Social Security & Medicare Notes

So they say government is worse than PRAVATE health insurance? They lie.

This is reported in Digby and from a news report.

In the coming debates over health care, when your Uncle Bob pulls out the old conservative trope asking, "would you really want government bureaucrats to be in charge of your health care?" give him this article:

Five months ago, Rose Camilleri was a superstar at the Zales outlet at Woodbury Common Premium Outlets.

In November, the diminutive grandmother with an Italian accent was flown to Dallas, home of Zales' headquarters, where she was honored with a 1-carat diamond necklace for making $1 million in sales last year.

[...]

It was the fifth diamond Camilleri had earned during 4½ years at Zales, where she received nearly a dozen commendations.

"I loved my work," she said. "I loved the people, and I loved it when people came in and asked for me."

But in early March, Camilleri developed bronchitis and went for a chest X-ray and an MRI. Her doctor discovered an aortic aneurysm, a weakness in the wall of the aorta, which, without prompt treatment, might rupture and cause quick death.

Camilleri told Zales she would need surgery as soon as possible.

"I told my manager I can't get upset because it could explode any minute," she said. "I typed up a letter asking for time off and guidance from human resources."

One week later, on March 14, she was asked to attend a meeting with a new regional manager.

"He said, 'You're terminated,'" Camilleri recalled. "I tried to keep myself very calm because I knew something could happen to me. I said, 'You're joking — you've never been in my store.' He said, 'It's the best thing.'"

It also meant Camilleri had to postpone her March 26 surgery until she could convert her insurance to a self-pay plan known as COBRA.

Two weeks later, Camilleri had not even received the paperwork.

Her son e-mailed the Times Herald-Record.

"We are told that it could take up to 45 days," Charles Camilleri wrote. "I lay awake every night fearing the worst."

Contacted by the Record, Zales would not comment. Charles Camilleri called Zales' human resources, explaining it was a life-or-death matter, and he simply needed a fax from Zales to start the COBRA process. He was floored by the employee's response.

"She said, "Well, if the surgery was rescheduled, then it's probably not a life-or-death situation," Charles Camilleri recalled. "I absolutely was blown away

Once again, the Record contacted Zales' corporate office, stressing that Rose Camilleri's condition could be fatal.

That afternoon, Charles got good news from Zales.

"They're turning my mother's health coverage back on today and expediting the COBRA information," he said.

After paying the first premium of $830, Rose had surgery last week and was back home on Sunday. "I don't think we would have had the surgery so soon if it weren't for your e-mail," Charles Camilleri said. "They probably would have kept us hanging."



If people really think that dealing with private industry bureaucrats is any improvement over government bureaucrats, they need their heads examined. Human resources is a cost center not a profit center and most businesses do not put their best employees there. (That's not to say there aren't good HR people out there, just that they are the step children of the business world.)

Private insurance is cheaper? Crap. Keep in mind that private health insurance plans have to pay out sales costs (including large sums paid as commissions or bonuses), and have to spend large amounts of money to make sure they are only paying for their own clients. The private insurance companies add around 25% overhead to the basic cost of paying for health care. That's why the private companies that are contracted to Medicare can only do so because the government subsidizes them with an additional 12% over and above what medicare charges to cover the same services.

Universal health insurance can cut the unreasonable expenses that medical care suppliers charge, and will stop the cost shifting in which hospitals get paid minimal amounts to cover the indigent and then shift the unreimbursed expense to private insurers, and especially to uninsured cash customers. So the real clients are paying for themselves AND for their own care at the same time. Then, of course, they also pay for the collection effort against non-paying clients. So the really customer is never charged the actual cost of their care.

Universal health care will stop all the cost shifting. If the system offers a government plan that competes on a fair basis without anyone giving a subsidy to keep private insurers in business, the private insurers cannot continue to compete on service and care.

The end result will be single payer government financing of health care, with much better care for the average user of health care services. And after about five years, the system will have so many happy customers - including taxpayers who will be paying less for health care expenses.

The story that Digby recounted will become a thing of the past.

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But... but... private insurance offers individual "choice"! We all want choice, right? Here's an example of what is so out of whack with the current absence of a health care system. Tell me - where is the "choice" in this story? A System From Hell: My Personal Health Care Nightmare by Kate Michelman .

Read the story. Then let me emphasize the end of it.

I do not tell this story because it is unique. On the contrary, the point is precisely that countless people across the country are living it. And millions more are a crisis away from joining them--one lost job, a diagnosis, an accident. Most people do not have the luxury of being able to call, as I do, on powerful friends for help. Not even these friends, of course, can change the predicament my husband and I face. Nor will the situation change for anyone until political leaders get serious about comprehensive healthcare reform.

By "comprehensive," I mean that piecemeal approaches will not work--not economically, not morally. The healthcare crisis is not a series of isolated problems. The problem is not just the uninsured. It is not only the underinsured. It is not the young or the old. My husband had excellent health coverage; our daughter had none. He faces chronic illness in the twilight of life; she suffered a terrible injury just as her adult life was beginning. Between them, they span the complete spectrum of healthcare economics in America, but when crisis struck, they found themselves in the same place.

Our story also illustrates the unique challenges women face in the healthcare system, as in the economy at large. Women are paid less and given benefits less frequently--yet they are the ones on whom the responsibility of caretaking disproportionately falls. In addition, women disproportionately, but hardly exclusively, understand the perverse economic choices the healthcare system imposes. In my case, I had to quit working to care for my husband, only to arrive at a point at which he needs care I can afford only if I can find a job. The bills, meanwhile, are often inexplicable, sometimes contain mistakes and are always impossible to resolve without encountering a thicket of red tape.

Even on the other side of that thicket, the insurance companies cannot answer the most vexing question my husband and I--and so many others--ask: if "health insurance" does not pay for healthcare when people need it, then what exactly do those words mean? And all this says nothing about the fact that my husband had the foresight to purchase long-term-care coverage. The problem is that it nominally covers long-term care but does not cover its actual cost.

There simply is no "Choice" in this tale. Kate Michelman and her husband did everything by the book, just as the current so-called "system" demands. And the result is the same damned bankruptcy that would have occurred had they not planned at all. And there is no damned help for them as there would be in every other civilized industrial nation in the world.

Why do the Republicans oppose universal health care? The answer is sadly obvious. The insurance companies - who cannot compete fairly with the government as an efficient and relatively low-cost financier of health care - want to continue to gouge the public and make their CEOs and investors richer. This is an issue of American class warfare in which the upper class of wealthy Americans is fleecing all the rest of us and doesn't want the gravy train to stop. They don't like having to find honest work (or honest investments for their ill-gotten gains.) So those so-called moral conservative Republicans are financing their election/reelection on the backs of the desperately ill and dying people who cannot gain access to the kinds of adequate health care available in every other major industrial nation in the world.

Labels: Health care, Health Care System

posted by Richard @ 10:35 PM