Monday, October 5, 2009

Thinking About Health Care (what choice do I have?)

I admit it, I'm bitter. I've been working the same soul sucking dead end job for the past five years and before that it was the same job, different place.

Why? Because it's safe.

I work in an office with lots of other moms like me. I don't do it for the money or job satisfaction. I have a second job to buy groceries and without my husband's income I could barely put a dent in our bills. I work in an airless office where I am expected sit in one spot with nothing but my fingers moving for 60% of my waking life for the free health insurance. One day, when those kids have their own insurance (or my husband finally gets a job that includes health insurance) and I don't have to be responsible anymore I just might follow a dream that doesn't involve the carpal tunnel syndrome and the secretary spread. Because writers and dog trainers don't get health insurance as a rule and they don't tend to make enough money starting out to pay the $300+ or so a month to afford health insurance for a family of 4.

When Obama first started talking about health care reform, I started daydreaming. Yes, I could start training full time. I could spend my spare time writing in a regular meaningful way because I would finally be able to afford health care without depending on the corporate vampires. Maybe, but maybe not. A girl can dream.

I can't get away from health care now. It's on NPR, it's in the paper, it's in my email and I'm pretty sure if I had a TV I would be saying it's on there too. The things they are saying about this reform is alarming and it makes me feel awfully silly for ever having had a daydream.

Here's a look at some of the things I've heard, and this Pagan mom's thoughts on them:

Health care reform, or health insurance reform?
The health insurance companies seem to be right on board with this whole reform thing and that makes me suspicious. Why? Because I don't trust health insurance companies.

Think about it: they would charge me $300 a month to pay 70% of my health insurance costs after a $5000 deductable. What are the chances I'm going to pay more than $5000 in health care, even with two kids? After we've all paid for our physicals & the blood tests that go with them, we'd still need to go for about 10 more visits throughout the year - all including tests, to break $5000. It's a gamble. It's a racket. Health insurance is like a casino. They are betting you don't get sick enough collect back any of the money you gave them and you're betting you are. Meanwhile, if you put that $300 a month in the bank, you've got $3600 to spend on whatever health care you want with no middle man.

But I'm a mother, and everyone knows that responsible mothers insure their children, in case they get cancer or something. So you pay the racket. Insurance companies are like the mafia that runs the neighborhood- if you don't play by their rules you're a pariah.

Which brings me to my next concern.

Mandates.
Some folks are pushing to require everyone to be covered or... what? We get fined? Maybe individuals (maybe not) but certainly employers. Does that include my dog training boss, even though I'm an independent contractor? I don't know. But I highly suspect if he had such a mandate he'd suck it up, with a tear in his eye, and skulk back to corporate hell. Is it good for the economy to put more strain on employers? I don't think so. There are likely going to be exceptions for small companies with only a few employees and probably independent contractors won't count.

If not, I suspect we're going to see a lot of small businesses close down. Of course I live in Michigan which is the worst place in the country (as far as I know) to start your own business. Maybe elsewhere it wouldn't hurt so much.

And when we go back to the idea of insurance companies being a racket, what if you don't want to buy into it? What if you decide, "You know what, I'm a healthy person, in the prime of life, I eat well, I exercise, I am rarely ever sick. When I am sick, I go to a holistic practitioner who doesn't take insurance anyway and most insurance companies wouldn't touch with a 10 foot pole if he did. So I think I'm going to take that $300 (or more) a month I spent on insurance and put it in a bank account and pay for my own health care in cash." (Of course I can't make that choice because I'd be a Bad Mother, but if I didn't have kids, I would have a long time ago.)

Now I know what everyone says because I've heard them say it, "But what if you get cancer?" Well, it's my right, isn't it, to decide whether or not I am going to even bother treating my cancer. There is something to be said about dying gracefully and I would rather make that choice than have an insurance company make that choice for me.

In my dream world, I would decide what tests I got and go get them without waiting for my doctor's permission and my HMO's approval. Then I'd get online and read the results myself, consulting with the doctor of MY choice. If I had pain, I would go to the practitioner of MY choice, as it is, I already have to pay for holistic practitioners and a chiropractor out of pocket and he's the one who noticed my legs were slightly different lengths finally solving the mystery that years of intermittent physical therapy (when the doctor gave into my pleading and the HMO approved it) and muscle relaxers could do nothing for.

I don't like mandates because I don't like insurance companies. I don't think we should have to be insured. Yes, there are some people who can't handle their own health care without the guidance of a primary care physician. There are some who have chronic diseases that need supervision, there are those who just have no clue about health and disease and there are those who simply do better following schedules and getting advice. Then there are people who like to handle it themselves and I think they should be allowed to. We don't all need to be sheep.

At the very least I'd like to be able to fire my doctor without asking my HMO for permission and waiting a month for it to be effective.

Concern about "heath care shortages"

So I heard through the grapevine that there is a commercial on TV about how when everyone has access to health care there won't be enough doctors to go around and we're all going to have to wait and wait and wait.

First, I think it's rather appalling to say in effect "Dude, if all the poor people can go to the doctor than all the rich folks will be inconvenienced!"

Because I'll tell you something, us middle class folks, we wait and wait and wait. When I had to go to physical therapy, I had to wait six weeks for an appointment SIX WEEKS. Can you imagine going six weeks with constant pain? If I had to reschedule any of my appointments, I had to do it six weeks out. (I was lucky, two of my coworkers on the same HMO got their physical therapy denied recently, one has fibromyalgia and the other is recovering from a broken ankle.)

The last time I made an appointment for a physical it took nearly as long to get in to see my primary care physician. When I got there, even though I had an appointment, I waited 3 hours in the office before I was seen. Have you ever been to the emergency room? If you think there's any chance at all you're not going to die and you've got anything else going on in the next 48 hours, you're better off staying home. Let the doc re-break that arm and set it in six weeks when you can get an appointment.

We already have a health care shortage. It's been in the news for years. Rich peoples' doctors aren't going to add to their case loads. Doctors have a maximum of how many new patients they will take and then they stop taking them. The rich folks are safe. The middle class folks are screwed anyway so who cares and the poor folks, well they get to buy into the racket now.

The insurance companies are all a-twitter and they should be. Not only is their scam legal, it's proscribed. It's really alarming.

Love it or hate it?

So am I against health care reform. No. I'm not. Health care is screwed up, we need to do what we can to make it better. Personally, I'd prefer an all or nothing approach. Give us state funded health care or strip the insurance companies of their power and legality.

Without insurance companies we'd use our cash to pay for health care and we can set up subsidies for poor folks. Without the insurance companies, doctors and hospitals would have to compete on price which would make things more affordable. Or they could all be government employees and leave us out of it altogether. Personally, I'm for the hands off approach, but I've not met a single person who doesn't want to shout me down on that. Still, I should have the option not to sell my soul to an insurance company.

I'll take what I can get but it should be something that allows people more health care independence, not less. I think of all the people like me who hesitate to start their own businesses because of the health care issue. Those people could provide jobs for other people, if only it didn't mean living under the threat of not being able to receive health care when you need it. This is why health care needs to be fixed, so that our workforce has the freedom to grow our economy.
Yea, I'm selfish. I'm a capitalist.