Health Care Reform? If You Say So.

14 Feb

There’s been a lot of back and forth over the Affordable Health Care Act of 2010 which while it is considered “landmark” legislation by many for others, like yours truly, it has been more of a landmine than a landmark.  The division is of course, between those who now at least have health insurance and those of us who found our own access to care being steadily eroded during the run up to it’s passage.

What a lot of people were either failing to see or refusing to acknowledge during the seemingly endless discussions prior to the passage of the AHCA is that it was never a bill intended to actually improve health care, or even access to adequate health care for more people… in it’s final form, it’s purpose turned out to be to provide access to private health INSURANCE for more people and if you don’t see the difference there, I’m definitely wasting my time.

When universal single payer or any form of “MediCare for all” were taken off the table before the discussion even started, those of of us already in the system knew we were about to be thoroughly screwed.  When cuts in services began to show up quietly, almost surreptitiously, at the same time the politicians were busy assuring us that they weren’t going to happen, we knew we were already being screwed.  When the states were allowed to gut Medicaid programs to balance budget shortfalls caused by their own stupidity and shortsightedness and without ever once asking their versions of the Yacht Party to pay their fair share of taxes, we knew that the screwing was going to take a while and we might as well resign ourselves to it, because the one thing that was readily apparent… or that should have been readily apparent… is that there weren’t too many people, either in DC or the state houses… that were willing to stand up on their hind legs and fight for grandma and grandpa.

One of the things I’ve always tried to point out since I started my little blogging effort is that it’s one thing to read about the depredations of the 1% as regards certain demographic groups such as the elderly, the disabled and the poor.  Every day some prominent Progressive economist or sociologist is up in arms about somebody doing X to the elderly while another is ranting against people doing Y to the disabled and of course everybody is terribly concerned about the plight of the poor and lately the middle class now that so many of them are becoming poor.

But for a huge number of bloggers and pundits… or blundits as I like to say sometimes, for no reason whatever… it’s nothing but numbers.  It remains a total abstract and many of them remain incapable of imagining what it’s really like to plan your entire month’s grocery shopping around what might go best with Ramen noodles tonight.  And the exact same thing applies to decent health care as many of our most prominent “experts”  cannot fathom the massive variations between the levels of care available as you work your way down the economic food chain whether you have private insurance or not.  The tendency is to lump us all together in one bag in a kind of weird alternate universe where a decrease in quality is more than justified by an increase in quantity.

The main thing the AHCA really did when you break it right down to it’s bare components, was to provide a captive clientele for the private insurance industry up to and including the providing of subsidies and “incentives” for those who couldn’t afford their own insurance.  It totally failed to account for the fact that 99% of the problems that befall Americans in being able to access adequate health care are results of actions or inaction by exactly that same private insurance industry.

One thing that has to be abundantly clear to anyone with half a brain is that as long as the level of care you receive is predicated in any way upon the amount of money you can afford to pay for it, we will never have equal access to health care in this country and many… probably most…  of us are never going to have a basic level of care that insures good health for ourselves and out families.  We will continue to have a health care INDUSTRY and decent health care and a profitable health care INDUSTRY are two entirely different, in fact mutually annihilating elements.

As one of those who has had to seek his own medical care in the almost 100% privatized “public health” system for a a while now, my little story is probably typical of those in my little category which I would describe as definitely poor but still managing to stay alive. Let me try to give you a little more personal glimpse of the life of a Medicare/MedicAid victim patient, these days.  I promise, I’ll try to keep it short.

For roughly the last four and a half years I had been seen by a physician for a private company that contracts with our county health department and which… for now at least… shall be nameless.  As you can probably guess, the result of the privatization of the state/county health care system in California has produced exactly the same result as it has in every other facet of government services to which privatization has been applied to any significant degree.  Think Walter Reed or the VA on a Podunk scale and you can start to see the picture.

In addition to all those things you may have read about in those more significant stories, things you might expect in any place where your life or death mean no more than a credit or debit on the bottom line, patients are veritably whipped through the examining rooms on an assembly line the speed of which would put General Motors to shame.  Doctors and other providers are obviously on a quota system wherein X number of patients have to be seen in a given time period.  My daughter got to witness several instances of me following him down the hall trying to get questions answered and having him go into another exam room and shut the door in my face.

The doctor that was originally supposed to replace him as my primary provider was actually fired for spending enough time with his patients to try to get an idea of what was actually ailing them.  I was actually told this when I tried to make a followup appointment with him.

I used to be required to see a cardiovascular specialist every six months but then those referrals virtually stopped.  During my almost four years with this clinic, I went to one stress echo test early on and never received another referral.  Even my labs went down drastically and a typical visit to this guy became almost a ritual… 45 minutes to an hour in the waiting room, 10-15 minute wait in the exam room (which included weight and vitals being recorded), maybe 3-5 minutes with the doc during which he listened to my breathing and then it was out the door.  His usual replies to any questions I managed to get in ran along the lines of “Well, you DO have asthma, you know.”, or, “You DO have CHF, you know.”.

At the time of my heart attack last Tuesday I had… as a result of getting a new primary provider… just been seen by a cardiologist for the first time in about four years and was in fact, on his surgery table undergoing an angiogram when the attack occurred.  Luckily , another surgeon who specializes in vessel repair was in the hospital and between the two of them, they kept me going long enough to effect an emergency repair of the vessels on the right side and get me stabilized and I go back in about 6 weeks, after I’ve recovered from the attack, to have the left side done.

The main thing I took away from the experience was that my heart was allowed to reach the point that 6 vessels were virtually clogged… that I displayed all of the classic signs and symptoms of major arterial blockage… and that extraordinary measures had to be taken in order to keep me from croaking right there on the operating table… and the man who had been my primary physician for several years either never had a freaking clue or was too busy meeting his quota, to worry about it.

Yes blundits, the numbers are shocking, the facts and figures are shocking and the very idea that people are out here actually dying because to keep them alive detracts from someone’s balance sheet is shocking.  Keep hammering the suckers with everything you’ve got but also  try to realize that in spite of all the hoopla and even the good things that it did accomplish (and there were some), the AHCA didn’t really fix a damned thing in regard to health care itself for the masses and now is no time to become complacent because the prez passed a piece of “landmark” legislation that nobody else had been able to pass.  All it was… or should have been… was just the first shot in a war that is nowhere near over (I hope).

What it did do was effect some quid pro quos and shift some of the various financial burdens around some so as to get more people in the hip pockets of the insurance companies but until everyone in this country enjoys exactly the same level of basic health care services regardless of how much they contribute to whose stock portfolio, the fat lady ain’t done her solo yet and declaring the mission accomplished when it’s only just beginning does nothing but make us all look like Bush announcing he’d just won the flipping Iraq war and was going to Disneyland.

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Posted by on February 14, 2012 in Uncategorized


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