I Want Health Insurance
According to John Conyers' office, which I spoke to a couple minutes ago, their plan is to offer up H.R. 676 this evening. H.R. 676 is the right way to go: single payer universal coverage — the government covers everybody. It essentially puts the health insurers out of business, but why not? Is the public's health just another commodity? If the experience of other advanced industrial countries is any guide, and it is, with H.R. 676 we as a nation would get much better health care results for a lot less money. We wouldn't be rationing health care according to ability to pay. And probably, though this is empirically not entirely clear, even the wealthy (according to epidemiologists) would wind up with better health. It's a sensible solution finding its way to us about a half a century late. But better late than never.
I have no idea how politically viable H.R. 676 is at this point but I hope it becomes a serious basis for discussion in Congress. And I urge you to call Members of Congress to lobby for universal, single payer health care.
This issue is of more than theoretical interest to me because I haven't got health insurance. When I was in the foreign service I had it, of course, but when I left I didn't keep it up. Some years later I started to get really sick in a very mysterious way so through a writer's union I picked up coverage from the George Washington University HMO. Still, my condition deteriorated. The HMO did all the tests they could think of but couldn't figure out what was wrong. Finally, in 2000, the family doctor insisted I get a liver biopsy, with the results of which he diagnosed me as having inherited iron overload disease, or hemochromatosis.
What happens is, for reasons medicine still doesn't understand, the body continually absorbs too much iron. The iron accumulates in soft tissue, causing all manner of problems. If not treated it is 100% fatal. Men will commonly die of undiagnosed hemochromatosis in their 40s or 50s. Treatment involves phlebotomy, taking out blood on a regular basis (nothing to replace it put back in) for the remainder of a patient's life.
Hemochromatosis is difficult to diagnose because its wide range of symptoms manifest very differently, in different combinations, in different individuals. It's one of the most commonly (perhaps the most commonly) misdiagnosed and undiagnosed illness in America today. Not so surprisingly, then, the HMO failed to make the diagnosis in my case, particularly as I have only one of the two mutated genes that are normally present (to their partial credit they did do the genetic test), making it statistically extremely unlikely that I would ever develop symptoms.
When presented with the family doctor's diagnosis the HMO refused to pay for treatment, saying that it wasn't "their" diagnosis. As treatment, initially, was terribly expensive — a pint of blood taken out two or three times a week — I let my HMO coverage lapse, not wanting to pay for service I wasn't getting.
Still, it would be nice to be able to see a doctor about this issue on a regular basis. I do have a fellow I go to once a year to get my prescriptions for therapeutic phlebotomies, which I have filled at the American Red Cross, though they charge me $180 each time and then they toss the blood out (blood taken from hemochromatosis patients is used in Canada as it's perfectly good blood, so you'd think the Red Cross would be glad to get it, use it, and not charge for extracting it, but that's another story).
When I have trouble, as I've been having the past six months, frequently getting sick with symptoms just before my scheduled phlebotomies, it hardly makes sense to go in for battery after battery of tests that I can't afford on the off-chance that a doctor will spot something unusual that isn't working with my treatment. And it would be nice to have the option of new drug therapies, but those are so much more expensive than the phlebotomies that I can't justify trying them out.
So I'm in a jam. I'm not about to die, but I really don't much care for being sick either. This weekend, for example, I spent a couple days throwing up impossibly vile gunk along with having explosive diarrhea. Today I've been sipping hot boiled water and in a little while I'll try eating some plain organic brown rice. As I get older I worry about cracking a rib from throwing up, having a heart attack, or just not being up to the physical strain of these symptoms. Proper health care would bring me great peace of mind.
When I called Conyers' office I gave them a very abbreviated version of my story, making the point that universal health care is a middle class concern, too. Hopefully Conyers will make progress in getting his colleagues to take the issue seriously.
Posted by George Kenney on January 26, 2009 5:57 PM 
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Comments
Hang in there George. You are really valuable to all of us who read and listen to EP.
Maybe one of these days there really will be a politician who puts people above profits. We certainly need to get single-payer in this country, but we will have to fight tooth and nail for it.
Meanwhile, if you haven't seen it, there's a shocking BBC documentary currently on YouTube that shows how desperate Americans are for health care and how the heartless corporate right is fighting it. This is the kind of reporting we no longer get in this country.
Posted by: Democracy Lover
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January 26, 2009 10:37 PM
I've been thinking about this for a while, and this is the one suggestion I believe might start a change. Aside from the need to offer healthcare because it should be considered a right in a modern society, it also makes economic sense. The United States' industrial base must be revitalized. We must produce at home and have the technologies in place to support the next generation of innovation. Also, as an educator I see first-hand that a wider spectrum of citizens — particularly those who might not have the skills or aptitude for office work, but are competent with their hands — need these kinds of jobs. These jobs will never expand in America if the companies of the manufacturing industries are forced to unfairly compete with cheap labor abroad. We will continue to shovel money and our best ideas overseas if we don’t address this serious issue. However, American productivity will win out if employers feel they have a chance. Health care costs must be nationalized for many reasons, but the one that can best be sold to a wary public is to give American manufacturers and American workers a level playing field and a fuller spectrum of high paying work. NATIONAL HEALTH CARE is a necessary step in returning America’s industrial base and the jobs that go with it.
Posted by: Michael H. | January 26, 2009 10:39 PM
As a Canadian, there is a long list of ways your country conducts itself that seem, frankly, crazy. The way you manage the care of the health of your citizens is near the top of this list.
Posted by: David Ford | January 27, 2009 12:06 AM
To add to Michael H's comments: most other industrialised countries have essentially turned public healthcare into a an essential piece of shared infrastructure for the economy. It seems Obama is willing to invest in other areas of infrastructure to support American business (highways, broadband, energy), so I would say there is a strong argument that healthcare, despite the gargantuan cost, falls into the same category.
Publicly funded healthcare is far from a perfect system: in all countries it leads to rationing (for example there is ongoing controversy about public funding for cancer treatments such as herceptin where the results of clinical trials are still debatable), but at least in these cases rationing is determined on the basis of proven clinical results, rather than the patient's ability to pay. Public healthcare is not cheap, but it's cheaper, more equitable and offers greater benefits to patients that the current private insurance-funded model in the US.
Posted by: Richard
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January 27, 2009 2:14 AM
People can buy private health insurance in England, Japan, Canada, France, and other countries with public health care.
http://www.oecd.org/dataoecd/42/6/33820355.pdf
The chart on page 5 is interesting — the U.S. does not spend much less public funds, as % of GDP, on health care than do Japan, Canada, Germany, and other OECD countries. What exactly are we buying with private health insurance?
[In Canada private insurers are strictly regulated so that they can't cherry pick the public system. Most if not all private insurance is for things the public system doesn't cover. I suspect that's the case as well in other OECD countries with public health. Separately, your point on public spending comparisons is well taken. g.]
Posted by: Dwight | January 28, 2009 4:31 PM
I was thinking that fear of rationing is not a valid concern, because people who can afford it can pay for extra services in those countries. It's usually those that can afford it, and are least likely to have health care made unavailable, that raise the fear of rationing. I'm thinking of Foster Friess, who appears in a recent BBC documentary.
http://www.fosterfriess.com/transforming+america/healthcare/
BBC docum part 1
http://www.youtube.com/watch?v=rD65UKgB6hU
Posted by: Dwight | January 28, 2009 6:04 PM