Saturday, September 26, 2009

Why we need health care reform NOW

Usually I eschew the dramatic and seek a more reasoned approach to any discussion. The passions of any theme will almost always lead away from a rational discussion... but this story is emblematic of the lunacy of our current health care "system", which really has no resemblance to a system at all. And as the Republicans and Blue Dog Democrats scream to "slow down" health care reform, this story is even more poignant.

Kimberly "Kimi" Young (at left), a healthy 22-year-old recent college graduate, got the flu. She was sick with fever and upper respiratory symptoms but delayed treatment because she lacked health insurance and was concerned about the cost. After two weeks her condition worsened to the point her roommate took her to the hospital, where she subsequently died. Died of suspected swine flu.

Okay this is one tragic case and no conclusion about any large population can be drawn from one tiny example in a society of 300 million people.

A recent federally funded Harvard study estimates 45,000 Americans die each year from lack of health insurance. Yes, detractors will say these numbers are spurious even by the most objective analysts, and sure many of those deaths may be people who are already infirm, and yes there are probably many other problems with such a study, but the number is out there.

Even if this number of deaths is inaccurate, the costs of caring for people who live is higher when treatment is delayed. Even if Kimi were to have lived, her delayed treatment was certainly more expensive than the week's worth of oral antiviral Tamiflu that may have mitigated the criticality of her illness had it been administered early.

Americans who have comprehensive insurance or who never get sick just have no idea the insanity of the current US health care "system." Even people with high deductible insurance will ponder what to do when they feel ill. Whenever someone gets sick they sit down and think about whether to get treatment. Why?

No matter how much time an individual takes to think about it, they will never acquire the expertise to triage their medical condition and render the proper care. One 10-minute visit with a doctor or nurse practitioner, or even a phone call to the office nurse, can allay fears and frustrations, or may save thousands of dollars-- and in Kimi's case, maybe even save a life. By constructing hurdles based on financing, we are adding to the extant hurdles we all struggle with in pursuing medical care. Nobody "wants" to go to the doctor: to sit in the waiting room, to talk about their personal issues, to get undressed, maybe get poked with a needle, etc. So why add yet another burden like payment to the mix?

Kimi is gone, and while I hesitate to get all dramatic over this one case, it is a tragedy which was avoidable. A waste... not only for this young woman and her family and friends, but for all of us. Thinking selfishly, we must consider that we will never benefit from the expertise of this college graduate, a seemingly wonderful and productive member of our society. She is gone forever, and all because of the relatively tiny cost of health insurance.

So when you hear Congress debating issues that have long been debated, and calling to table the current health care reform bills, think of the 4,000 people who die needlessly every month, think of Kimi.


Anonymous said...

A sad anecdote indeed (akin to BO's exploitation of Teddy's passing during his joint session speech as an opportunity to remind us of the moral obligation for reform - sorry, I don't consider the founder of the Chappaquiddick Divers Club a moral beacon).

Meanwhile health insurance reform "debate" continues to ignore (or obfuscate) structural cost drivers and how such reform is to be paid for (in keeping with liberal traditions of governance).

We recently learned from BO that we've been waiting for health care reform as far back as Teddy Roosevelt (news to most).

A counter-anecdote:

A case history regarding current proposed "reform":

Why fiscal reality matters:

Since there are more urgent problems facing the nation, BO's best bet would be to table this "reform", focus on higher priorities, and begin anew with an emphasis on more deliberate and less hasty patient-centered reform that better incentivizes all health care stake holders. That would improve his chances for re-election in 2012 but require the leadership to stand up to progressives in his party and delay Alinsky-inspired change. Fortunately, that's not likely to happen and this and other policies amounting to an attack on the US economy and an unprecedented expansion of an already obese Federal government will be limited to a single term. Since every government intervention is a reduction in liberty, let's HOPE for more CHANGE in 2012.

Tony said...

I usually don't respond to anonymous comments, but I'll make a couple brief points:

1. Nothing in the current House or Senate bills resemble the Canadian system. Altho even if we went to a single-payer hybrid system it would look much different here in the US just based on the size of our economy and the geographic availability. Canada has an economy the size of Ohio spread out over an area as large as the US.

2. Massachusetts is a case point that health care reform cannot be done half-assed. If you are going to allow for-profit insurance, then they have to be regulated and required to cover certain things. Some physicians believe that Mass is a cautionary tale that only proves that nothing short of single payer will suffice.

Even with the costs and inherent problems, it's hard to say that Mass is worse off than other parts of the US.

3. The political wrangling was predictable mainly because there are so many dollars at stake for private insurance companies that are raking in profits under the current unregulated oligopoly. The GOP watched as health care costs have skyrocketed and now still lobby for the status quo. Sure, one way may have been to institute free market reforms, open up insurance across state lines, do it piecemeal... all valid approaches that were not undertaken when the Republicans controlled the govt.

4. Invoking Teddy Kennedy is of no consequence to me, but I see it ruffled your feathers. But Teddy Roosevelt: yes, the health care debate has been around for a hundred years:

5. I don't promise to have all the answers, but I do know that as long as we regard basic health care as a de facto right, we should find a way to a) make it affordable, and b) pay for it.

Tony said...

And while comparing any case two studies is problematic... comparing a sore leg in a 70 yr-old-- who ended up with proper treatment (heaven forbid she had to pay for it!)-- to the death of a 22 yr-old is plain silly.

Anonymous said...

"A recent federally funded Harvard study estimates 45,000 Americans die each year from lack of health insurance. Yes, detractors will say these numbers are spurious even by the most objective analysts, and sure many of those deaths may be people who are already infirm, and yes there are probably many other problems with such a study, but the number is out there."

Oooo...the number is out there, which means what exactly? The study you reference sounds moronic: Do the death certificates for these people list cause of death as "no health insurance"?

If so it would be logical that since way more than 45,000 people with health insurance die each year, one could reduce their odds of death by not having health insurance. You may be on to something. This news would certainly not be good for the insurance industry and would hasten their demise as people drop their insurance coverage. Then we really would need a public option.

Your diatribes on the health insurance "reform" issue are bleeding heart silly. Do liberals ever give serious consideration to numbers that start with "$".

The whole debate is based on a fallacy: health care is not a right. It consumes resources (human and monetary capital) to produce and provide. It is not now and no entitlement program will ever make it free. No one has a right to the time and resources of their fellow citizens at someone else's expense.

You are so funny. You make me laugh...HA HA HA HA HA HA!!!!

Tony said...

Anon, your gripe is not with me. Health care is indeed a right in this country since the govt requires acute care hospitals to treat everyone. Are you campaigning to remove this requirement-- if so, kudos. But my gut tells me that you are like Eric Cantor and other pseudo- libertarians who talk a good game, but do not want to go on record telling people, "too bad, your lack of personal responsibility means you're going to die."

Even the most hard core libertarian are willing to sign up physicians to get up in the middle of the night to treat someone for free. that costs money because hospitals and doctors pass that cost onto the ones who pay.

All I'm saying is if you gasbags want to lower costs, then find a way to pay for people's care before it gets really expensive, or allow hospitals to turn the sick and uninsured away. When you have a minute from your "Anonymous" and ill-informed commenting, google "EMTALA"