Give me my socialized medicine
Posted by BrianJames Taranto pointed out this editorial in an Oregon newspaper. It describes the response of the state’s health care system to a 64-year-old lady with lung cancer.
After her oncologist prescribed a cancer drug that would cost $4,000 a month, the newspaper reported, “Wagner was notified that the Oregon Health Plan wouldn’t cover the treatment, but that it would cover palliative, or comfort, care, including, if she chose, doctor-assisted suicide.”
The column speaks of how the state “tries to ration health care.” Health care rationing. That sounds fantastic. Remember what happens when you ration something?
In this particular case the cancer drug wasn’t authorized because the patient stood a less than 5% chance of survival, which is the state approved threshold. This situation provides a perfect “ultimate extension” argument against socialized medicine - the government deciding who gets to live and die. Actually, this case is worse than what I originally anticipated. I expected to hear stories about treatments being denied. “Sorry Fred,” the doctor would say, “but you don’t qualify for heart surgery.” Instead of simply just letting you die what we’ll actually see is the government offering to just kill you.
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July 31st, 2008 at 10:51 am
Is that any more heinous that what a for-profit insurance company would have done? Their threshold would probably be much, much closer to 100%, even.
July 31st, 2008 at 11:30 am
I have to agree with the above poster. Only if you had a specialized (and extremely expensive) cancer coverage plan would such a medication have been covered. Such a plan is rarely (if ever) affordable to the average person, and even if you are covered, rest assured that the insurance company will do everything in its power to make sure that there is some loophole that will excuse it from having to pay up. Just ask my aunt who was denied coverage for her ovarian cancer treatment because she “failed to disclose a pre-existing condition.” The pre-existing condition was a yeast infection– not exactly a red flag.
All that being said, private insurance is always available in addition to any socialized coverage. But that’s assuming that a private insurer would have covered anything at all. Patients are also welcome to cover their own medical expenses should they wish to receive care that is not covered by a socialized health care program– just as they would be under a private insurer. At least the socialized coverage is offering “comfort care” which does include pain medication. It’s doubtful that a private insurer would have covered that much.
July 31st, 2008 at 1:27 pm
ttownfeen - Is it any less heinous than what a for-profit insurance company would have done?
ALMod - Just curious - on what basis do you claim a private insurer would not have paid for “comfort care”? A lot of plans would cover that. Do you have some professional experience or study base (note - not anecdotal evidence), or are you making a conjecture based on personal opinion of said companies.
July 31st, 2008 at 10:30 pm
[...] Flashpoint Brian considers an anecdote of government health care. [...]
August 1st, 2008 at 12:38 am
I only know from my own personal experiences, Jonathan. I wish I didn’t. I wish I’d have only seen it reported in studies and statistics, but I’ve seen it with friends and family more than once.
Yes, some plans will cover “comfort care.” In fact, as you noted, “a lot of plans would cover that.” Unfortunately, “a lot” and “all” or even “most” are not the same thing. And even if you have insurance, there’s no guarantee that they won’t drop you mid-coverage:
http://rawstory.com/news/2007/Report_Bonuses_paid_for_dropping_sick_1109.html
I can find more articles if you’d like.
My point is this: Why must it be all or nothing? Would not a limited socialized health plan with the option of buying additional private insurance be better than nothing at all?
August 1st, 2008 at 5:24 am
Let’s be frank - neither government run nor privately run health care is a panacea. Both have their own, unique set of cons. The biggest con (and there are many important others) with government run care is that it will have a depressing effect on innovation in the health care industry. There is just something about profits that encourages people to try really hard to find new cures and treatments in order to enrich themselves.
As for this case, it is considerably more sinister for your government to offer to kill you (unless you’re a hardened criminal) than for a private company to make the same offer. Don’t get me wrong, both are “heinous.” But I think there is more of an expectation that the government exists to protect you from threats and provide you with a just legal system, not kill you.
August 1st, 2008 at 6:32 am
Thank you Brian - that was my point with the “heinous” comment. This is not a role of the state - and how particularly eerie to see they will pay for you to kill yourself when they consider you a burden to society.
ALmod - Yes, I admit not all plans would cover it - which is why I said a lot - I don’t know the details of 100% of the plans in America so I can’t tell you if most would. I’m sorry your friends and family have had such problems, but the state denying them the same care isn’t going to make it any better.
No a socialized split is not going to be better. One, like Brian says with government run care there will be a depressing effect on innovation in the health care industry. Why do you think so many people from around the world come here for health care - it’s the best you can find. That’s not just sheer luck, it’s because of the system of health care we’ve maintained.
August 1st, 2008 at 1:44 pm
Well, as someone who has, in the last year, had to buy an individual family policy instead of having group BCBS, I have to say that my view of health care reform, universal health insurance, socialized medicine, or whatever you want to call it, has changed a LOT.
People with group policies through their employers - especially if it’s a large company - can’t even begin to imagine the hoops you have to jump through with a private policy, the cost of it, and the exclusions and limitations the company is free to impose.
And this is one area - in Alabama at least - where the magic “free market” really sucks. It’s the individual against the insurance company while the state regulating agency yawns. Guess who wins? Alabama has almost no consumer protections for people trying to buy their own policies.
We put it off as long as possible, but my husband finally got fed up with the job he hated in a large company and set up his own business. We’re lucky that he’s doing great so far, but there’s no way we would have risked it if anyone in the family had any health problems or chronic illnesses. Health insurance companies just won’t cover you individually (group policies are much different and better regulated) if there’s any problem. Or, they’ll cover you for everything except the health issue you have.
It’s not just a matter of life and death for some people, or opening your family up to financial ruin if you lose your job and benefits, it’s stifling entrepreneurs and small businesses.
I used to sneer and throw out the “socialized medicine” epithet with the best of them when we were securely covered by BCBS group health care. But this past year with good old Humana and their individual policy (and they were the best of the lot) has opened my eyes a lot. We don’t need the government running the system a la Great Britain, but DAMN IT somebody needs to start looking out for the individuals, because we’re getting screwed.
August 1st, 2008 at 2:30 pm
Lynne’s point is one that I’ve been trying to make for a long time. Something is always better than nothing. I’m just as much for a free market as anyone, but the reason why I don’t lean as pure libertarian is because it’s not a perfect world, and leaving the market without some government regulation will end with monopolies and unsafe products. In the end, to not regulate would be the government failing us on the basic principle of protecting us. Medical care follows under one of those basic needs for survival. By NOT allowing you access to good medical care, we are basically doing the same as having the government offer to kill a person. We’re just doing it more slowly and painfully and leading them to financial ruin in the meantime. If you are sick, you should be able to see a doctor.
Yes, people should be able to regulate themselves and take personal responsibility. Yes, the same should be true for businesses. But it’s not a perfect world, and let’s face it, people and the corporations that they run are greedy and irresponsible, and without a little bit of babysitting, they’ll make mistakes that will screw over even the most responsible of the rest of us.
And while there seems to be some fear in the development of new cures and treatments, I believe it to be unfounded. I may not have complete faith in a completely free market, but I do have complete faith in the ability of the wealthy elite to get sick as well as complete faith in the greed of corporations who want a better, cheaper, readily available treatment that the government and even private insurers will pay for.
And like it or not, we aren’t number one on everything. There is vast medical research going on all over the world. Iceland in particular comes to mind. All you have to do is use Google to find it.
August 1st, 2008 at 2:34 pm
Lynne,
There is no free market in health care insurance and there never will be as long as the insurance is, in most cases, tied to your job. I was on an individual BCBS policy until yesterday through ALFA but started on a group policy today (also BCBS) through my job. The individual policy didn’t cover as much upfront like copays and prescriptions but once you get past that, the policies were identical. The individual policy also cost less than the group.
August 1st, 2008 at 2:54 pm
Bill,
We spent months evaluating policies before hubby made the jump to self-employment, and nothing we could buy individually matched the coverage he had at work. We’re now paying 2.5 times as much for less coverage.
And, because he has a family history of colon cancer, even though he’s never been diagnosed and has had regular screening, he’s permanently excluded from coverage for any type of cancer. That’s from 3 different insurers.
In another case, according to our (high deductible) policy, routine physicals were covered. I took our 14 yr old daughter for hers and the only problem was some acne that the doctor gave us a prescription for. So, Humana said that, since we had “sought treatment” for a condition (the acne), then the physical wasn’t a physical, but an office visit and wouldn’t pay the cost of the physical. Now, we didn’t “seek treatment,” the doctor noticed the acne and was concerned about the nature of the breakout. It took 4 calls and 3 letters to get the matter settled. I just wondered what it will be like if one of us gets really sick. How many letters, calls, even lawsuits will it take to get the coverage we bought?
If you’ve got good individual coverage, I’m sincerely glad for you. I thought ours was just dandy until I had to fight with the $%#@ company over everything. Be alert and don’t assume anything.
The best “reform” any politician or party could offer is the ability for individuals to buy into group-type policies - with some controls over what’s “excluded” and what’s not.
I never thought much about this before, but health care has turned from a peripheral concern in our family into a really big issue for us this election year. I don’t want anything handed to me, but I do expect a fair and honest system. We approaching 50, so we’re in the demographic that is really at risk even though we’re very, very careful about diet, exercise, etc.
We’re terrified now that one of us may be diagnosed with some chronic illness (it happens as people age). Then, we’re either locked into our present company who is free to raise our premium as much as they want, or look for a new company who, we know from experience, probably won’t cover us. After all, if Humana excludes my husband on the chance he may get sick, what if we really were sick?
A system that leaves even relatively wealthy people feeling this insecure isn’t sustainable. It’s going to be ripe for some harebrained government program like the Medicare drug plan or the real estate bailout if we aren’t careful. Congress gets enough pressure to do something, then they’ll do ANYTHING, whether it makes sense or not.