I want to apologize to President Obama. But first, some background.
I found out three weeks ago I have cancer. I’m 49 years old, have been married for almost 20 years and have two kids. My husband has his own small computer business, and I run a small nonprofit in the San Fernando Valley. I am also an artist. Money is tight, and we don’t spend it frivolously. We’re just ordinary, middle-class people, making an honest living, raising great kids and participating in our community, the kids’ schools and church.
We’re good people, and we work hard. But we haven’t been able to afford health insurance for more than two years. And now I have third-stage breast cancer and am facing months of expensive treatment.
To understand how such a thing could happen to a family like ours, I need to take you back nine years to when my husband got laid off from the entertainment company where he’d worked for 10 years. Until then, we had been insured through his work, with a first-rate plan. After he got laid off, we got to keep that health insurance for 18 months through COBRA, by paying $1,300 a month, which was a huge burden on an unemployed father and his family.
By the time the COBRA ran out, my husband had decided to go into business for himself, so we had to purchase our own insurance. That was fine for a while. Every year his business grew. But insurance premiums were steadily rising too. More than once, we switched carriers for a lower rate, only to have them raise rates significantly after a few months.
With the recession, both of our businesses took a huge hit — my husband’s income was cut in half, and the foundations that had supported my small nonprofit were going through their own tough times. We had to start using a home equity line of credit to pay for our health insurance premiums (which by that point cost as much as our monthly mortgage). When the bank capped our home equity line, we were forced to cash in my husband’s IRA. The time finally came when we had to make a choice between paying our mortgage or paying for health insurance. We chose to keep our house. We made a nerve-racking gamble, and we lost.
Not having insurance amplifies cancer stress. After the diagnosis, instead of focusing all of my energy on getting well, I was panicked about how we were going to pay for everything. I felt guilty and embarrassed about not being insured. When I went to the diagnostic center to pick up my first reports, I was sent to the financial department, where a woman sat me down to talk about resources for “cash patients” (a polite way of saying “uninsured”).
“I’m not a deadbeat,” I blurted out. “I’m a good person. I have two kids and a house!” The clerk was sympathetic, telling me how even though she worked in the healthcare field, she could barely afford insurance herself.
Although there have been a few people who judged us harshly, most people have been understanding about how this could happen to us. That’s given me the courage to “out” myself and my family in hopes that it will educate people who are still lucky enough to have health insurance and view people like my family as irresponsible. We’re not. What I want people to understand is that, if this could happen to us, it could happen to anybody.
If you are fortunate enough to still be employed and have insurance through your employers, you may feel insulated from the sufferings of people like me right now. But things can change abruptly. If you still have a good job with insurance, that doesn’t mean that you’re better than me, more deserving than me or smarter than me. It just means that you are luckier. And access to healthcare shouldn’t depend on luck.
Fortunately for me, I’ve been saved by the federal government’s Pre-existing Condition Insurance Plan, something I had never heard of before needing it. It’s part of President Obama’s healthcare plan, one of the things that has already kicked in, and it guarantees access to insurance for U.S. citizens with preexisting conditions who have been uninsured for at least six months. The application was short, the premiums are affordable, and I have found the people who work in the administration office to be quite compassionate (nothing like the people I have dealt with over the years at other insurance companies.) It’s not perfect, of course, and it still leaves many people in need out in the cold. But it’s a start, and for me it’s been a lifesaver — perhaps literally.
Which brings me to my apology. I was pretty mad at Obama before I learned about this new insurance plan. I had changed my registration from Democrat to Independent, and I had blacked out the top of the “h” on my Obama bumper sticker, so that it read, “Got nope” instead of “got hope.” I felt like he had let down the struggling middle class. My son and I had campaigned for him, but since he took office, we felt he had let us down.
So this is my public apology. I’m sorry I didn’t do enough of my own research to find out what promises the president has made good on. I’m sorry I didn’t realize that he really has stood up for me and my family, and for so many others like us. I’m getting a new bumper sticker to cover the one that says “Got nope.” It will say “ObamaCares.”
Spike Dolomite Ward is the founder and executive director of Arts in Education Aid Council, a nonprofit organization that is restoring the arts to public schools in the San Fernando Valley. This piece originally appeared in the L.A. Times.
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My husband was given three to four months to live in 2011. He was diagnosed with SMALL CELL (oat) LUNG CANCER. Oncologist said, “Get your affairs in order.” After ONE chemo treatment he said, NO MORE….I’m going to die anyway so I am not subjecting myself to this barbaric non-treatment. In the meantime our daughter had brain tumor and went to Shands in Gainesville, FL They removed the tumor size of small orange but unfortunately dendrytes had covered the brain and intertwined with blood vessels. Someone gave her a bottle of ESSIAC TEA (aka 4-herb tea) and when she went back 6 wks later, she was completely healed! She gave her dad a bottle, he started after the first & last chemo and in six weeks his stage 4 cancer was gone. That was almost two years ago. He is healthy and happy and still takes this old Objibwah native treatment l tsp a day. Our daughter is still healthy. We have shared this tea with hundreds and those who have contacted us are ALL CURED. Rene Cassie brought it to USA in l920 but the powers that be have KEPT IT FROM US AND TRIED TO DESTROY THE FORMULA which are simple weeds that grow wild. Check out Herbal Healer Academy, Inc (AZ) click on 4-herb tea and read the TESTIMONIALS. Also see: Rene Cassie Story and Google Dr. Gary Glum. You will be elated and ANGRY that the BIG BUSINESS side of cancer industry is more about making money than healing. The tea is about $30 for a bottle that lasts six weeks.
State exchanges, of federal if the state doesn’t have one start in 2014.
“So I say without apology, let’s give the new legislation a chance to work. That time is still years in the future. it can’t be much worse than what we now have.”
It could actually be much much worse becuase it undoes so much of what is already in place. Its like taking out someone’s heart and replacing it with a liver and saying it can’t be much worse.
For example when the Federal and State governments spend trillions and have nothing to show for it you don’t get that money back. Future generations are going to have to repay this failure which will severly strain their ability to spend elsewhere it is needed.
When you give 30 million people(supposedly) coverage its hard to pass a bill one day taking it away. Medicare is the perfect example of this, major failure to accomplish its stated goals and the cost is thousands of times higher then it was suppose to be, but its stuck in place becuase no one wants to be the person to cancel insurance on 30 million old people.
While MA, CGT, and VT got their waiverts Indiana was denied even though they are trying to expand a succesful proven program. The problem with waivers is it makes the process political, if your a liberal state advancing liberal agendas you get a waiver. If your conservative trying a more conservative solution you get denied. Unless you believe liberals have a monopoly on good ideas this is obviosuly a receipt for disaster.
If enacted there will never be any going back from PPACA, the damage will be real and forever.
I talk to the guy every year. We cannot find anything like this plan. You describe.
First problem if you only talk to your broker once a year your doing it all wrong. Second maybe its time for a new broker.
What’s your current Deductible?
How many employees do you cover?
Very very few cases should an employer with more then 10-15 employees have a deductible under $5000. If you do your just throwing money away 90% of the time.
isn’t a $5000 deductible that will cover you if you get cancer better then no coverage at all? Your insurance needs to match your sitution, when your unemployeed you don’t eat at Morton’s every night or buy a new BMW do you? Let go of the cadillac insurance, buy a high deductibcle, and save as much as you can until your sitution improves. I would say its common sense but obviosuly it isn’t.
“Employee-subsidized health insurance may have been a good idea when the Blues were created but since then, especially with the creation of for-profit hospitals in the Sixties, it has served to lead the majority of beneficiaries to have no idea about the true costs of health care until they are faced with the retail prices without the employer subsidy.”
Compared to Medicaid and Medicare participants who have an exact idea of what their care cost? Or how about those in siocialized systems that are doing so well in Canada and Europe, they grasp the consiquences of their consumption?
“That 18-month coverage is available but the full costs hits the newly unemployed person with a savage burden at the exact time that money suddenly becomes scarce.”
You mean the required disclosure when they are hired doesn’t prepare them for this cost? Why don’t they save 18 months worth of COBRA premium while they are employees so when they do lose their job they are prepared? Ah becuase who in their right mind would give up cable TV and annual vacations to save.
“It’s no wonder that a very small minority of people even use COBRA coverage. ”
The actual reason so few people use it is so few people need it. Most people leave work already have another job lined up. A large number of people have coverage through a spouse. Even more people are willing to gamble they wont get sick before their new coverage starts, which is a safe gamble as you have 60 days from notice to go back and elect. Truth isn’t nearly compelling is it?
“This started in 1910 when we didn’t create a sustainable business model.”
What other industrialized nation is stil standing from 1910? In fact we created the only sustainable model and thats why we are still here in pretty much the same form as 1910.
What are you paying $500 a month in co-pays for? And why aren’t you paying your expenses pre-tax?
http://www.bgladd.com/NoCryingInHealthCare.jpg
So? You think I care what party affiliation is at hand!?
Think about this little fact, folks. These idiots in Congress can’t even work to do their f—ing jobs directly, that being come to some middle ground in handing the debt, and you lame defenders think they can fix health care!?
Supporters of PPACA, sorry, but I hope you get screwed as much as the rest of the country if the Court cluelessly favors this garbage legislation.
Governor Roemer IS a Republican….
From you? No.
You NEVER learn, do you?
What, the song about Johnny versus the Devil?
Have no respect for OWS crowd. Dependency is not a right, it is a weakness that only furthers destruction of a society,
Frankly, Democrats really are enablers and codependents in the end. Not to give Republicans an out, they are equally enabling the biggest addiction in this country, that being greed.
Cue the violins.
Here you go Dr. D…. Enjoy, or despair…. 🙂
http://www.youtube.com/watch?v=8oMoAMnFczY
So funny, I forgot to laugh. If someone came along and ruined your profession, you really think you would enjoy others laughing at your expense?
Exhibit A for colleagues, non clinicians making light of health care’s demise.
Nice try.
First, we had “ObamaCare.” In 2012 we will have “ObamaHair.” The key to re-election.
http://www.bgladd.com/ObamaHair2012.jpg
Gee, if you don’t embrace the party line that is the basis of this site, ie foster the use of EHR and other computer tech interventions, you are labeled a crack pot or annoyance or called just plain rude, even when the accusers do the accusing as rude as the dissenters. And then, when the dissenters get sick and tired of the dismissals or frank projections by the apologists and defenders of said above agenda and do get rude, then the attackers get to say “see, I told you so”.
Give me a break, writing long posts at threads and linking to sites that are equally as long do not validate a position. Sometimes, making your point short and eloquently is impressive and appreciated. I stand by my position, there are those here who are antiphysician, they just pontificate to minimize the simple statement being said. Maybe Mr G is not frankly antiphysician, but, he can come across as such at times. Must piss off the overt ones who just want to “dispatch” us as simply as pushing off a cliff.
Obamacare is not a solution, just some piecemeal ideas that could get us there with better full input from all the parties involved. But, do politicians want solutions, or just quick fixes. Anyone here want to be that can being drop kicked, in this case off the cliff?
(Don’t worry. The day is arriving when long-term care issues will be more pressing than anything else and the problems CLASS was intended to address will make today’s unemployment look like a walk in the park. Perhaps then the political will may force action. Or maybe not.)
John,
Long before this could ever happen the young will have already dispatched the old off the cliff. All my young friends (30 ish) are conservative and wondering who thinks they are fool enough to pick up the tab for the senior follies.
Is DMD the new Nate?
@DMD December 13, 2011 at 7:15 am
“antiphysician”
Right.
Have a nice day.
Here’s a tip, although per your writings I doubt you will be interested: making statements that basically defends someone makes you an accomplice. Had you just said the first time something similar to “here’s the clip, I don’t interpret her statement as you do” would have been a bit more neutral. And repeatedly challenging me even after I at least acknowledge she did not word for word say “pass the bill and we’ll find out what’s in it” just gets old and annoying.
So what is my partisan bent? That I support physicians being allowed to practice providing care as trained? If that is partisan, guilty as charged. And doing my job is a crime?
If you believe that as a yes, thanks for the validation, antiphysician!
It does not follow that, because you “despise both parties equally” you are somehow loftily “non-partisan.”
“why the hell do you defend what Pelosi basically said back in March 2010?”
Document for me where EVER posted a defense of it. (Hint: You cannot.) I merely, repeatedly point out your misquoting her precise words (Google Pelosi pass the bill). How you construe them is your right and your problem.
“enslaved clinicians”
You remain utterly free to go Cash-Only Concierge.
Seek help.
Really, what defines partisan to you, I despise both parties equally, one gave us a war that enriched the military machine, and then the other gave us legislation that enslaved clinicians, and we will find out it will enrich the cronies behind the scenes. If partisan means I worship a party principle above the needs of the public, you tell us who that worship is to.
And if you read this legislation along the way and continue to write what you write, then tell us who you worship, because I do not read your commentary as so neutral and concerned for the well being of the public. For instance, why the hell do you defend what Pelosi basically said back in March 2010?
This is pathetically piss ass poor legislation as a whole. And it belongs in a hole.
“You partisan hacks really annoy me!”
That’s rich. Everyone but YOU is “partisan.”
Moreover, your addiction to annoyance is by now exhaustively documented.
I followed every PPACA draft along the way to enactment. It wasn’t difficult to do (and I made my displeasure known). So, spare us the canard that this was some mysterious law that just appeared incognito.
Having followed this sausage from the time they killed the pig I only partly agree with your Left vs Right observation. It’s true there was (and continues to be) a fundamental political disagreement about how much government control over the private sector is appropriate. In the case of ACA, though, my impression is that the big players behind the scenes were corporate more than political — insurance, pharmaceuticals and powerful interest groups ranging from various physician and hospital organizations to AARP — all plowing tons of money at both political parties and all sides of the political spectrum, Left, Right and Center.
The result has been a very uneven product, although the core insurance reforms are probably more important than anything medical. The most significant change medically has been putting teeth in Medpac, a panel of experts that has been around since 1997 making recommendations but without any real authority to execute any of those recommendations. Until ACA Congress had the final say and as we have seen recently Congress says as little as possible and won’t go near anything that looks politically risky, much less radioactive. Now that panel can make recommendations and they will be followed unless Congress pro-actively intervenes to stop them.
Aside from that, the main corpus of what is in the legislation won’t be unrolled completely until 2017, and even then much of it will still be in a state of flux, mainly because Medicare reimbursements will be subject to go up or down for every provider depending on how closely they have followed guidelines and recommendations.
As Dr. D. gleefully notes the famous “mandate” is up for discussion by the Supreme Court in the spring and the CLASS act, which was chucked into the bill at the last moment as a tribute to the late Senator Kennedy, was tossed out due to insurmountable actuarial problems. (Don’t worry. The day is arriving when long-term care issues will be more pressing than anything else and the problems CLASS was intended to address will make today’s unemployment look like a walk in the park. Perhaps then the political will may force action. Or maybe not.)
And yes, this post and comments thread is a good illustration of the result of wholesale negative propaganda.
Sure, the right put up a negative campaign that has it’s inappropriateness, but come on, don’t be so equally partisan and trying to jam rose colored glasses on those who want the facts. Because, and I know my peer Mr G will harp on this in a heartbeat, but she said it basically, Pelosi used as one excuse “pass it to find out what’s in it” is NOT a reason to pass legislation.
And since it passed we are finding pretty large and ugly warts. Example, CLASS? And why is it the mandate and demand on states to have to participate is getting reviewed by the Supreme Court? Not so cut and dried were these parts, eh? But, partisan legislation has no dark side to the group that passed it, equally eh? Just like we had to buy that simple and quick war in Iraq almost 9 years ago now, eh, eh, eh?
You partisan hacks really annoy me!
While the policy was good, the Patient Protection and Affordable Care Act suffered most from a lack of effective public relations about it. While it was making its way through Congress, people didn’t understand its implications.
The right, however, put forth incredibly effective negative propaganda against it.
This post is a good example of the result.
I am referring to all of their gov’t profligate spending of money they do not have. Their public option was to drive off the cliff much faster than we are.
You cannot keep people out of the ER. Gatekeepers have been tried. Higher copays have been tried. EMTALA flies in the face of keeping people out of the Er.
That is my place. Everyone comes to the ER. It is “free”. It is 24 hrs. It is always available.
It will be crushed by ObamaCare.
Your heart attack will wait behind everyone whining about crap.
Today I saw NO ONE who needed a doctor for an emergency. My patients and those of my PAs would have been fine without us.
i will receive if I am lucky 35 cents on the dollar.
No other specialty gives it away (has it stolen) like the ER.
MD aas Hell
The theif is US.
This started in 1910 when we didn’t create a sustainable business model.
God bless all who can not afford care.
My cost with my conditions with moderate plan 45 years diabetic, 33 years hep C, spinal stenosis = $500 mo premium + $500 mo CoPay. Lets see: $12 K after taxes since I don’t meed threshold. Most of my neighbors earn $22K-$44K.
In my career I have watched ego kill patients
In my career I have been asked to project an inividuals life-span to determine if their assets were sufficient to create investment opportunity in extended care.
In my career I have been denied glucose monitoring devices, fought the fight because I am the lucky 1% of patients who are educated on how the system works, clinical guidelines and down-right stuburn.
In my career I have watched wealthy (>= $100M net worth) people become richer by selling vapor-ware.
My judgment: We made a mistake in 1910 when we allowed the AMA to talk us out of universal coverage which would have forced a, more efficient and still innovative healthcare system (sorry too many scientist friends in other nations who validate my points).
See ya on the freeway with my cardboard sign.
DMD at December 10, 2011 at 6:51 pm
“Can you really look people in the eye and tell them they have the “right” to demand complete access to all care options, even if they do not have the ability to pay for the care?”
___
Predictable Straw Man.
“And, then, having codified it, we don’t lie awake nights worrying that everyone will demand a Special Forces FOB dug into his or her front yard, or an occupied Metro PD Black & White, an ambulance, and a hook & ladder truck parked at the curb 24/7.”
Show me where I EVER argued that everyone has a “right” to EVERYTHING all the time.
Do you have a reading comprehension problem, or is it simply an impenetrable ideological firewall?
Again (tiresomely), none of this is exactly news. Google “Allocating Health Care Morally,” Elhauge, 1994.
Wow, re reading that comment was the ultimate Freudian slip on my part:
“we just don’t want to EXCEPT the odds, do we?” It should have read “accept” the odds. Saturday night is alright for fightin’, per Sir Elton John.
probably catch the grief on Monday, enjoy your football games tomorrow!
No one touched my comment at an earlier thread asking if third world societies have a “right” to health care. Hmm, you think silence can be validation at times? Is it really a right, or, societies like ours that are more giving and allow more opportunity create false hope and expectations? Can you really look people in the eye and tell them they have the “right” to demand complete access to all care options, even if they do not have the ability to pay for the care?
I am not saying I have the right to say otherwise, but, let’s be honest folks, that gorilla dancing in the room eventually steps on toes, and 800 pounds sure can hurt like hell on those toes. Oh yeah, I forgot, the apologists and defenders are either clinging to the walls, or found the door to get out. Ignorance is not bliss, it is just avoiding the truth. Caring does not mean you can’t call it as it is!!!
People just don’t want to accept cold hard truths. People die of unfair causes, and it sucks! But, technology has given false hope, thinking that buying a couple more months, even a few years, is worth the cost, UNTIL, others realize it isn’t the patient paying for the care as a majority of the cost this wonderful and accessible care can provide.
Maybe it is time for some to come to the realization that this planet was not intending to have 10 Billion humans walking on the soil. Read the comment currently at the end of this thread and think about what it will mean to keep more people alive those few more years, and then who is paying those bills. Hey John Ballard, got some hundred dollar printing plates in your basement to print out all that extra cash to foot PPACA!?!?
Read this article in this weekend’s Parade magazine, about a 10 year old girl, Matisse Reid, who is still alive today after being born with a congenital condition called chronic idiopathic intestinal obstruction, who managed to survive until her parents, from New Zealand, brought her to a hospital in Pittsburgh and eventually got her an organ transplant last year.
Wonderful story to run in Parade magazine. Except one little thing that makes a story like this very unlikely to read in Parade magazine by the year 2017: you think that health care around PPACA will be able to finance situations like this? And the next comment will incense readers to the end of time, but, why is a situation like this happening? Isn’t life about limits? If one of my children had an illness of this magnitude, what would I do? Probably be angst ridden while I tried to find ways to help him/her live on, but, would I finally come to terms this was life saying this life opportunity was limited? This child will be on anti-rejection meds the rest of her life as of now. You think being on anti-rejection meds will be simple and uneventful? No iatrogenic consequences? And the literally hundreds of thousands dollar question: who paid for the care? Don’t know the details, but doubt the parents paid much. Are you happy you did as a taxpayer or fellow insured patient in their plan? And the rates go up for payments of this magnitude. Still smiling after reading the story and then considering the unmentioned details!?
This is yet another example to me why health care is in the mess it is in. No one wants to bury a child. No one wants to bury anyone we love. But, as long as we artificially extend life beyond what the natural boundaries intend, we are faking ourselves out. The article ends with noting how the child is now enjoying the activities a 10 year old should. But what if issues go south. Did anyone ever think of how the child will think and feel to be robbed of a “normal” lifestyle if illness recurs? No, we don’t want to think of negative and detrimental futures. But, statistics don’t exist for the sake of having academic classes on it. Numbers are truth to a fair degree.
We just don’t want to except the odds, do we?
Ya think?
All I know is what I read in the papers.
http (colon slash slash) shr (dot) tn/0TWF
You are scary.
See my post “Public Optional”
“How can we say that people have an “intrinsic right” to military defense, or to police and fire protection, (or to safe food and water, or to otherwise safe products that won’t electrocute us when we plug them in)? Well, we simply SAY it. And then we codify it. And, then, having codified it, we don’t lie awake nights worrying that everyone will demand a Special Forces FOB dug into his or her front yard, or an occupied Metro PD Black & White, an ambulance, and a hook & ladder truck parked at the curb 24/7.”
Again, “rights” are things that societies agree to codify and defend — as, say, “obligations.”
e.g., fundamentally, your “inalienable rights” to “life, liberty, and the pursuit of happiness” exist to the extent that your society will defend and enforce them. Absent that, you have a Tribal Warlord Might–Makes-Right ethos.
That the definition and administration of “rights” and societal resources is an endless pain in the ass (otherwise known as “government”) diminishes the core point not one whit.
http://bgladd.blogspot.com/2009/08/public-optional.html
I think I tend to see it more as an obligation than a right, but maybe my religious beliefs influence me too much in this.
Steve
I like most of these ideas, and have suggested the same or similar elsewhere. Your end of life suggestion is not currently politically viable. It would take government action and would be demagogued. The current GOP will not allow it to take effect. I was asked to write some health policy by our (GOP) congressman. I put something very similar into my suggestions and this was a no-no.
ER utilization is tricky. I have not read a practical way to make it work, but am open to suggestions. If people are not going to go to the ER, they need viable alternatives.
Your co-pay idea is interesting, but already know from other research that when co-pays are high, patients often choose to forego the care that would be most helpful. Besides, the patients dont order tests, we do. Maybe the risk should be borne by the doc, but then how much do we miss?
I like the goals idea. I know private insurers have tried it. The results, IIRC, have been mixed.
I think my point here, if I have any, is that health care is really, really hard. It does not act like ordinary markets. And, since we started with some poor lady who has breast ca, I would note that our system really does fail people. We pay much more for similar care than other countries while covering far fewer. Rather than having Cadillac insurance, it sounds to me like this woman had insurance equivalent to what most of us carry. When she lost her job, or her husband lost his, they lost their insurance, which seems to be the norm in our country.
Steve
@Peter, Great comment!
@John, I think you misread the little exchange above. There is no cat fighting. This is actually a very rare moment, when I believe Dr. D and I are (almost) in full agreement, and I must say that I think I see Dr. Mike’s point as well, up to a point.
Either way, the way I see it, health care, which is only a symptom of a larger ailment, may present a rare opportunity for physicians to reassert a leadership role on behalf of all of us, instead of passively (or furiously) accepting dicta from above in the hopes of maintaining a privileged income for a little while longer.
There is an enormous amount of largely well deserved trust that the public has in their doctors, and in this day and age when Congress approval ratings are in single digits, this trust could be utilized for the public good, which I believe is very well aligned with the profession’s long term interests.
“health care is not a right. It is a commodity.”
That’s a moral decision a society makes. Not an objective fact.
The question is not whether this lady, or the millions of other people in the same position did not make flawless decisions in their life, it is that they are employed, or were employed in jobs/businesses that did not come with the guarantee of recession proof income that would have allowed them to maintain coverage/lifestyle, or that their time to recover and continue paying premiums just ran out, along with their 401Ks and savings and maybe help from relatives and friends before the economy came back.
The smug among you who continue to get full income, or at least income that allows for continued health coverage, are in NO position (or no smarter) to look down your nose at people who choose different careers that contribute to this economy and which support your lifestyle, but do not offer the same income protections (like doctors). Maybe everyone should take a career that has the strength of political lobbyists to maintain their cash flow, or better yet, keep the bonuses coming and no jail time for financial fraud that created this fiasco of an economy which has relied on debt for the masses and the redistribution of taxes for the wealthy for 30 years to keep the GDP chugging away on the boom and bust cycle.
Ask the FED where Ms. Spike Dolomite Ward’s bailout is.
I have been president of our corporation for quite a while. I have taken care of our insurance broker’s wife when she comes to the hospital. I talk to the guy every year. We cannot find anything like this plan. You describe. Our plan runs about what she pays. While you keep calling it a Cadillac plan, I dont really know what she has. I do know that if you have any kind of illness, individual insurance is sky high or unobtainable. Pardon my skepticism, but when I cannot find these $300 plans, I wonder. Is your wife the same age? Are you in a small business group?
Steve
So your answer is to find a situation in which an idea doesn’t work, and then claim that proves it a bad idea? Why do people have such a hard time imagining new ideas?
Half the population below average intelligence? Yes, that would be true seeing as with large numbers half are above and half are below any mathmatical average. But your statement implies something that is not true – that the below average half are far below average and that simply is not the case. The great majority are within a few points of average.
Here are some ideas just for starters (not proposals, just ideas. There is a difference as these are just for discussion, not being represented as having been fully thought out)
How about a website with a video about end of life choices, presenting pros and cons. Medicare pts view the video, fill out an advance directive and health care power of atty online, and medicare waves their deductible for the year, no matter what their election was regarding EOL care.
How about negative feedback for over utilization of the ER – is that really so hard to imagine how to implement?
How about rewarding patients for achieving goals. It would be fairly easy to come up with a one page health inventory, score it and have that affect your medicare premium.
It really wouldn’t be that hard to have the copay for a certain subset of expensive testing procedures be based off of a worksheet to determine pre-test probability of the condition, with the copay waived altogether if the condition sought is actually found.
Why not reform the payment system so that patients share in the savings by choosing institutions that provide value. (What is in an ACO for patients anyway? – they get sucked up into a system they might not have choosen to participate in otherwise, just so the docs and hospitals can make more money)
I also believe it is worth further discussion to consider somehow tying health care spending in the last 6 months of life to the tax consequences on the estate. Yes, thorny subject, but there are m