Why We Need National Health Care
Apr 14th, 2008 at 5:33 am by Susie
Oh, come on. This isn’t about keeping premiums low. This is about keeping profit margins high, and is a perfect example of why we can’t afford a for-profit system:
Health insurance companies are rapidly adopting a new pricing system for very expensive drugs, asking patients to pay hundreds and even thousands of dollars for prescriptions for medications that may save their lives or slow the progress of serious diseases.
With the new pricing system, insurers abandoned the traditional arrangement that has patients pay a fixed amount, like $10, $20 or $30 for a prescription, no matter what the drug’s actual cost. Instead, they are charging patients a percentage of the cost of certain high-priced drugs, usually 20 to 33 percent, which can amount to thousands of dollars a month.
The system means that the burden of expensive health care can now affect insured people, too.
No one knows how many patients are affected, but hundreds of drugs are priced this new way. They are used to treat diseases that may be fairly common, including multiple sclerosis, rheumatoid arthritis, hemophilia, hepatitis C and some cancers. There are no cheaper equivalents for these drugs, so patients are forced to pay the price or do without.
Insurers say the new system keeps everyone’s premiums down at a time when some of the most innovative and promising new treatments for conditions like cancer and rheumatoid arthritis and multiple sclerosis can cost $100,000 and more a year.
But the result is that patients may have to spend more for a drug than they pay for their mortgages, more, in some cases, than their monthly incomes.
America’s health insurers … bringing us universal un-coverage.
“The system means that the burden of expensive health care can now affect insured people, too. ”
That sentence says more about the failure of our press to deliver accurate, meaningful information on our health care system than anything I’ve ever seen. The number one cause of bankrutptcy in the country is medical bills – the majority of those bankruptcies affect people with insurance.
The NY Times, the paper of record, apparently doesn’t have a health beat reporter who understands that.
The for-profit model fails us miserably and the story that drug companies won’t be able to come up with new drugs without it are a lie and a sham. We need the system changed now or sooner. Every civilized country in the world has universal single payer health care except the United States. We have to expose the thieves and liars who have kept us from having this and get the word to all the people.
Also, the president who signs universal single payer health care into law will be revered for generations. He or she could have a Viet Nam type foul-up in the resume and still be remembered fondly by Americans for generations.
At the rate that health care costs are increasing, it may well replace the mortgage crisis as the prime agent driving the economy into recession and toward depression. You’re right. Single payer health care is a “must have” for this country.
There is a little truth to the lowering of premiums by shifting cost-sharing. Typically, it’s a measure put in place by an employer trying desperately to control the skyrocketing insurance premiums for employer offered benefit plans.
I think the aim of the original piece in the NY TIMES is simply off a little to the left of the bullseye. In the case of Rx, it’s “Big Pharma” that is artificially increasing prices, concealing prices, engaging in lobbying to keep prices in the U.S. higher than for comparative drugs out of the States. This is the appropriate target for the now ridiculously over-priced pharma industry, not the insurance companies, per se (this time).
Also, one might keep in mind that most insurance plans, specifically those offered by employers, have an Out of Pocket Maximum. Although high, it does limit the individual’s exposure to maximum liability (common maximums are in the $2000 - $4000 range, per individual).
Of course… many plans also do not apply Rx expenses toward the OOP Max, or have a separate max for Rx… so I guess that brings us full circle.
People are going to die from this.
I have Rheumatoid Arthritis. I use Remicade ($5,000 billed to ins company every two months). I live with pain 24hrs/day. This disease was NOT something I could have avoided by “eating right” or jogging 5 miles/day. It just happened.
Without this medicine I would be looking for a gun to end it all…
Denise - you’re right. Unless we (as individuals) are lucky enough to have friends or partners or whomever to advocate for us when we get sick or hurt and cannot do the research and fact-gathering and loop-hole-finding ourselves, more and more of us are going to suffer and die. It’s hard enough to work the system even if you know your ABCs and have an internet connection, but add to that the fact of being ill and disabled by your illness, and you realize just how much of everything is a matter of dumb luck. And as we’re seeing, it can happen to any of us. I have a little more money than the “have-nots”, but I’m still kind of a “have-less”, but even for the “haves” and “have-mores”, one accident or illness can quickly turn catastrophic.
I can’t imagine that this would ever affect some folks - for example, all of the currently living Cheney family. Liz Cheney, Mary Cheney and their kids will always get everything they need. But damn. Eventually even Cheney descendants are going to mingle with the masses. I believe Dick Cheney loves his kids and grandkids, but god knows people like him don’t seem to care one bitty bit about whoever follows.
Damn. Cheneyism always gets me off-topic. Here’s the thing: are they (the spendy folks referenced in the post) kind of counting on this misery as a way of thinning the herd? And how soon before those of us with expensive and inconvenient maladies are offered special “early check-out” incentives? Like, change your instructions to Do Not Resuscitate and your grandkids get a discount on tuition. Or taper those meds and drink this and your partner won’t have to spend-down into poverty.
Sorry - my reference to “the spendy folks” was actually to this post by Jill at “Brilliant At Breakfast”:
http://brilliantatbreakfast.blogspot.com/2008/04/republican-economic-policy-bets-that.html
While working in an emergency room in 1982 a man came in with a prescription written for his father still living in Communist Poland. On the prescription for Cimetadine (Tagamet) there were three numbers 20, 40 and 100, the 100 was circled, meaning that for his father, the prescription would be free (100% off). The only problem was that the state owned pharmacy did not have any cimetadine.
Lacking here is the evidence that by socializing medicine there will be greater efficiency and hence more people can be provided services at a lower cost. The challenge remains that if that were the case, it would be the first time in human history. By way of example, here is a fact worthy of considering: Aspirin or Ibuprofen and a cane are cheaper than knee replacement surgery for people with crippling arthritis.
Be aware of unintended consequences, you can get cheaper health care and precisely what you pay for.
Tom
http://www.tomcoss.com
Good god, Tom. First time in human history? Do you think that I believe that if universal access to health care can’t be perfect, free, available to all, mistake-proof, and never, ever unwieldy, then feh, I don’t want it? Canada does better than the U.S. A number of other countries do. There’s so much room for improvement, but proffering an anecdote from a defunct Soviet bloc country is really kind of ridiculous, isn’t it? Anyway, variants of that same anecdote abound. Do you really think that a single-payer or universal coverage plan or some other sort of health care reorganization automatically shuffles us off into a monolithic totalitarian economy?
I’m just about to go off on you again, but it occurs to me that maybe you are not being as callous as I think, but that you are implying that a change in our health care system might mean that instead of well-insured people getting knee replacements while under or non-insured people just suffer, we’ll all get free aspirin or ibuprofen and a cane. Is this what you mean by unintended consequences? That by trying for something more equitable and more compassionate, we may simply distribute the pain more “fairly”?
Because otherwise, I’m wondering if you are saying that Americans are simply spoiled and that we think if our knees hurt, then OMG we’re petulant brats who think we’re entitled to new ones, when we should just suck it up and deal, much like our ancestors had to.
Oof. What is this anyway? Didn’t we use to be good at doing revolutionary stuff? Didn’t we use to think of ourselves as pioneers? Didn’t there use to be a free world? Didn’t we use to think we were the leaders of it?
Tom, tell me I’ve totally misunderstood you, and I will apologize. Otherwise, damn, son.
The universal health insurance could be a great solution if it were built upon a stable economy. However if the situation is different it can`t be efficient. Everybody of us needs health insurance and it doesn`t have anything in common with the fact that I`m working for a Toronto life insurance company. I think that one step forward would be if a greater focus were paid to the health education.
Universal anything insurance — mandatory everything insurance — could be a great solution if I were an insurance company. Especially if I’m clever enough first to leave my insured customers just barely enough money to make being insured seem financially better than being uninsured.
Once the insured folks are covered about as well as the uninsured — but paying me for the privilege — making laws requiring everyone to buy insurance from me ought to be pretty easy. Just point to those free-riding uninsured bums.
“Their coverage is just about the same as yours –”
that is, non-existent
“– and dammit they’re not paying” a dime!”
To me.
“I ask you, good people — is that fair!?”
“Proudly.” I forgot to say “proudly.” Proudly bringing us universal un-coverage.
When this practice spreads to private insurers protected by ERISA, it will get considerably worse for patients. Here’s a recent scholarly paper on the conflicts of interest that ERISA fosters and the resulting problems of care it creates: http://papers.ssrn.com/sol3/papers.cfm?abstract_id=1114670
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