As featured on p. 218 of "Bloggers on the Bus," under the name "a MyDD blogger."

Thursday, August 27, 2009

There's Something Happening Here

Quietly, almost imperceptibly, the voices of those giving testimony to the essential immorality of the broken health care system have become prominent, and the desires of the defenders of the status quo exposed.

Witness the changing tenor of town hall meetings, which changed from meeting spaces for teabaggers and Larouchies to venues for powerful expression. See this video of a woman desperate for help in a nightmare system, where her husband's insurance company has denied him coverage for a traumatic brain injury, and Rep. Tom Coburn's (R-OK) incredible response, that her neighbors (who I guess are all speech pathologists) can help her. This is made all the more insane when you know that Coburn is a doctor:

And we're starting to see real emotion and anger on the side of reform, too, like at this John McCain town hall:

Why don’t I have the health insurance you’ve got! Because I’m paying for it! And I’m paying for the President of the United States’ health insurance and Congress’ health insurance. Why don’t I have that! I’m your employer! I’m your employer! You work for me, and you’ve got a better health insurance plan than I’ve got!

McCain later evicted an angry woman who wouldn't let McCain get started. And she was indicative of many in the crowd, some who yelled about how much money McCain pocketed from insurance companies over the past year.

But I'm more interested in the series of personal stories popping up in the media, as individuals share their own crises navigating the broken health care system. Here's Cynthia Tucker in the Atlanta Journal-Constitution:

Having just relocated to Washington, I have to find a new pediatrician for my infant daughter. I sought recommendations from several acquaintances, and the same name came up repeatedly. (I’ll just call her Dr. Amy.)

I called Dr. Amy’s office and was given an immediate appointment. But I was also told she is “out-of-network” for Aetna.

Called Aetna. They explained I would pay several hundred dollars a year extra for the privilege of taking my baby girl to Dr. Amy.

So, I called another pediatrician who is “in-network.” She said she could see my baby at the end of October.

I have a choice to make: Pay through the nose for a highly recommended doctor who can see my baby immediately. Or, go to the doctor my insurance will pay for, which would mean my child would run months behind on her vaccination schedule. This isn’t a disaster, but it is certainly frustrating.

That's a minor inconvenience compared to this expose on the Remote Area Medical tent in Los Angeles last week:

The LA Forum, the arena that once hosted sell-out Madonna concerts, has been transformed – for eight days only – into a vast field hospital. In America, the offer of free healthcare is so rare, that news of the magical medical kingdom spread rapidly and long lines of prospective patients snaked around the venue for the chance of getting everyday treatments that many British people take for granted.

In the first two days, more than 1,500 men, women and children received free treatments worth $503,000 (£304,000). Thirty dentists pulled 471 teeth; 320 people were given standard issue spectacles; 80 had mammograms; dozens more had acupuncture, or saw kidney specialists. By the time the makeshift medical centre leaves town on Tuesday, staff expect to have dispensed $2m worth of treatments to 10,000 patients [...]

Along the hall, Liz Cruise was one of scores of people waiting for a free eye exam. She works for a major supermarket chain but can't afford the $200 a month that would be deducted from her salary for insurance. "It's a simple choice: pay my rent, or pay my healthcare. What am I supposed to do?" she asked. "I'm one of the working poor: people who do work but can't afford healthcare and are ineligible for any free healthcare or assistance. I can't remember the last time I saw a doctor."

And then this must-read from David Goldhill in The Atlantic, hardly a left-wing rag:

ALMOST TWO YEARS ago, my father was killed by a hospital-borne infection in the intensive-care unit of a well-regarded nonprofit hospital in New York City. Dad had just turned 83, and he had a variety of the ailments common to men of his age. But he was still working on the day he walked into the hospital with pneumonia. Within 36 hours, he had developed sepsis. Over the next five weeks in the ICU, a wave of secondary infections, also acquired in the hospital, overwhelmed his defenses. My dad became a statistic—merely one of the roughly 100,000 Americans whose deaths are caused or influenced by infections picked up in hospitals. One hundred thousand deaths: more than double the number of people killed in car crashes, five times the number killed in homicides, 20 times the total number of our armed forces killed in Iraq and Afghanistan. Another victim in a building American tragedy [...]

I’m a businessman, and in no sense a health-care expert. But the persistence of bad industry practices—from long lines at the doctor’s office to ever-rising prices to astonishing numbers of preventable deaths—seems beyond all normal logic, and must have an underlying cause. There needs to be a business reason why an industry, year in and year out, would be able to get away with poor customer service, unaffordable prices, and uneven results—a reason my father and so many others are unnecessarily killed.

As Goldhill comes to realize, the system is rife with distortions, where every stakeholder's economic interests clash with the public interest of quality and affordable care for all. And what's more, everybody knows it, even if only intuitively.

As August fades, people are starting to see the forces of the status quo as nothing more than a sham, and starting to reconnect with their own struggles in the health care system, struggles which suggest that it needs fundamental change. The question is whether Congress will listen.

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