Karen Tumulty: The Health-Care Crisis Hits Home

The Health-Care Crisis Hits Home
By Karen Tumulty / San Antonio Thursday, Mar. 05, 2009


When you've been strong and fit your whole life, it can be easy to discount your body's first whispers of sickness as merely the side effects of daily living. Looking back over the past three years, my older brother Patrick now understands the meaning of his increasingly frequent bouts of fatigue, his fluctuating appetite and the fact that his blood pressure had crept up to 150/90. But Pat had always put off going to the doctor until he had to. Having bought health insurance that carried a $2,500 deductible, he knew he would have to pay for a checkup himself. That is no small consideration for someone who makes $9 an hour, as my brother did in his job as an administrative assistant for a lighting firm in San Antonio. He also struggles with Asperger's syndrome, a disorder sometimes described as high-functioning autism. Pat can multiply three-digit numbers in his head with ease, but he has trouble accepting the unfamiliar and adjusting to the unforeseen.

The unforeseen was exactly what turned up when Pat went in for a physical on Nov. 30, 2007, his first in five years. The doctor found high levels of blood and protein in his urine, results that were confirmed in another round of tests in December. Soon after that, Pat discovered that his urine had turned brown and foamy. In the middle of all this, he was laid off from his job, and finding a new one while doing temp work was his most pressing concern. Finally, last July my brother's doctor insisted that he see a specialist, who quickly ordered a biopsy. That's when Pat, who is now 54, learned that his kidneys were failing.

The diagnosis was only the first shock. The second came a few weeks later, in an Aug. 5 letter from Pat's health-insurance company. For six years — since losing the last job he had that provided medical coverage — Pat had been faithfully paying premiums to Assurant Health, buying a series of six-month medical policies, one after the other, always hoping he would soon find a job that would include health coverage. Until that happened, "unexpected illnesses and accidents happen every day, and the resulting medical bills can be disastrous," Assurant's website warned. "Safeguard your financial future with Short Term Medical temporary insurance. It provides the peace of mind and health care access you need at a price you can afford."

Kidney failure would seem to be one of those disastrous "unexpected illnesses" that Pat thought he was insuring himself against. But apparently he was wrong. When my mother, panicked, called to tell me that the insurance company was refusing to pay Pat's claims, I told her not to worry; bureaucratic mix-up, I assumed. I said I'd take care of it, bringing to bear my 15 years of experience covering health policy, sitting through endless congressional hearings on the subject and even moderating a presidential candidates' forum on the issue.

Confident of my abilities to sort this out or at least find the right person to fix the problem, I made some calls to the company. I got nowhere. That's when I realized that the national crisis I'd written so much about had just hit home.

more...

http://www.time.com/time/nation/article/0,8599,1883149-1,00.html

for bush. She and milbank were two of the worst bush propagandists.

I know the horrors of dealing with insurance on this issue, of dealing with Medicare advantage plans (there is an advantage for the insurers but not any senior who actually falls sick) and finally finding out the hard way that traditional Medicare was the only health care that took care of him. This is why I am so militant about getting single payer or Medicare for everybody. It works and is the most cost effective system out there. All the BS about waste in Medicare is about a system that can be improved with a little care and thought. I hope future senior citizens don't lose it.

There's a difference.

Health care can be provided in many ways without health insurance being involved.

For example, there can be Medicare for all and community health clinics provide the first level of care.

Or Medicare for all and a person picks their primary doctor. Or Medicare for all and a person picks a group rather than an individual doctor.

And so on, and so on.

Single payer is the only way that I can see.

Worried about all the insurance company employees losing their jobs? Have them bid on providing the administrative support, like they do for companies that are self-insured. Most of the high paid executives can go find meaningful work.

Medicare doesn't pay its executive tens of millions of dollars in bonuses year after year.

if you can call it that, about kidney failure is that Medicare pays for dialysis.

My brother went into kidney failure as a complication of diabetes some years back. He was on dialysis for four years and then got a kidney transplant. The down side of the transplant is that now he's on his own to pay for very expensive meds.

Yet another example of why we need health care for all. And the truly sad thing about this is that Pat's situation is not particularly unusual. Every single day hundreds, maybe thousands of people in this country find themselves sick, or diagnosed with something that needs to be treated, and they just don't have health insurance and they don't have lots of money set asided to pay for it. I honestly can't figure out why anyone in his or her right mind would move to this country these days, given the sorry state of our health care coverage.