Monday, May 17, 2010

You can't live with 'em, you can't live without 'em

I remember when Rowlf the Dog sang the song "You can't live with 'em, you can't live without 'em" with Kermit the Frog. They were singing about women. Today, I'm singing about health insurance companies. I am definitely waiting for something better to come along.

As a teacher, I have had increases in premiums and decreases in benefits. Every year it is worse. My children all had health issues and while raising them I spent a considerable portion of my income on health costs. I made enough money to provide for the needs of my family and to pay health costs but there was never enough to save. Many years I was tax free because of medical bills. Charles had brain tumors, Katherine had a very mild form of cerebral palsy

Last fall during open enrollment, I received a recommendation that I should change insurance plans with the same company based on what I have previously had as medical expenses. Today, I received a medical bill for a little over $1100 from a hospital for my portion of the deductible.

When the conservatives tell me we don't need a national health care plan, I think of my son who can't afford health insurance and I think back to the many times that I have had to fight with the insurance companies to pay claims for basic services. When you break a leg, they don't pay for the cast. They don't pay for this medicine, or that medicine that a doctor recommends. They don't pay for out of system doctors. If you go to an in-system hospital, the anesthesiologist, pathologist and radiologist might not be in-system and you can't choose them, because they are on staff at the hospital. It is a constant struggle to understand what insurance companies cover and what they don’t cover.

The conservatives also tell me that I don't want government bureaucrats making medical decisions for me.

The liberals tell me that I must pay for health insurance for everyone. As a member of the working class, I see my tax bill going up significantly to pay for everyone. I understand that when the government in our country gets involved, mess happens.

This is what I know. Bureaucrats are already making my medical decisions. Instead of government bureaucrats, they are insurance company representatives. I am already paying a considerable portion of my paycheck for health insurance and my employer is paying large insurance premium for me and my family. For full health coverage, I would gladly pay what I'm paying to insurance companies into a government health plan if it was well run.

Lawyers have encouraged law suits regarding medical malpractice and many insurance companies pay malpractice claims because it is cheaper to pay the claim than it is to defend the suit. The insurance company increases the doctor's premium, the doctor increases our medical bill, and our medical insurance companies choose how much they want to pay. It really sounds like the insurance industry is calling all of the shots for medical care and coverage. They make a fortune while the citizens pay the bills.

What we really need is to reform our insurance industry, create medical arbitration panels that decide if medical law suits have merit and we need to have understandable insurance policies.

In their rush to put a health care plan in place, the government acted without careful consideration of all of the parts of the health care plan. In fact many of the senators and congressmen only read summaries of the bill and not the bill itself. The legislation was passed with more emphasis placed on damaging the public opinion of the other party than on solving real health care issues. The sides were so polarized that it wasn't the content of the bill that was being voted on as much as it was the political party. Pelosi threatening to pass it whether the American people liked it or not and Republicans who negotiated to create the bill refused to vote for it. In the middle of the great debate the insurance lobby kept pressure on the members of Congress telling them how it would damage their industry. Frankly, I wouldn't mind damaging the insurance industry a little (okay, so I mean a lot)

How can a bill that is 2409 pages long be understandable to the general public? The number of lawyers needed to interpret it, and the legal fees spent trying to make sure that employers, businesses etc are in compliance with the bill will be passed on the consumers. The insurance companies will make more profit, the government hires more workers, and more lawyers will be needed to handle the issues. I'm sure that the costs of health care will once again go up and that the red tape and bureaucracy of a combined federal and insurance company effort will hurt the average working class American.

Right now we can't live without insurance, but we certainly don't want to live with what we have. We're waiting on something better to come along. That means we need to get to work.

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