Sunday, July 29, 2012

There is Always Blood

It's happened to you and it's happened to me. The car goes in because there's a noise in the engine and the minute you pull into the repair bay the mechanic starts adding up random numbers in his head. He needs to get braces for his youngest girl's teeth and his son needs new shoes and football equipment, and there's college coming up like a speeding car in the rear window. Suddenly, the little noise in the engine becomes a major repair job.

It's expected in a way because the auto repair business is a for profit concern. The mechanic has to make money, as do the bank holding the mortgage on his shop, the utility company, the phone company, and everyone else that keeps his business in business. You are a cog in that wheel.

It's the same with medical expenses. The doctor needs to pay off the student loans that got him or her through medical school, internship, and residency, and the cost of all the equipment to set up shop or dues to the American Medical Association (AMA), and hiring people to answer phones, type reports, file, fix coffee, sit with patients while the doctor examines them, utilities, phones, computers, etc., etc., etc. The doctor expects to make a profit, too.

And then there are hospitals, which seem increasingly more interested in the bottom line than actual health care. Full beds mean revenue which means the stockholders get a big return on their investment and the hospital gets to keep running. And then there are the pharmaceutical companies testing out their drugs in human trials, lots of space age technology to look inside the body and see what's going on, etc., etc., etc. The thing about technology is that one test is never enough. Where there is one, there will also be 3 or 4 or 10 more. And that's just the standard tests, like EGDs, colonoscopies, mammograms, and CT scans. There are thousands of tests and doctors like to use as many of them as possible because more complex tests means more money which is good for their children's future and getting those snazzy new golf clubs and that sports car.

Not all doctors are more interested in the bottom line than in taking care of their patients, but I often wonder which side of the fence they would land on. Diversified stock portfolios, rental properties, vacation homes, maids, drivers, etc., etc., etc. Hospitals are as bad and often worse. That whole full bed means revenue is only good for as long as the hospital makes money on them, and turning over patients is often like turning over pancakes to see if they are done, and the cook is a nervous Nelly that wants the pancakes to cook faster and faster.

Into this mix comes the Big Guilt Trip -- why doesn't America have universal health care yet? Why haven't they joined the rest of the world and jumped on the bandwagon of socialized medicine? Probably because it wouldn't make much money for the doctors paying off student loans and the hospitals paying huge dividends to the stockholders. Or maybe it's because of the socialized in socialized medicine.

Americans must want the poor and indigent to die without a doctor's care because otherwise we would have had socialized medicine by now. After all, the rest of the world (not all of it, just the socialized parts) has jumped on the socialized medicine bandwagon and we should, too. That sounds an awful lot like the arguments I used on my parents when I was a teenager. "Everyone else is going to the parties after the prom. Why can't I?"

I imagine because America isn't a follower and because universal health care has been packaged badly. There's also the question of Medicaid and Medicare, both of which have been in place since the 1960s as part of the whole food stamp, aid to dependent children, and medical care package that we bought when Johnson was president. That was supposed to cover things. Don't forget Blue Cross/Blue Shield insurance that covered everything, and then came the HMOs to muddy the waters, and now it's providing health care for illegal aliens because it's the right thing to do.

HMOs seemed like such a good idea at the time. I had one; it was United Health Care, and I loved it. Low co-pays and $5 prescriptions that almost reminded me of health care when I was growing up as an army brat, except without the co-pay and paying for prescriptions. There was no cost and I got the best health care in the world, a lot of times from doctors serving a term or two in the military to pay for their medical education.

Then came the greed and insurance companies started denying medical claims because of pre-existing conditions (the ones that had been identified and treated by another insurance company or before there was an insurance company). Then came people hopping from one insurance company and HMO to the next to get the best deal. The services dwindled. The co-pays increased and prescriptions cost $50 to $150 or more a piece instead of that $5 or $10 for quality medication.

Insurance companies paid out less and demanded more, demanded higher deductibles while providing less protection and even less service. Medicaid still worked and so did Medicare, but Medicare recipients had to have another insurance company, and often 2 or 3 insurance companies to cover what Medicare didn't cover, and Medicare covered less and less and cost more and more of that slender social security check the 3rd of each month. People started taking less medication which, considering the side effects and questionable efficacy of the main medication, wasn't such a bad idea.

Into this wrangling over pre-existing conditions and dwindling service for a greater cost comes the Big Guilt Trip. We have to have universal socialized health care so that no person is left behind. Sounds a lot like the "No Child Left Behind" program that graduates stupid children who know only the answers to a test and no longer learn anything useful or become infected with a thirst for knowledge that takes them beyond the books and the classes.

We must get in lockstep with the rest of the world and provide health care for everyone, even the illegal aliens who creep across our borders to have their children in America so they can get Welfare, Aid to Dependent Children, and Medicaid. Do you wonder why Americans balk at the terms "Universal Health Care" and why they fight so hard not to fall into step with the other socialized countries of the world? We've been down this primrose path before and it has not turned out well. We've been bilked, cheated, and raped -- and no one suggested or offered lubricant either.

What looks like heartless Americans denying basic health services to the neediest among us, who by the way have good health care through Welfare and Medicaid (I've done the paperwork when I worked in insurance and doctors' offices and I know what is paid out), is a big case of "NO MORE" from people who are tired of the runaround and bills that go through Congress with so much pork and legalese it is difficult to even find the part about what is and is not covered in this universal health care plan, and the method of our continuing rape sans lubricant. We are understandably wary.

So, here's my proposal. A simple health care plan with low co-pays, say $20, and affordable prescriptions, say $10 no matter what the medication is, and everyone is covered. No fancy legalese, no pork, no hassle, and no legislative sleight of hand or BS. Everyone is covered and there are no ifs, ands, or buts about it. There is no clause that says mental health care is limited to 6 sessions per year or that birth control and other well care measures are strictly forbidden. Everything is covered, including dental, and the government takes 2% of everyone's income to cover the cost. There are no oversight committees and no forms to fill out for insurance. Everyone gets paid and everyone gets the health care they need.

It's a simple plan and there will be no riders, no hidden clauses, and no microscopic writing. Everyone gets on board and we do not get some retooled socialized medical plan from some other country disguised as the next best thing, and that is something else Americans are wary of -- imported, retooled, and refitted socialized medical plans from other countries.

We weren't given our independence. We fought a bloody war for it. And we were the first country to fight Britain for our independence, although not the first country to fight for its independence from a colonial nation. We were born in blood and we will likely die in blood, and it takes us a while to get what we want. It's in our nature not to trust anything that is offered with us (or offered with a guilt trip) like a man handing out candy to children from a van or SUV. We know better than to take the candy and to give the man a wide berth.

We'll get there to the everyone has socialized medicine party but we will get there in our own way and our own time and . . .

there will be blood.

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