In the past weeks I have seen first-hand the challenges caused by our current healthcare system, even for those with insurance. About 2 months ago my mom called to tell me she has breast cancer. It was a kick in the stomach, but mom is strong willed and, given the scientific progress made in this area, she was and remains optimistic she can beat it. Eight days later my mom called again. When she asked if I was sitting, I figured it was serious and that maybe the cancer was worse than expected. The actual news was probably just as bad. My dad also has cancer – of the prostate.
Over the last six weeks I have flown to see them twice: Once for mom’s lumpectomy and last week for dad’s prostatectomy. My dad has never been seriously sick a day of his life and we were all hopeful that he caught it early, like my mom did with hers.
Dad has worked hard all his life and now runs his own business. He has some of the best insurance available. You wouldn’t think someone in that situation would be pushing for reform of the system. But, this is why I am writing. Follow me below the fold for more...
We got the pathology results for dad on Tuesday. The cancer spread a little beyond the prostate and will require more treatment. Dad is a calm man. Nothing rattles him and he rarely complains. When I called last night he answered and was angry and frustrated in a way I hadn’t seen since I would push his buttons as a kid. Why? It wasn’t because he was sicker than he thought. It wasn’t because he is just 1 week removed from surgery. It wasn’t because he is dealing with the pain of that surgery and a minor infection while also trying to get back to work (he’s a CPA and for tax accountants, this time of year, till April 15, is akin to the holiday season for retailers). No, dad was angry and frustrated because mom went to her doctor for some of her treatment yesterday and was told she "owed $3000 and had to pay if she wanted to be treated."
My parent’s plan has a $3000 deductible, for the family, for major medical. They’ve actually paid it twice so far this year. But, each time they see a new provider, they keep getting asked for it because some paperwork hasn’t been processed correctly. On top of that, mom got a call today saying a payment from their flexible spending account had been refused (it works sort of like a credit card). There’s thousands of dollars in that account, but, despite repeated calls, the bill isn’t getting paid.
So here dad is, in pain from week-old surgery and an infection, trying to decide where to spend his limited energy: dealing with the insurance company so they can keep getting care or on his own business to ensure he can pay the bills.
Keep in mind that my parents HAVE GOOD INSURANCE! One of the most memorable things I’ve heard Obama talk about is how his mom argued with insurance companies as she was dying from cancer. I could never appreciate that until I heard my dad last night. People struggling with major illness should not be forced to argue over unpaid bills. What’s maddening is we know they are covered. The bills aren’t paid because of PAPERWORK PROBLEMS caused by a system so complex even professionals working in the system every day have a hard time with it.
There’s more. Dad was diagnosed in December. By Christmas the diagnosis was confirmed through biopsy. But then it got a bit worse. Rather than "run of the mill" prostate cancer, he has the more aggressive kind. His family doctor stressed the urgency with which this cancer needed to be dealt with. If the cancer was contained within the prostate, survival was near 100%. If it spread, survival was lower (perhaps 33%). He couldn’t wait till after tax season ended April 15th. When he tried to make an appointment, the best he could do in his area (major city, not some small town) was 6 weeks later! And this was just the initial appointment to talk options. It would be a few more weeks till surgery. Some calls to a doctor in a large city an hour away met with even longer waits. Fortunately, dad tried again. There was a cancellation and he got an appointment just 10 days later. Surgery was about 21 days later.
One of the arguments against universal health care is that service would be "rationed", waits would be long, and service would go down. We can never know for sure, but my dad had to wait 6 weeks to get the surgery he needed (it could have been even longer had he not persisted and traveled to another city). One can’t help but wonder if the small amount of cancer that was found beyond the prostate could have been stopped had treatment happened sooner. The point is we already have long waits. Perhaps a more efficient system would allow us to spend more on care providers and less on administrative overhead. This would lead to more timely care for all. While we can never know for sure, doing so might have allowed my dad to get the cancer out before it spread. Further, a less complicated paperwork system would lead to less stress and more time healing for those dealing with major illness.
I had a similar experience, with a less serious issue. Before a routine physical a while back, I noticed a spot on my leg. My doctor suggested I see a dermatologist. The first available appointment was 8 weeks out! When I finally had the appointment, the dermatologist sad the spot wasn’t a problem. While there, I learned I could get in for cosmetic issues within a week. So, potential cancer: 8 weeks. Wrinkles under the eye: 3 days! WTF! It turns out this is a common situation all over the country. Clearly the system is broken when life threatening disease takes a backseat to Botox!
Our system is broken and it needs to be fixed now. My parents and thousands like them can’t wait. And those without insurance can afford to wait even less. According to an article in the New York Times, it sounds like President Obama and Senator Kennedy are gearing up for the next big push and that is likely to be healthcare.
Since last fall, many of the leading figures in the nation’s long-running health care debate have been meeting secretly in a Senate hearing room. Now, with the blessing of the Senate’s leading proponent of universal health insurance, Edward M. Kennedy, they appear to be inching toward a consensus that could reshape the debate.
This is going to be a long and bloody fight. But, the fact remains that we pay more for healthcare in this country and get relativly poor results. Reform does not mean long lines and rationing (but our current system already has this problem). Other nations have solved this issue and so can we. Please, when it comes time to push this issue, please do what you can to make universal healthcare and healthcare reform happen! Its too important for too many people for it to wait!
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Small update:
My favorite part of the NYT article.
But so far Republican aides have stayed away from the sessions, saying they felt they would be relegated to a secondary role, with no opportunity to set the agenda or choose the outside participants.
You can't play if you don't show up. If you don't show up you best not be whining about "not having a say" in the bill.