freedom is absent today - parte una

Nobody wants to admit that we aren't free. But I'll say it: We aren't free. Nobody is. Some people are to a greater extent than others, but there are different grades of freedom. They all come at a cost.

While we were en-route to our ultimate free market economy we became trapped in a cell in which I believe we still reside. About a week ago I got a notice from my insurance company (Oxford) saying that they would no longer cover me. I am insured under a New York State law that created an insurance option called "Healthy New York". It gives lower cost insurance to people who are employed (and therefore do not qualify for other government aid or medicare), but don't make enough money to afford the $500+ a month price tag of run-of-the-mill medical coverage. Insurance companies are forced by the government to give me medical insurance at a lower rate (I don't say "low rate" on purpose, because even the price they give me is still way too much). They don't like this. Apparently their inability to charge me an exhorbitant sum to cover my near non-existant medical costs makes them mad. So they screw with my insurance coverage any chance they get. They drop my coverage without telling me, send the bills to random addresses, and mail me paperwork a week before the deadline to submit it.

We need to realize that not everything is better off in the hands of private, money-making individuals. Such is the case with health insurance. Insurance companies now own our hospitals and our doctors. Those doctors that don't accept insurance are forced to charge so much that only the elite can afford to see them.

My wife cut her finger about a month ago. It was an inconvenient circumstance because we were expecting about 30 people at our house for a barbeque and they were to begin arriving in about twenty minutes, but I felt it prudent to see a doctor - just to assure us things were okay, or to stitch it up if necessary. I, however, need to remember a little more often how backwards things are with the American healthcare system, and that no emergency room doctor is going to send us on our way with a bit of good advice. So here is the run-down, followed by the climax.

Emily cuts her finger and says "it's fine."

I, in a moment of complete mental paralysis regarding my knowledge of the "emergency room", and forgetting we live in a neighborhood with probably 30 doctors and plastic surgeons, say, "I think we should go to the emergency room and have them take a look at it."

Finger wrapped in a paper towel and off we go.

The one highlight of our time at the hospital begins (and ends) here, with the security-guard standing outside the door. I pulled right up to the door and he walked towards us. I was readying myself for battle with him as I was sure he was going to tell me I had to move - and I was about to say, "my wife's finger is cut and I need to walk her in" when he said, very calmly, "what's the problem?"

I told him that my wie cut her finger. He replied, "okay. I'll walk her inside and show her where to go. You can park right up that hill and to the left." He took her purse, and walkd her in. He made me feel calm and comfortable, and I thanked him afterwards.

But then the circus arrived in all their ridiculousness. I'll give the shortest version possible:

Emily gave far too much information to a woman behind a glass window. Then we sat for two hours in a freezing cold waiting room that smelled like rat poison.

When she was finally called in, they sat her on a table in a room, and pulled a curtain in front of her that was so close to her it touched her knees. She was wearing a small black dress you would wear only to the pool or a barbeque and it was freezing, but they offered her no blanket. So I found her one.

After another 45 minutes or so, the doctor arrived and looked at her finger. Then she left and I think she went out to dinner because she didn't come back for at least a half-hour. She said she was looking for whatever it was she needed to fix Emily's finger. Then she used a very unique method to clean the wound: she ran it under cold water. Oh, by the way, the room was a mess. There were medical supplies all over the floor and the cabinets were a mess. I believe a medical student came in at one point and picked up a package of gauze off the floor and brought it into the room next door.

So then the doctor, who was completely and utterly confused as to what to do with Emily's finger, asked the medical student what he thought she should do. This was not a teaching moment, mind you. She was really asking him because she didn't know. He was sitting at a computer looking at an ebay auction, and he kept saying in a dry tone, "there's lots of kids out there. Maybe we should bring some of them in." She ignored him. After ignoring him twice, she announced she needed something else, and left for another twenty minutes. Almost the whole time she was standing by the admissions counter blabbering with some interns. I don't think she thought I could see her standing there. She returned with nothing she hadn't left with.

Finally, with much bumbling, and with what seemed to me to be the medical knowledge and understanding of a high-school freshman, she put glue all over my Emily's finger, wrapped it in fifteen feet of gauze, and we left.

Now here is the climax: we recieved a "bill" in the mail yesterday amounting to just under $1,200.00 for our visit to the "emergency room". We only have to pay $50 of it, but that doesn't stop me from complaining, because ultimately, you and I are both paying this bill.

First of all, thank God this wasn't a real emergency, or Emily would have been in trouble. But this brings to light the tip of the iceberg that is the failing American healthcare system.

...continued in parte due..

freedom is absent today - parte due

Our healthcare system is being plauged by a conflict of interest. More and more our hospitals are being bought up by the insrance companies that pay the bills. The system works well for the hospitals, and the insurance companies alike.

It works for the hospitals because the quality of their care and the knowledge of their staff doesn't matter all that much. If people are dissatisfied, tuff shit for them. The hospital still gets paid. If we were on a system where the patient was expected to pay at least a greater part of their hospital bills, only one in ten would be paid. I don't believe this is because people can't afford it ($1,200 isn't a lot of money in a day and age where people spend more than that on a TV), it's because if I had received that bill, I wouldn't pay it on the grouds that I was completely dissatisfied with the service my wife received. If you hire someone to put in a door at your house, and they show up and have no idea what they're doing and it takes them 2 weeks to finish, they make a mess, and the door doesn't work, what do you do? Do you pay them anyway? No. You would complain to them, possibly contact the Department of Comsumer Affairs, and you would refuse to pay them for their work. Because there is no direct contact between the "customer" and the "supplier" (so to speak) in the health-care system, there is no system of checks and ballances in place. Insurance companies aren't going to refuse to pay the bill for two resons: first of all, as far as they know, the patient received top-notch care. The second brings me to my second reason why this works for both the hospitals and the insurance companies themselves. That reason is that, more and more, hospitals are coming under the private ownership of the very insurance companies that pay them.

That's right. Insurance companies invest large sums of money, and even buy the titles to many of the hospitals they make their checks out to. Basically, if you break it down to simple terms, they're paying themselves. So the hospital writes a bill for $1,200 for low-grade care given by un-qualified doctors and medical students, the customer doesn't care about the bill because he/she only owes fifty dollars, the insurance company writes a check for the $1,200, but then the insurance company itself makes a profit on that money, because they own the hospital they wrote the check to.

Sound crazy? That's because it is. But it sounds right, given how upside down everything else has become.