8.04.2009

Ohmommy Made Me Do It

Ugh...blech...patoey:P I curse thee Ohmommy for making me dive into this pool *shaking fist in the air* (I kid, you know I love)...

If you are not aware, Ohmommy lit up the blogoshpere over the weekend with this post, followed by this post on the proposed
Obama health care plan.

Now, I DON'T pretend to know what the answer is, and NO I have not read the proposed plan. That being said, I need to address some of what I read both in the posts, and in the comments.

First...one of your commenter's Karen (
who I can not link to since she left no link) I believe she is a nurse, said...

"I'm sorry, but I must live in a bubble...

The pediatric patients,that I encounter everyday and care for regardless of their sex/race/financial status, receive free treatment, from a team of people that sincerely care and make sure they receive the attention they need/deserve. The children receive this care regardless of their idiotic parents that refuse to get a job, because life is better living off the benefits they receive from our government.

Vaccinations for their children must be hard to pay for when there are acrylic nails, cigarettes, and alcohol to be bought."

There seemed to be a general consensus that if you had insurance and a good job, it was because you worked hard, and if you didn't it was because you were lazy. I wish life were that easy. (please know Karen that I mean no disrespect to you, I am not walking in your shoes...it may be that way from where you are standing)

What I do know is...the day I went into the hospital to have Miss Peach for reasons completely beyond our control, our insurance was yanked out from under us (illegally)...the. day. I. went. in. That was followed by a 9 day stay in the NICU for Miss Peach.

I am a hustler, I have and will continue to work hard all my life. Husband is the smartest, and hardest working man I know, and we got knocked off our horse. The timing could not have been worse, and it was completely out of our control. That said...we came home from the hospital, having to sell our house to pay a $28,000 hospital bill. (that was not the only factor for selling the house, but it weighed in) I still consider myself lucky that we had an option. I know there are many folks out there who don't have options. To make the assumption that those people are lazy or unwilling to work is not only naive, but it is elitist. How can anyone make that assumption about anyone else without being in their shoes? Is it true in some cases? Probably. In all cases? Absolutely not.

I also can't help but notice the problem you Pauline, and some of your commenter's have with the idea of doctors being paid by salary.

"...work as hard as you can in school and get into Harvard Med School and then work even harder; but, it actually doesn't really matter because you will get paid the same as a non-specialist"

Is putting doctors on salary really the end of the world? I'd be willing to bet many people go into medicine to actually HELP people, and not simply for the monetary gain. Let's say we did put doctors on salary...would that really be the end of the fine medical care that many great hospitals in the US currently give?

I find it interesting that two of the three hospitals in your question...

"
Name three hospitals in the United States. Easy, no? John Hopkins, the Mayo Clinic, the Cleveland Clinic."

currently pay their doctors by salary rather than procedure or volume based (The Mayo Clinic, and The Cleveland Clinic).

They pay medical doctors a fixed salary that is unaffected by patient volume. The thinking behind this is to
decrease the monetary motivation to see patients in large numbers and increase the incentive to spend more time with individuals. Salaries are determined by the marketplace salaries for physicians in comparable large group practices. So, it seems to me that these hospitals are ahead of the curve...

I know I don't have the answers...I'm even pretty gosh darn sure Obama
doesn't either. That said...I know where we are now is not good enough. When Burgh Baby said...

"My mother died of breast cancer because we did not have the means to pay for insurance or any health care."

I know
that is not what we as Americans should settle for. Why do we either have to choose what we have now, or adopt what Europe or Canada have? Why can't we as Americans expect something more...something better...for everyone? I'd like to think more hospitals can adopt the kind of practice being done at The Mayo Clinic. I'd like to think that doctors will be able to practice medicine in an environment where they are able to treat the patient rather than throwing expensive tests that may not be necessary to make more money.

Perhaps I'm asking for
too much? Perhaps unicorns will fly out of my a$$ and it will start raining gumdrops? I do know one thing...change will not happen until we come to the table and start talking about it. It seems to me, that's where we are now. Let's get this one right.

31 comments:

  1. We have a friend who's a doctor in our small-town coomunity (in the Midwest). She, and most of the doctors in our community are part of our hospital's "network," which means she receives a salary. Essentially, she's a network employee. She loves it PRECISELY BECAUSE she has a set salary she can count on, regardless of the number of patients she sees, which allows her to focus more on quality of care than getting huge numbers of patients herded thru her practice.

    My guess is that mist of the people opposed to this health care reform have never faced staggering health care costs. Hubs & I are both college educated (advanced degrees) & are hard working, responsible people. Our daughter was born with multiple chronic medical condition that required 3 months of NICU & continual, long-term care with specialist appointments & home medical equipment. She's been in the hospital once a year at least at an average cost of $30,000 per stay (think about that). ONE specialist visit averages $500. We see 4 specialists, & see each one 3-4 times per year. Her NICU stay (90 days) was about $30,000 PER DAY (how's the math going?). She's three now, these issues are ongoing and the financial burden has become staggering. We have not claimed bankruptcy yet, but we are SO close, it's genuinely frightening. And we have "good" insurance (Ha!). If you were doing the math, do you see how quickly our deductible and co-insurance alone become overwhelming??? I cannot even imagine being in this situation and not having insurance, and I know that many who are out of work or at the mercy of employers who can no longer afford to provide employee insurance benefits are facing that very horror.

    It seems like health care should be a basic human right. It seems like everyone should be allowed the same rights to quality care. It seems like, as fellow human beings sharing this experience of life that we should be willing to give a little more of our "fortune" so that the less fortunate are treated as well. I have no problem paying higher taxes for a better system FOR ALL.

    As for the typical argument that Canadian/European healthcare leads to huge wait times for procedures, I again think the people making the argument have not dealt with OUR current system much. My sister has Stage 4 Endometriosis, and is currently living with a lot of pain. To have the surgery she needs, HERE IN THE GOOD OL' US, she has to wait FOUR months.

    I'm 100% with you in the belief/hope that the US can develop a health care system that 's FAR better than what we have now, and different/better than anywhere else in the world. It won't happen overnight and it might take multiple tweaks, but the time is now to start working on it.

    Thanks for such a thoughtful post!!

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  2. All doctors are not paid the same. For example a periodontist makes more then a dentist at the Cleveland Clinic. Which is extra years of schooling and residency. Which is extra money of loans. Which is more money to be insured. Which... means they should be paid more. I guess that was my point. They should not be paid the same. Yes the doctors at the clinic are on salary and it makes those hospitals the best in our nation. We should run hospitals as non-profits.

    You know you can't write EVERYTHING in your posts for they would be too long winded. I was just talking like I normally would to a friend.

    And the best part of this all.... is that it got other people talking. THAT is totally priceless. Now Im going to link your post to my post. Thanks girlfriend!

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  3. Right...I said "Salaries are determined by the marketplace salaries for physicians in comparable large group practices." I said they were on salary...not paid the same:)

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  4. Um, forgive all my typos above. That entire comment was typed from my iPhone, which seems to think IT knows what I mean to say better than I do. LOL. :-)

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  5. I don't know what the answer is but I agree what we have is not working! Thanks for writing this post and the unbiased nature of it!!!

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  6. I'm sorry, I shouldn't have been so all-inclusive with my comment. Yes, I do believe there are people that are jobless beyond their control, and to them I am greatly empathetic. My stepfather has recently lost his job, along with his insurance, but despite his extensive debt due to a back injury, he continues to work his ass off, in pain, to make ends meet for him and my mother.

    I do believe there are people that are very comfortable with their way of life, receiving free food, transportation, housing aid, and healthcare from our government and no motivation to better themselves. I witness this everyday with the population I take care of, needing a cab voucher, from my hospital, to get to their hair/nail appointment...

    Not to mention the fact of letting their child's free healthcare lapse because they didn't renew their application every 6 months, it comes with a free, stamped envelope for Christ's sake!

    Yes, the system is flawed but should we all have to pay more taxes for people that already milk the government for everything it's worth?

    Karen

    p.s. Thanks for picking apart my comment, would it have hurt to include the first part of it?

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  7. Sorry Karen...I didn't think the whole quote was necessary. Since you feel it is...I added it:) I'm curious why you are posting anonymously?

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  8. Because OHmommy made me do it ;-)

    Karen

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  9. Hey.... I made no one do anything. LMAO. Silly girls.

    This is great that people are discussing politics. Especially since we don't normally do so. This is a great thing.

    Please read this post as she nailed it: http://moraliablog.com/2009/08/oh-mommy-kicks-off-her-stilettos-and-gets-political/

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  10. Ohmygod too many things to say. And I did already write a post about the LANGUAGE of the bill.

    For what it's worth I'm for the healthcare plan. Also, there are so many many misconceptions I feel another blog coming on.

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  11. So, just so you know - I wrote my draft on my view about health care and it will be published tomorrow morning, thanks to OHmommy opening up the floodgates - in a good way. I am a lover of discussions and heated debates, especially when dealing with smart woman who can make their point and not get offended if someone else has a different view. What this means is we care about our country, the people, and especially the children, our future.
    Great post, Cynthia. I wish there was a perfect answer to health care...

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  12. While I agree that something needs to change, I just don't think that more government programs are the answer. We currently have several gov't health programs that we can't pay for and are mired in bureaucracy and fraud. In fact, the recent budget CUT medicare. Talk to someone who
    relies on VA or Native American or Medicare and tell me how happy they are. They're not.

    More importantly, how on earth are we going to pay for this? Except keep raising taxes. Which, I don't know about you, but in MD we pay upwards of 65% of our income to taxes when you factor in all of the different directions they come at us (fed/state/local income tax, property tax, sales tax, gas tax, cell phone tax, gas&elec tax, etc.). While I agree that not all of the recipients of gov't programs are lazy, good fer nuttins, there are a large enough percentage of them to make it hard for me to swallow.

    A good start might be in tort reform. Malpractice insurance is insane. In MD, we're losing OBGYNs by the droves because of it. Next, if people who have fairly mild medical conditions like asthma and migraines is such a huge part of the uninsurable, then why hasn't someone started a high risk insurance company? Surely there is a market for it? Finally, why don't we just expand medicare/medicaid? Why don't we fix what is broken before starting more soon to be broken programs.

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  13. LOL. I linked to OHmommy today. I agree with you that not everyone without healthcare is lazy. And I also agree with OHmommy that the plan proposed by Obama and his cronies is NOT the answer. I like your conclusion - can we come up with something better? I'd like to hope so, but I'm not holding my breath. Sigh...

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  14. Tort reform is not needed, certainly not in the form of caps on damages. That sort of tort reform, in fact, would needlessly harm patients who have suffered catastrophic injuries due to malpractice. A cap of $250,000 or even $500,000 would bring financial ruin on a family that has to provide a lifetime of care to someone who has suffered something like severe brain damage or spinal cord injury. Believe me, the insurance industry can afford to pay the $5 mil that might cover the family's costs.

    And they can afford to do it without needing to raise premiums. The greatest scam the insurance industry has ever perpetrated is the push for "tort reform". They hire lobbyists to complain about how medical malpractice insurance premiums keep rising every year while no one ever points out that insurance profits have been rising right along with them. See, malpractice premiums really haven't needed to increase to keep up with the relatively few numbers of large payouts that have been awarded to severely injured plaintiffs. The insurance industry has a huge fund available to pay out those claims. But, they're not the least bit shy about using a large pay-out, which hasn't actually hurt their budget, as an excuse to raise premiums yet again. If we want to talk about implementing caps somewhere, it ought to be in relation to insurance companies' profit margins.

    As for why those with seemingly minor pre-existing conditions are so uninsurable, there really is no market incentive for any insurance company to offer those individuals high-risk poicies. There just isn't enough profit to be had in providing insurance to that population of people who require daily maintenance, no matter how minor.

    The absolute bottom line re: health care reform that I can see is this: we have got to take profit out of the equation everywhere we can. (I'm talking corporate profit, here, not individual salary.)

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  15. Ugh. All the arguing is giving me heartburn. Give me good rousing discussion over the central theme of a piece of literature any day.

    That being said, Nap Warden, I think I'm with you, particularly the bit about not having to either stay with what we have or switch to the Candadien/European approach. As you said, we could actually expect BETTER.

    And maybe I've been sniffing too much fairydust lately to think that could actually happen, but...

    I'm gonna go take some Tums now.

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  16. I no nothing about whats going on in the US and healthcare at the moment but I like what you have to say here. Doctors should all be paid a salary, all over the world.

    That $28,000 bill you got stuck with sure sounds scary. Especially now that I'm expecting baby no2!

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  17. I don't think this bill is the answer, but, yes, we do need something. How about figuring out why a doctor can charge $89 for an appointment for someone with insurance, but if you don't have insurance and pay cash, you have to pay $149? Charge the $89 to everyone and it would be more affordable!
    We have always had amazing insurance. Then my husband was laid off. While he still works hard and has a great paying job, he is a contractor and has to pay our insurance on his own, at a rate of $1200 a MONTH. We are now losing our house. We can't pay both. And we can't drop the insurance. Seriously. The company refuses to let us drop it, they take the money from our paycheck and we don't get an option until October. So, we lose our home or quit the job with no prospects lined up. (it took 4 months to find this one)
    My sister has a lazy, no-good ex who refuses to work so he doesn't have to pay support. She has to work, and does, but since her employer offers health care she has to take it and can't get state support for her girls. If she pays through her employer, she can't afford her home. But she can't get help. Fun, huh? That is the system that needs help.
    In spite of that, I am NOT for this plan. I would rather go without insurance. Yes, it could devastate us financially, but I would rather take that risk. I am watching a friend lose everything from having a premie while on supposedly great insurance. He just happened to have his hospital stay go into the new year and they doubled all their bills. It doesn't really matter what you have, you can still lose everything over medical problems.

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  18. It's a sad story, told over and over!

    We're your average family and we were making decent pay, but when we found ourselves in and out of All Children's Hospital for the first two years of our daughter's life due to multiple seizures, we ended up with multiple medical bills, in the thousands. We refinanced our home to pay everything but re-occuring hospital stays just racked the bills up again.

    I really get annoyed at the elitest attitude of well I'm not sick and I shouldn't have to pay for everyone else. I PRAY you never find yourself in a situation such as ours or that of a person with cancer, etc. If people were a little more giving and less what's in it for me we might get somewhere.

    I'm not looking to live off the backs of anyone, but other countries are providing the same and sometimes higher standards of care and the cost is a lot less than what Americans pay.

    Just my 2 cents! :-)

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  19. Oh Cyn - you go girl. I am totally into this discussion as most of us know that SOMETHING has to change. My brain is swirling with thoughts - mostly incoherent :-) - but here are some things that are standing out to me:

    1) It's obvious that we all have a million different stories that can illustrate different problems with both our current system and the proposed scenario with the bill on the table. Your truth, Karen's truth, Qtpies' truth....it's all truth to each person who has had a story with health insurance. The problem is trying to find an answer that addresses as many "truths" as possible.

    2) I love what Cara Bee said about not adding another broken program to a host of others. Amen to that a million times over. I can't see wanting to hand over my HEALTH to the government. Hell, I would never want the government to run Direct TV!! - The thought of my HEALTH care being run by the government frankly scares the crap out of me. I personally do not think they can run health care program without it quickly getting broken.

    3) I want choice. That is what America is all about in my eyes. I want options and choice and opportunity to handle my health the way I see fit. Period.

    4) I would love everyone to have access to decent medical care. Living in Los Angeles we are overrun with illegal immigrants and the cost of providing health care to that population. Although I have heard certain stories where I say YES of course I want to help that person, I have also heard other stories where I say, "Holy shit why are we all working so hard to PAY for THAT?" So I can see Karen's point from where she is standing because she sees stories that represent the latter end of that spectrum.

    5) Personally I do NOT see doctors to be a significant part of the problem. I agree with whomever said that a lot of people get into the medical profession because they want to HELP not because they want to get rich. BUT being wealthy for being a kick-ass doctor should not be looked down upon. And our insurance companies are not helping our kick-ass doctors be accessible for all. My amazing OB-GYN dropped ALL insurance because it was not worth it for him and on the Westside of LA he is able to get a clientele who will pay for his services. BUT when I came to him at 35 weeks prego with my third kid and upset with the OB I WAS seeing, he took me in, struck me a deal and delivered my lil' guy. That is awesome.

    6) Insurance companies?? Hello? Can someone please explain to me why I pay so much every single month to insure our family and yet, it seems very little is covered??? This is where the problem lies to me.

    Enough said - I feel I might need to have a little health care chat on MWOB.....geez.

    :-)

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  20. I really can't bother commenting on her blog. augh, blech, vomit.
    she talkd about the medicare patients seen along side her son at Cleveland.... that is govt funded healthcare. what about medicaid patients? what about the unisured?

    I would gladly go to paris and wait for 4 hours to get myself stitched up, right now I can 't get private healthcare even if I pay ridiculous amounts for it. I can't get insured. would I trust the public hospital? hell yes. will I trust them even if the bill went through today? yes.
    Now I can't agree with everything in the bill, but I def think it is step in the direction of what me need to be. we do need to be equal. and hell congress and the president get paid seriously dough, and have lifetime benefits, of course their program will be different. that has always been an issue, but as long as you keep electing those assholes (congress) nothing will change.

    this topic gets me so fired up because people look at it like Repubs agains demos and that just isn't the case. some of the richies are worried they, what? might have to go to the same place as a homeless person? be treated the same as them? shame on you. no actually FUCK you!

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  21. "I'd like to think that doctors will be able to practice medicine in an environment where they are able to treat the patient rather than throwing expensive tests that may not be necessary to make more money."

    you are so right on the money.

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  22. Everyone gets relatively the same amount of care for Fire, Police and Schools. (Relatively. Obviously there are areas where schools suck and the police is corrupt.) Why can't everyone get the same health care? Why is it free for me to call the fire dept but not an ambulance? How does one differ from the other??

    I am FOR health care change. I am for health care for EVERYONE. I despise insurance companies and their ability to take advantage of their loopholes. I despise their profits from the deaths and misery of others.

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  23. amazing post NW! Love all the comments - I'm all for some sort of change . . . but I don't like the idea of the govt running HC . . . gives me really bad vibes!

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  24. I have kinda stayed out of this but I think this was an excellent post.

    I am a Canadian and our system is not perfect but I can tell you that the thought of an illness bankrupting someone is terrifying to me and I think it should be a much more pressing concern than raised taxes or the fear that hospitals might become less innovative if doctors are on salary, etc. etc..

    Also? Last I checked the US Govt paid our more $ per capita for helath care than Canada and our system is free! That hs to tell you that your system needs change.

    Again, excellent post and kudos to OHMommy for starting this debate in such a respectful manner.

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  25. Great post! The healthcare system in this country is one of the many reasons we are seriously considering a move back to the UK in the near future.

    I'd take a govt. run health industry over an insurance-run one any day.

    Obama's plan may not be perfect, but it's a start.

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  26. I love your final statement.... Excellent post! I'm Canadian, so I don't have much to say on this topic, but I do feel lucky to have the system we have. I shudder to think of what Americans go through when they get ill. I've heard nightmare stories about the costs.

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  27. I love this post, especially that you have (correctly) wondered why we can't aim for the best in the world. We are so far from that now that it's actually embarrassing.

    When I hear people put down other countries and their systems because of long wait times, I always wonder, has that person gone to the ER for a non emergency HERE? When I thought I might have broken my foot, I called my primary care practitioner for an appointment. They said I had to go the emergency room for treatment. They didn't have an x-ray machine at their office and the only way my insurance would cover the bill was if I went to the ER. So, I walked into the ER and waited to be seen. And waited. And waited. Keep in mind, I WORKED for that hospital. I knew everyone who was on staff at the time, and I know for a fact I received preferential treatment. With preferential treatment it took over eight hours to get x-rays, a temporary cast, and the referral I needed to see a specialist. I didn't pay a penny because, again, I worked for that hospital and had crazy good insurance. The hospital system is one of the best in the nation, but I still don't think sitting around for eight hours should be considered world class care. We CAN do better.

    We have to.

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  28. Come link up with me in my comments, because much like Facebook for you, I have no idea how to do that. Bravo for taking a dip into this pool. Our opinions need to be heard, both good and bad and we need change. WE can do this!

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  29. Just started following your blog and wanted to share that i LOVE your posts! So funny and relateable..lol

    april

    http://mommyhoodunscripted.blogspot.com

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  30. I'd just like to respondon to one of the early posters, who seems to slam those who at one time or another must rely on government services:

    While it's clear that there are people in the world who will abuse any system, holding those few who do so as an excuse not to provide assitance to the needy fallen on hard times is simply unfair. I amthinking here of absued women, victims of domestic abuse, who don't have a choice to remain with a spouse for their health care. Why should women and children suffer even more - first with an abusive parent, and second with lack of health care or government assistance (often temporary until mom gets on her feet)?

    I don't know what state you're writing from, but not every state provides free services equally. Some are more limited than others, and "welfare" is by and large no longer the government teat you purport it to be. California is one example - one can only be on "welfare"/WIC (food stamps) for 5 years, ONCE, throughout your entire life, regardless of how many children one has beyond that. Once you've used your allotment of welfare, that's it, forever. Also, instead of "free" housing, spending money, or transportation (none of which are part of the package in California) the benefits provided by the state by and large are either subsidized education or a work-study program, 35 hours a week every single week of the year (excluding federal holidays). If you fall behind your 35 hours, you are removed from the program. It's a full time job, and most recepients work extremely hard to balance life for themselves and their kids with the cards life has dealt.

    So please, next time you make assumptions about those you asssume "are very comfortable with their way of life" on the taxpayers' dime, take a good look in the mirror and ask yourself whether the disillusionment is theirs or yours. They are most likely trying to make the best of a bad situation, and I as an American taxpayer am more than glad to help other fellow Americans get back on their feet.

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