So this is my blog and my first topic

So more than a couple people have told me that I should create a blog, just to write out my thoughts on various topics. I'm not positive exactly why, but maybe it's because I at least try to make reasoned arguments when I write, and it would seem (or I at least hope) that they give people something to think about. With that being said, one topic that seems to find its way into the news lately is national healthcare.

I used to think that this was a horrible idea, through and through. All that would happen, as it does with so many things, is that once something is free, then it's abused. Over the last ten years though, I've had the chance to live a bit of my life, meet people of different backgrounds, and rethink this opinion.

I've had healthcare (Premera/Blue Cross) for about 5-6 years now. In that time, I think I've used it a few times for doctors visits, and probably 15 or so times for prescriptions. Nothing major really, just the odd case of strep, ear infections, etc. I've been rather lucky in that I'm friends with a doctor, so if something's wrong with me (such as paronychia (Google image search, kids!)), I can give him a call, he takes a look and I'm back on the road to recovery. Honestly this is a huge service for me, in that I don't need to schedule an appointment a week out, or take time off work. Beyond that, I can have a reasonable conversation with him about any past issues, or the current situation, and I have absolutely zero doubt he's paying attention to me and the current situation.

Contrast this with my last experience at Kania Clinic. Nothing against the doctor, as I know they're rushed, but it took me three times (inside of 5 minutes) to tell him what the problem I was having was, and how it related to some recent treatment I'd received. This doctor simply would pretend to listen to me until I explained that I thought (and rightly so) I was having some side effects from the hydrocodone I'd been prescribed. If I'd let myself be run over, I'd have been sick for another few painful days, needlessly.

So, you may be asking yourself, what does this have to do with anything? The point I'm trying to make is that the system is broken. When I, someone who is adequately insured, must strongarm a doctor into listening to me, not because he's a jerk, but because he's overworked, the system is broken. Doctors are forced to see multiple patients simultaneously, putting many services onto assisting staff, when perhaps that's not the ideal solution. Why do they do this? Because the insurance companies have strong-armed them into accepting 50 cents on the dollar for their services.

Essentially it boils down to this. If a doctor wants to run a practice, for all intents and purposes he (or she, but for ease of diction, I'll use the androgenous form of he. Please forgive me, any of you militant feminists) simply must accept insurance payments. The insurance companies, in order to maximize profits, bargain with the doctors, and negotiate a rate that frequently boils down to saying "those visits that you charge $80 for? We'll pay you $40. If you don't like it, no Blue Cross patients for you." What is the doctor to do? Due to the state-by-state basis of insurance companies, we don't have nationwide competition amongst insurance companies. Sure, there are multi-state corporations that provide insurance, but to say that there's true competition is ludicrous. So the doctor must agree to this. Furthermore, they're bound to not tell their fellow doctors what the rates they're getting are, so the doctors can't even form an informal union, in that Dr. A could say "I know Dr. B is getting 60% from you, so I want that too." The deck is loaded against the doctor from day one.

Beyond that, collecting the money is an insane hassle. Terms are frequently Net 30-Net 90. Imagine working for your employer, and getting paid for that work three months later! If you talk to an insurance biller, you'll quickly learn how hard it is to submit a claim. If a single punctuation mark is out of place, or a word misspelled, the claim is denied, no reason given. Insurance companies have bought the politicians to make this possible. Many practices go out of business, not for lack of customers, or billable services, but simply because they're unable to collect, and thus unable to keep their doors open. This has happened in the Tri-Cities, it does hit home, and it's disgusting that in our country we allow this fiscal abuse.

So that's the best possible case. What happens if someone isn't insured? Falling down a step and twisting your ankle can set you back tens of thousands of dollars. Millions of people are a simple medical emergency away from financial disaster. Just to walk into an ER cost me $800 5 years ago, and I was an outpatient case. Now its true that hospitals won't turn you down if your life is threatened, but you still will be cognisant of what things cost. A friend of mine, when he broke his ankle (so bad it required surgery), when consulting with the doctors later joked about how he was bargaining about which kind of anesthesia he would receive, not on the basis of which was best, but which would be the cheapest solution. This is not right.

I'm not talking about someone who is a bum and wasn't working, but a very productive member of society. However, seeking out insurance for just one person if you are an independent contractor or just a family that doesn't get insurance through your job is nearly impossible. Rates charged will be easily 3 times higher than a small business might get, when there's no more risk of that family having a catastrophe than someone who works at a large company. It's simply the insurance companies using their leverage to hurt the little guy.

Furthermore, in cases of major incidents, insurance companies employ people to find reasons to deny claims. If you get cancer, but didn't disclose an unrelated infection you'd had years prior, you can have your coverage denied, on the basis of not being honest on your application. This is criminal. It is fraud, legalized through the power of lobbyists in our government.

But what can you do? What other options are there? There are a couple things that can be done. First thing that could happen would be a major regulation of the insurance industry. These guys have been running the show for so long now, this may not work. They have too many politicians in their pocket, and our two-party system gives little to no options for real relief on many major issues. Insurance companies make money by taking in premiums, and giving back as little as possible. Providing coverage for good healthcare is a speedbump in their road to building profits.

Insurance companies are the problem. There is no two ways about this, they are the scourge of our healthcare system. Any time they become involved in your care, you can bet that your quality of care just went down.

There is another option, and it's one that EVERY industrialized nation on earth, but for the USA employs, socialized medicine. They're not homogenous, and each is different. Some are better than others, so we might be able to take a page from the winners, and learn from the mistakes of those that don't have it quite right. You don't, for instance, hear of huge waits in Japan, like you might in Canada. You still have the option of private coverage in the UK.

People seem to object to this word, socialism. It seems to be a relic from when our country was "fighting" communism. However, there are many services that we use that are socialistic in nature. We have a socialist police force, fire department, department of transportation, and air traffic control. Not everything that government gets involved in must be a failure, no matter what Rush Limbaugh, Sean Hannity, and their ilk say. And this is one area that profit cannot be the driving force.

Will this be the silver bullet that cures everyones ills? No, it won't. Every system has its faults. But we cannot sit idly by and relegate ourselves to being in the mid 30s in worldwide quality of healthcare. We are much better than this. The era of paying the town doctor for a house call is over. It's time to bring american healthcare into the 21st century, and we're already 9 years late.