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6/2/2009
Burri: Not to worry - government will handle it
It's an outrage! A woman needing care, needing treatment for a life-threatening condition, denied that treatment by an unfeeling, uncaring insurance carrier.
Isn't that just the way? Insurance companies are, after all, for-profit businesses. So if they can avoid providing expensive care for a customer – even if they owe her that care – so much the better. If the vast and tangled maze of bureaucratic small print can get them out of paying a bill, good on the shareholders, man!
But, no, not good. Just look at this story: a woman with a brain tumor. A life-threatening – life-ending – condition. She needed care, and her provider refused to give it. They delayed, they denied, until finally she was forced to go off on her own.
So she did. And she got – finally – a diagnosis from a specialist. She needed surgery, and right away.
Three weeks later, her provider still refused. Still hid behind their fine print, still made her wait. So she went off on her own again, got the surgery, saved her own life. Because the bureaucrats occupying the cubicles where life-and-death decisions are made were more interested in the bottom line than in making sure she got the care she was promised.
The care she was promised.
It's exactly that attitude – the profit-at-all-costs attitude – that's turning us to single-payer, government-run, "universal" health care. If private care won't provide, then by gosh, Big Daddy Government will.
But wait: this wasn't a private insurer. It wasn't a for-profit company refusing to pay. This woman's name is Shona Holmes. She's Canadian.
Canada already has single-payer, government-run, "universal" health care, but if she’d waited for Canada to take care of her, she’d be dead today.
What gives? Under government-run health care, this sort of thing isn't supposed to happen?
But it does. Ms. Holmes was told to wait six months for an appointment with a specialist. Six months with a tumor growing in her brain.
She refused, and crossed the border. The Mayo Clinic examined her, diagnosed her, and told her: get surgery. Now.
Three weeks back in Canada, being told, again, to wait: she crossed the border again. If she hadn't, she'd be dead. One of those bureaucrats in one of those cubicles would have crossed her name off the waiting list, perhaps a little relieved to have one fewer person in line, whatever the reason.
The American Left wants – demands! – a system like Canada's. They look around and see insurance companies denying coverage. Hiding behind long contracts with tiny print. Trying to make money, when people need help.
As if government doesn't have small print. Number-crunchers. Bureaucrats who make decisions by the rulebook. By the bottom line.
That's what happened to Ms. Holmes: it was too expensive, you see, to have enough of the kind of specialist she needed. So they didn't. So Ms. Holmes – and one wonders how many more patients like her – have to wait.
Or, they have to come to this side of the border, where our horrible profit-driven system will see them right away.
Nobody is saying the U.S. system is perfect. It's not. Nobody is saying that the "free market" will "fix" health care. It won't. Under a pure free-market system, people would sometimes go without. Under a pseudo-free-market-slash-government hybrid like we have, people sometimes go without. People sometimes face financial ruin. People are frightened by the sheer cost of major care.
Ms. Holmes' story proves: that doesn't change, just because the government's in charge.
Lance Burri is a contributor to the Badger Blog Alliance and The TrogloPundit.
COMMENTS
So here's the question of substance (in my opinion). What SHOULD we do?
Mr. Burri's post is so effective because most everyone has either lived or knows someone who has been through the scenario he painted with an insurance company. I certainly have, to the tune of TENS of THOUSANDS of dollars which were 'skirted' throughout the course of my life by legal mumbo-jumbo which I couldn't afford to hire counsel to recoup on my behalf.
I've been to Canada recently and talked with as many people as I could about the 'Canadian Health Care System'. Some moved there to get on board with the Canadian program ... most are delighted with it. Sure, there will always be care denied to some and it is tragic. My guess is that there are far more cases of inaccessible care here in the U.S. than there are north of the border. I can't substantiate that - but I think it's a pretty safe guess and would welcome the opportunity to see objective numbers (IF they can be obtained).
Does that mean I want to trust the Feds with my health care here? NOT FOR A SECOND.
I'm a big fan of Credit Unions. Why? You cannot serve two masters. Banks are beholden to investors - not to the customers. The right-minded Credit Union realizes that they are beholden to the customers because those very same individuals ARE the owners.
Why not take that approach with health care? Cut out the middle-man, the money changer if you will. Why not allow providers to set up accounts for clients and let the patients pay a monthly amount right in to the provider's coffers ... guaranteeing that their health care needs will be met.
Would there be differences of opinion if the agreement was being met? Sure, no system is perfect, but for a far larger number of patients the need for services would be met - far more cost effectively (because we're not paying to have people in the middle of the transaction figuring out ways to say 'No', the building, and the technology & benefits which support those "Agents of 'No'").
The other side of the coin is that providers would be directly rewarded for excellence and cost effectiveness by a better bottom line.
While much would have to be done to iron out the wrinkles, I have to think that a direct relationship between patient and doctor would benefit both parties, and if one of the two major providers in our area would offer such a program, I'd enroll in a heartbeat!

Jeff Riedl (Tue Jun 02 07:59:34 2009)
It has been obvious to me for a long time that insurance is the problem, not the solution. Insurance, by definition, can not cover a scheduled expense, what we have is a massive health care brokerage system, very expensive middle men, I can see my chiropractor for $20 cash, or $45 if I go through my insurance. Other than catastrophic coverage, health care should be on a cash basis, routine doctor visits shouldn't be any different than buying yourself a new pair of shoes when you need them, you get out your wallet and pay for it.
Unfortunately I think we are going to have socialized health care shoved down our throats whether we want it or not, Washington sees it as a solution to the insolvency of social security/medicare. All the money currently going into private health insurance will be rerouted to the government, and expenses will be limited by rationing care.
The preliminary steps towards this are already law, they were burried in the stimulus bill, its just a matter now of getting the funding to establish the necessary beaurocracies. If the Cap & Trade bill ( now called Clead Energy and Security)is passed, and right now it appears that they have the votes, they will have the funding, and socialized medicine will be a fait acompli.

David Martin (Tue Jun 02 08:52:33 2009)
Jeff -
I agree there is no perfect system. But any system that is better than what we have now needs to be able to withstand coverage for everyone, and to keep it affordable, require everyone to participate.
A payment direct to the provider "credit union like" system would only be feasible if they couldn't refuse anyone. However, this sounds like an impossible scenario because those that most need health care would likely not be able to afford it.
The sad reality is that to ensure coverage for everyone there needs to be a cap on the benefits. While we may have the technology or ability to treat, we don't always have the money to pay for it. Individually we make these decisions every day in what food we buy, what house we live in, what technology is in our homes/apartments and in our transportation choices.
If we are looking to give the most people the most health care coverage for the lowest cost we need a system that gives the most benefit per dollar (non for profit model) and requires everyone to enroll. A general cap on benefits would allow most individuals freedom to choose providers and procedures and those that needed to go over that cap would have to get pre-approval or fund on their own.
This, of course, is only a part of the equation of more affordable and universally available health care, but it is a good a place as any to start with.

Doug Gieryn (Tue Jun 02 10:34:37 2009)
I, too have lived in a "single-payer" system and believe me, they do refuse care MUCH MORE OFTEN than an insurance co. does. I know somebody (who knew the person who died) whose friend was literally TURNED OUT OF ER, whilst in the middle of a heart attack--who went home and died.
But please, do not refer to our system as 'free market', because it isn't! It's a third-party-payer system, whether govt or insurance is the third party. As such, it is wasteful. It is far better to have catastrophic insurance only, with a choice as to whether one wanted to pay for it or not, and PAY THE PROVIDER DIRECTLY.
Just as one pays a plumber, electrician, or carpenter directly. I know folks who eschew insurance for everyday things, (They have catastrophic w-high deductible)and their dr cuts them a deal as he doesn't have to put up with insurance nonsense. My daughter pays out of pocket, and doesn't get charged nearly as much as when she had insurance. Imagine what it'd be like if everyone did that...bang would go the inflated prices!

emily matthews (Tue Jun 02 12:11:42 2009)
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