Monday, August 13, 2007

See Sicko Before You Get Sick

I'm sick, which is actually quite apt because I had been planning to post about Michael Moore's new film, "Sicko." I'm one of the lucky members of the privileged class in the United States who was not featured front and center in "Sicko." Not only do I have a well-paying job, I also have health insurance through my job. I even have dental insurance, though all it covers is the cost of a cleaning or two, and since I hate the dentist I rarely take full advantage of it.

Under my health insurance plan with Oxford Health care, I'm allowed to choose my primary care physician and I have only a $15 co-pay each time I see her. My plan covers only 30 mental health visits each year (apparently patients are only allowed to be suicidal or clinically depressed for 7 months out of the year and then they have to get over it), but the co-pay is significantly more than for my primary care physician. It costs me $40 each time I see my therapist. It's worth it to me because I'm worth it, but the cost does not escape my notice.

My prescriptions cost me between $10 and $20 under the plan. Thankfully, Ambien is covered. I'm not sure what I would do without my Ambien, but I'm sure life - not to mention me - would not be as pretty. Gardasil, the vaccine against the most common forms of HPV - the sexually transmitted disease that causes cervical cancer - and a drug which Texas made mandatory for girls younger than me - is not covered. However, since I actually care about my reproductive system and because I believe in preventative health care, unlike my insurance company, I paid over $600 out of my own pocket to get myself the vaccine. To my knowledge, I don't have cervical cancer or HPV, and I'm planning to have other sexual partners in the future, so - with the exception of the rather large $600 fee - getting vaccinated was a no-brainer. My plan also does not cover other vaccinations, but because I didn't want to contract Malaria, Typhus, or Hepatitis C when I went to India a few months ago I paid approximately $350 for the pills and shots necessary to protect me during my travels.

Getting back to that bit about having a well-paying job. I would wager that a large section of the American female population does not have $600 lying around to spend on an HPV vaccination, not too mention sleeping pills, travel vaccinations, or for that matter trips to India. Until 3 years ago when I started working as a lawyer, I most didn't either. I also didn't have enough money for health insurance. Shhhh, don't tell my parents. It makes me shiver now to think back on all the potential catastrophes that could have befallen me during my uninsured periods of time, the most recent of which was - gasp - three months ago while I was in between jobs, traveling to foreign countries, flying on airplanes, and braving the traffic of New York on a daily basis. A poor decision, no doubt, but I simply could not stomach the idea of paying $800 to continue my plan in between jobs. It was too outrageous.

Aside from the prescriptions that aren't covered, relatively high mental health costs, and the hazards of limbo-ing in between jobs, for the most part I've been lucky, covered, and had little to complain about with respect to my own health insurance. But, as "Sicko" makes clear, many in America are not so lucky as me. Of course I knew that before I watched the movie. It was not news to me that there are many people in America who don't have insurance, that managed care leaves many dissatisfied, that there's far too little emphasis on preventative care, that the poor suffer the most, and that insurance companies will go to great lengths to deny coverage. I have siblings and friends who's jobs do not provide benefits, and as a lawyer I've worked on insurance cases in the past (and I've hated them).

There were a number of things from the film that were new to me though, including:

1) Universal Health care Exists! It's not impossible. France, England, Canada, and Cuba provide FREE universal health care to everyone, even to non-citizen Americans. It's been 24 hours since I learned this, and I'm still astounded by the implications. I guess a part of me was dimly aware of the fact that other countries provided universal health care, but at least in our country the idea has been painted as a feat too impossible to even imagine. Over and over again we're told that the health care system is rife with problems, that the provision of free care would cost an exorbitant sum, and that privatization is our only hope. Not surprising for a country that views Socialism as anathema.

But, here's a thought: Instead of allowing the CEOs of insurance companies to become billionaires, and instead of allowing insurance companies to employ 4X as many lobbyists as there are congresspeople, why don't we just take that money from the insurance companies and give it to the people who are actually providing the medical care, the doctors? Putting aside the perhaps overly rosy pictures of other nations' health care systems, "Sicko" made me stop and really start thinking about the health care system in which I'm participating. Under our current system, patients aren't winning, and neither are the doctors. The ones making out like bandits are the insurance companies, and that's just wrong. It's also inefficient and misguided.

* Excuse me, I had to go chug some NyQuil. I'm back now. *

2) Rescue Workers From 911 Are Not Receiving Medical Care. I don't know anything about this other than what I saw in the film, but to the extent it's true it is an absolute disgrace. I was not in New York the day the Twin Towers were attacked, but I watched the coverage around the clock of the rescue workers' efforts to locate survivors. I did what I could from far away; I sent money and I donated blood. I cried when I read the stories of the fire fighters and police officers who lost their lives trying to save the lives of others.

The rescue workers who came to the aid of their fellow human beings on 911 were and are still genuine heroes. They're heroes because they saw a need and they jumped in to offer whatever assistance they could despite the terrifying and devastating circumstances. In doing so, they put themselves in grave immediate and future danger, and now, apparently, many are suffering from respiratory and other illnesses that they contracted as a result of the work they did on 911. Worse than that though, is that apparently they are not receiving the medical care that they need for the medical problems they contracted as a result of 911. I find this so shocking and sad that I can't even comprehend it.

I guess really it's no worse than not taking care of the poor and disadvantaged in our society. But, in a sick way I can almost understand how our society can turn a blind eye to the poor (not that it's right, mind you). But, the idea that our society would also turn a blind eye to those that it has labeled as "heroes"? If that's the type of society we have, that treats both its poor and its heroes with so little regard, it's not a society that I can be proud of. Instead, I feel ashamed.

3) Guantanamo Provides Free Universal Health care to It's Detainees: I suppose I'm glad that Guantanamo provides health care to its detainees. That's one positive thing I've heard about Guantanamo. However, in quintessential Michael Moore flair, he demonstrated how absurd it is that 911 rescue workers are receiving worse medical care than alleged members of Al-Qaeda.

Now, I understand that this comparison was made for dramatic effect, but I have to say, it worked. This does not lead me to conclude, however, that we should take the health care away from the suspected terrorists at Guantanamo (many of whom are innocent, but that's the subject of another post). Rather, it leads me to conclude that if we see fit to provide our alleged enemies with health care, shouldn't we see fit to provide all members of our society with at least the same level of care?

* * *

There are more things that I learned from Sicko, but my glands are feeling swollen and sore, my head is feeling swimmy, and the NyQuil is beginning to kick in. I have to go to bed. If you haven't seen the film, go see it and let me know what you think.

What about you? What do you think about our health care system?


InterstellarLass said...

My healthcare coverage ended the day I left my former job. And I didn't have healthcare coverage for another 36 days, due to the 30 day waiting period for coverage (which I find to be totally saves HR on paperwork if an employee flakes). I have kids and a husband. But no way could I afford the $1200+ fee for COBRA coverage. One of the most worthless laws Congress has ever passed. The only way it would save me money is if I or a family member was in a catastrophic accident. I held on to the paperwork in case I needed to file and pay for the coverage within the 30 day time constraint. Paying for a doctor visit on my own was cheaper.

The other side to socialized medicine though is the waiting period. I've read several bloggers in Canada and England that have had to wait MONTHS for an appointment to see a mental health professional. Only people in the act of slitting their wrists get the attention they need when they need it.

However, I am totally with you about the insurance lobbyists and executive management.

A different twist though. The company I work for is a major pharmaceutical distributor. One of our divisions sells products that are used in conjunction with cancer treatment to replenish red blood cells, hence making people healthier during their treatment. The reimbursements doctors receive for using these drugs (from Medicaid and from the manufacturer and from the insurance companies that follow Medicaid) is huge. So, they were exceeding the 'recommended' dosages set by the FDA. OK, so maybe some doctors are trying to make a little more money. But, humans are biological creatures, and not all bodies react the same. So, perhaps some of those people really needed the extra dosages. Now Congress has seen fit to introduce legislation regarding how much of this drug can be prescribed for the type and stage of cancer for which the patient is being treated. Since when does Congress know how to treat patients? The insurance companies certainly don't know how. That too adds cost, to monitor prescription compliance, takes money out of doctor's hands, takes treatment away from people that could potentially use it.

It's all a big mess. How it can be fixed I don't know. The transition would be foreign to Americans. We like our choices. We don't like being told where to stand and how long we have to stand their. Instant gratification. Treatment now. But it's also an embarassment and a flawed system.

Feel better. :)

broadway baby said...

I feel largely uneducated now, but I do pay a lot of money each month to be on COBRA currently.

I do remember when my stepfather was dying in the hospital, one of his doctors told us that the insurance companies were calling him (the doctor) wondering why my stepdad was having such a long (3 or 4 days) hospital stay. The doctor had to tell the insurance company to back off! It really angered me that the insurance company was trying to put pressure on the doctor to treat my stepdad in a way that would save them money!

Let the doctors treat the patients! We faithfully pay the insurance companies each month...they insurance companies need to be ready to PAY when we need them.

The whole situation is a big MESS, I only wish I knew what the solution was.

Anonymous said...

Great post. Sad that healthcare has deteriorated into what it is, but at least someone is trying to shine a light on its flaws so that we may start a conversation about how to fix the system.

Like you, I've almost always had health insurance-- but even with it health care is expensive. I always joke that when I don't buy a new piece of clothing now, I'm saving the money to buy one aspirin in the nursing home in my future. If things don't get worked out in the healthcare industry very soon, my joke will be the truth.

Anonymous said...

Medical care may be free in the UK but it has plenty of problems. There aren't enough doctors or nurses and we have huge waiting lists for mostly everything. Some waiting lists are so long, it may be too late to save your life if you have something serious.

Prescriptions are not free to everyone which means you wrack up a huge bill until the doctor finely does his job and works out what's wrong with you.

It generally takes a week to get an appointment to see my doctor and I'm lucky if I'm in there five minutes before she asks me what I think may be wrong. Duh!

My grandparents both died because their doctor failed to his/her job properly. When you get to a certain age, no one gives a toss if you are seriously ill or not.

Willow said...

I'm a firm believer that we should have socialized medicine. It's one of the only things about socialism that I like. I realize that there are problems, such as caledonia mentioned above, but it seems to me everyone should be able to see a Doctor and not have to worry about it putting them in the poor house. Grrrr! Touchy Subject!

Thankfully, I now have good insurance with this job--but it's the first time since I was 21! Luckily(knocking on wood)I haven't had any catastrophic illnesses in my lifetime. I have witnessed all around me, people who CAN NOT afford to see a doctor--it's truly upsetting. I can't believe we take care of our prisoners better than we do our own people!

gravelly said...

A few facts: Gardasil is covered by insurance companies for ages 9 - 26, after that one must pay for each shot at $250 each. It was NOT made mandatory in Texas, the Governor tried to do that in the beginning but the vaccine has not been out long enough to show long-term effects. (Anyone remember thalidomide in England???) The vaccine prevents four types of HPV, there are at least 80! HPV can cause cervical cancer so it is important for many to get the vaccine.
We need to help Americans with healthcare first. In Savannah, every pregnant non-citizen was able to get complete prenatal care, including ultrasounds, delivery, and post partum visit. This must be the case all over the US.
Socialized medicine leaves much to be desired: in Sweden when i was pregnant, a long time ago, I know, one of the doctors who happened to be in the clinic that day was a pediatrician, so that's who I saw, even though I was seven months pregnant. And, one waits FOR HOURS to see ANYONE!! America is awesome, even with its problems, it is the greatest country in the world, and so many people take it for granted.

Sparky Duck said...

Mrs Duck did a whole rant on US healthcare after seeing sicko. Search last months archives, you may enjoy it.

ask yourself this, no matter how good your own insurance is, can you afford to pay 20% of an operation cost? A question we are asking ourselves every day

kevin said...

The alleged terrorists at Guantanamo receive better health care than the 911 rescuers! As Alice said, things just get ‘curiouser and curiouser’.

Anonymous said...

that's bad!
here in Australia Gardasil is free (and so it should be - cervical cancer is a common and nasty women's cancer!!)
O well.......
I hope the health care system in the USA picks up...