Spay or Neuter Please!

Alter's Sarcasm

I’m a fan of the journalist and author Jonathan Alter. I have seen him on TV a number of times and he wrote a great book on FDR’s first 100 days in office. I always thought he was pretty progressive in his thinking so I was surprised when I saw that he wrote an article called, “What’s Not to Like? Why do we need health-care reform? Everything is just fine the way it is.”

I quickly learned he was being satirical and I want to share a few important points. I’m very serious here. Dealing with health insurance throughout Heidi’s cancer and recovery has been a nightmare and we have had insurance the entire time. But here are a few thoughts by Alter:

I’m with the woman who wrote the president complaining about “social medicine” and added: “Now keep your hands off my Medicare.” That’s the spirit!

Please, please, please tell me you know the difference between Medicare and socialized medicine. Do you? Well, there is none. It might be hard to believe but Medicare is socialized medicine for everyone over 65. The only qualification is a social security number and 65 years of age and then you are guaranteed coverage.

I work in hospice care and we have far more problems with private insurance than we do with Medicare. Get this; many insurance companies only want to pay for six months of hospice care while Medicare is indefinite. So, if you are terminally ill but you take longer than six months to die…well, you have to come up with the $140 a day for hospice care. Good luck!

I had cancer a few years ago. I like the fact that if I lose my job, I won’t be able to get any insurance because of my illness…I like the choice I’d face if…the cancer recurs – sell my house to pay hundreds of thousands of dollars in treatment or die.

When Heidi moved to Texas we were naïve. We thought since her insurance had never lapsed we could purchase private insurance. Yeah, right! No insurance company will cover Heidi as a private pay client for at least 10 years.

Instead we had to purchase insurance through the COBRA program (at least we had this option, thanks President Clinton). It is expensive but it works and saved us twice. When you quit your job you can continue to pay for your previous plan for up to 18 months. But there is a catch; you pay 103% of the premiums. In our case it was over $600 a month…just for Heidi.

Medical expenses are involved in over 60% of US bankruptcies…wonderful. If you do not have insurance and you have a pre-existing condition I feel for you…you are already screwed but you just don’t know it yet. Don’t think for a second your case is special, you are not an exception.

I like the “lifetime limits” that many policies have today. Missed the fine print on that one, did you? It means that after you exceed a certain amount of reimbursement, you don’t get anything from the insurance company. That’s fair.

I believe the typical lifetime limit is 5 million. Heidi’s ordeal cost half a million so hopefully costs don’t keep going up too much or she might run out of dinero.

It’s a long story but a very successful and wealthy family once sued me because of this clause. I was involved in a fender-bender with a retired NFL linebacker. Over 20 years after leaving the NFL he had dozens of surgeries on his back and legs and burned up the 5 million allotment. Four years after our fender-bender he died and his family sued me for wrongful death in a vain attempt to pay of some of his medical bills. The case was thrown out.

Speaking of fair, it seems fair to me that cost-cutting bureaucrats at the insurance companies – not doctors – decide what’s reimbursable. After all, the insurance companies know best.

This is one of my favorite stupid arguments: “My healthcare should be between my doctor and myself and a politician should not be involved.” ARE YOU SERIOUS?! Do you really think your care is between you and your doctor?! I hate to break it to you but you don’t have a single thing done without the permission of your insurance company. The End.

Two stories, first Heidi and I had good insurance, PPO not HMO (If you don’t know the difference you need to learn ASAP). On one occasion Heidi had a two-inch needle stuck in her chest to administer meds. However, the doctor forgot to authorize a certain med, one she had already received several times before, and they had to call the insurance company for permission. Forty-five minutes later Heidi still had a two-inch needle in her chest, as we waited for the insurance company – not her doctor – to determine the med was a necessary.

Second story, my work changed insurance companies just before Heidi’s last chemo treatment. So despite already having 13 rounds of chemo according to the procedures set by doctors, the insurance company was not sure if Heidi needed one more round. Heidi was supposed to go into the hospital for her final treatment on a Monday…we got in on Thursday.

Don’t fool yourselves into thinking your care is between you and your doctor. Sure, the doctor tells you what needs to be done but it doesn’t get done until the insurance company says so. I’d rather have a politician, who is not in it to make money, than insurance companies, who actually make more money if you don’t receive care, determine treatment plans.

And how could the supporters of these reform bills believe in anything as stupid as a “public option”? Do they really believe that the health-insurance cartel deserves a little competition to keep them honest? Back in the day they had a word for competition. A bad word. They called it capitalism. FedEx versus the US Postal Service, CNN versus PBS - just because it’s government backed doesn’t mean you can’t compete against it. If they believed in capitalism, the insurance companies would join the fray and compete.

Who stands to lose the most with healthcare reform? Not the doctors, they’ll always make money. Perhaps a little less but they’ll still be plenty wealthy. Hospitals? Nope again, in fact they probably would get more reimbursed because most people entering their doors would have some sort of coverage. Those that stand to lose the most are the insurance companies and that is why they are spending over 1 million dollars a day on lobbyists to make sure things stay the way that they are.

The villain is not the government here, it is the insurance companies that have taken us all to town over the past several decades. I want to be optimistic but thanks to money-grubbing insurance barons our system is probably too screwed up to fix. We beg you, if you do not have insurance you better get some soon because if you don’t and something bad happens…well, you just better hope that doesn’t happen.

Was that a real happy entry or what?