A liberal's plea: Health care is too important to screw up

By Edward Copeland

(Please take the time to read this important post. Edward has been dealing with some pretty serious health issues recently, notably MS, and his experiences with the health-care system provide him with sound insight into what a more fair and equitable system would be. As always, all of us at The Reaction wish good health and send our warmest regards to our friend and fellow blogger, a valued member of our team. -- MJWS)

I have to go to the trouble of identifying myself as a liberal before I begin talking about the health care reform process because every time I say that I actually have good health insurance, that I'm not from the privileged class and not all insurers are created equally evil while it's been my experience that hospitals, most health care services and especially those who carry out billing for health care providers usually are the bad guys, I'm immediately accused of regurgitating right-wing talking points.

I do realize that there are plenty of bad actors out there in the health insurance industry, requiring pre-approval for tests, denying coverage for preexisting conditions, etc. However, my own personal experience has been something different and for that I know I'm fortunate (at least in terms of the insurance I have, not the hospitals I've dealt with). What strikes me as I listen to the pundits and the politicians blather back and forth is that it seems that none of them act as if they've actually had any experiences with the health care system, at least on the level of the average American.

That's why this sudden rush (as sudden as a rush can be for something that began being discussed during the Truman Administration can be) makes me ill at ease, admittedly for selfish reasons. Also because Congress' track record for legislation passed quickly is a piss-poor one. The argument for speed is that next year will be an election year and 2011 will be heading toward the next presidential cycle, but that's a load of bullshit. There's always an election around the corner and there is never a date on the calendar when Congress isn't populated by politicians and health care is too important for political gamesmanship.

Just take a quick look back at some of the fruits of quick legislation: approval for military action in Iraq (helped by Dems fearful of upcoming elections) which allowed the Taliban to regain ground in Afghanistan, further destabilize Pakistan and cut short weapons inspections in Iraq; Hank Paulson and the gang yelling the sky is falling, yet AIG coming back for more and more, the auto industry getting the shaft as Bush kicked the can down the road and bankruptcy happened anyway; the Patriot Act, etc.

A little background on what brought me to my point of view that not all insurers are bad, but most hospitals and health providers are. (In some nice timing, the American Medical Association, the supposedly good-hearted organization representing doctors, finally came out of the closet, as it always does, in opposition to reform. It's a simple truism: doctors have no financial incentive to get people well; there's no money in that.) I started developing all sorts of health problems that a myriad of doctors couldn't get a handle on until after two years of tests and trying and firing a few physicians (word of advice: it's good to remind doctors from time to time that they are the employee and you are the employer and fire their ass), I finally got the right neurologist who took the right test and who diagnosed me in January 2005 with primary progressive multiple sclerosis.

At no time during this long, arduous process did my insurer deny me a test and for all the complaints about being restricted to in-network and out-of-network, the insurer saved me money. Sure, the amounts deducted from my paycheck rose slightly over the years and co-pays rose a whopping $5 a year once for the entire time I worked at my newspaper. I managed to keep working for three years with my m.s. before I had to go on disability. Going against my instincts, I agreed with my urologist to have surgery to install a suprapubic catheter, an event that has irreparably damaged my life since, leaving me bedridden since May 2008 along with other side effects including a massive bedsore and other ailments. Needless to say, my medical costs are huge, but my after I reach a certain amount of out-of-pocket expenses a year, I have nothing to pay for most hospital expenses. It also has had me hospitalized for about 4 months total at three different hospitals over the past year.

It's those hospital stays where I truly became grateful for the insurance I have since all the hospitals, the not-for-profit and for-profit alike, have one thing in common: patient care falls way behind saving money. There is a nationwide nursing shortage and they still understaff on purpose. Thermometers and blood pressure machines break down so there is a rush to grab the working ones first, either delaying the taking of patient vital signs or skipping them all together. Don't even hope you'll get a timely response if you hit the call button. You might as well be trying to change a walk/don't walk sign.

Hospital administrators also love to lie and try to blame anything they can on insurers, which can usually work except they are usually some of the worst liars on the face of the earth. At the for-profit hospital I stayed at, the problems were so many and since we could get no satisfaction from the bosses there, I went over their heads to their corporate bosses. Needless to say, they were anxious to get me out of their hospital, whether my health was good enough or not. Even though we would need a special bed and a lift at my home for my parents to be able to take care of me, the hospital case manager said that I was probably going to be discharged that day but she'd check with our insurer. Unbeknownst to her, we'd already talked to our insurance case manager who had already approved me for extra days to allow for time for my house to be equipped. Sure enough, the hospital case manager came back and said that our insurer said that I had to leave that day. It was hard for my father and I to keep a straight face and told her we'd try and of course the insurer told her that we had the extra days.

So, obviously I have selfish reasons to be worried by any rushed plan. This isn't to say I'm not sympathetic to those with bad insurance or no insurance at all, but I think hasty legislation makes for lousy legislation and any health care reform should include not just efforts at cost containment and universal coverage but regulation of the way hospitals operate and especially how they conduct their billing operations, which often makes Wall Street accounting look pristine.

I also worry about how this will be paid. If I hear Sen. Kent Conrad say one more time that they may tax the benefits of the "Cadillac plans," I'll puke. I have a great plan, but it's not a Cadillac and I would say, you cough up first, Sen. Conrad. That's something I'd like to see journalists do: Truly report on what kind of health insurance members of Congress have. Maybe that is the simplest plan of all: How about letting all the uninsured buy into their plan and have Congress cut some of their perks.