

Unknown said...


Your comments expressing fears about Barack Obama was sent to me by a very conservative friend. Your comments were astonishing in that you talked about ACORN but not about Obama supporters such as Oprah Winfrey, Warren Buffet and Penny Pritzker. In your opinion those three are not much more than stupid Marxists with no knowledge as to how the "real' world works. Do you really believe that people as bright as the three I mentioned among thousands of others could not see through or detect that Obama is a lightweight phony? He is not and so far, he has been an exceptionally able president. For one, he has the courage to tell the Black Community that there are "no excuses", and to take on health care reform.

Do you know Lynn Woolsey's life story and why she feels so strongly about health care reform? Woolsey was a young wife of a San Francisco stockbroker and mother of I believe three very young children. Her husband died leaving her with huge debts. A friend found her a job as a clerk in an HR office and from there she recovered but never forgot what had happened to her.

You simply do not want to admit that we tried the "conservative" way of doing things as best shown by the great State of Mississippi circa 1925...about 5% of the opopulation did well while the remaining 95% lived at poverty levels or may be just above.

To close go read the Cato Institute website where you will see that this outstanding group of conservatives admits that yes, there is a health care crisis in America. What took them so long to reach this conclusion?

David Kaiser said...

JRuby -- could you please read the last blog entry, or any of them? Apologies will be accepted.
David Kaiser

Anonymous said...

I was sent your email History Unfolding by a friend and at first pretty much agreed with what I was reading but as the article continued it became clear it was a right wing attemp, once again, to discredit the president. I am so happy that I decided to "google" you and found that actually you never wrote that article and I am enjoying reading all your other articles.