BlueSun

Last active
2 years, 2 months ago
  • Oh, yeah. I should also point out that I have been unable to buy ANY insurance policy at ANY price since 1997 because of my long-cured “pre-existing condition.” My only option after 15 years of paying my own medical bills (which, ironically enough, have cost me less that the average employee’s insurance does), I have only 9 months to go until I get Medicare. My wife, who has been disabled for over a decade and a half, is able to get far better treatment, according to her medical team, than they are permitted to give out by any private insurance company. They have told us that the only people they are able to practice effective medicine on are people on Medicare and people paying with cash. Virtually every treatment decision they make for any other patient requires hours of the doctor’s time battling through numerous protective layers before they can even reach a bean-counting bureaucrat who may, or (more likely) may not allow the treatment. They have basically stopped treating anybody with private insurance, because there is simply nothing they can do for them within the insurance company’s restrictions. One benefit is that they were able to cut their office staff by six people, whose only job was to handle the myriad different forms and requirements of the different companies. They even had one full-time clerk who did nothing but make sure those who needed referrals got them in time.

    Helluva system. The best care in the world for the lucky few, care ranging from good through mediocre to poor for the rest of the privately insured, and almost 1 in 6 without any recourse to normal medical care at all (by the time you get to the ER – George Bush’s suggested alternative for those without insurance – disease is usually far more advanced and, at tax-payers’ expense, far more expensive to treat – and far less likely to save a life.

    What is to explain the coarsening of our country, the turning away from compassion, empathy, and every human emotion of sympathy? It’s as if we have, as a country, become a societal sociopath.

  • On April 10, 1997, six days after my 49th birthday, I was diagnosed with stage 3 colon cancer (after surgery and examination of sentinel nodes, that was restaged at 3+ as the first two nodes showed several cancer cells. As an independent software consultant, I had always been forced to buy my own insurance. I had at the time the best policy I or my independent agent could find – it cost me a monthly fee of some $1,300 (and this was 15 years ago, remember). I went through the entire regimen of radiation, a 9-hour surgery (performed by one of the best colorectal surgeons in the country), and six months of chemo with 5-FU and Leukovoran. All of my treatment and testing was pre-approved by my insurance company and I had no co-pays, so I was not worried.

    In 1998, I spent the year in Minneapolis on a contract to USBank. On my surgeon’s referral, I went to see Dr. Stanley M. Goldberg. As former 20 year head of the UM hospital colorectal surgeons, he had built the largest and most famous colorectal department in the country. He continues to this day to practice with his own private group (current age 80). He has been called by many of his peers as the dean of colorectal surgeons, and the UM hospital honored him in 1980 with the Stanley M. Goldberg Chair in Colorectal Surgery. Dr. Goldberg performed numerous followup tests for an entire year, with his office accepting my healthcare card each time.

    In 1999, to my surprise, I started to get an ever-increasing stream of bills from the hospital, radiologist, surgeon, oncological hematologist, and others on the team for bills that were supposed to be already paid by my insurance company for authorized care. Then, I found out that, claiming that Minnesota was an HMO-only state, my company refused to pay a penny for my year-long followup by Dr. Goldberg.

    I will be making substantial payments on my 1997-98 bills for the rest of my life.

    The only good thing to come out of it was that I went in with at best a 15% chance of surviving 5 years (after 5 years with no recurrence and no secondary liver cancer, you are considered totally cured, and any new cancer you may get is unrelated) is that the insurance company didn’t punk me until AFTER my treatment was basically over.

    I had the best medical care you can get in this country and, I’m sure my surgeon in particular was responsible for saving my life. Had the insurance company refused up front to authorize the treatment, instead of authorizing it and only afterwards weaseling out from paying for a large portion of it, I would likely have never seen the spring of 1998. As it is, despite the burden of a lifetime of bills, I came out better than the woman who had her insurance cancelled three days before a double mastectomy after an insurance company bureaucrat, searching her medical history with a microscope, found that, as a teenager she had once consulted a dermatologist about acne. They declared that since her medical history had omitted this, her insurance was subject to termination. As a result, by the time her doctors and lawyers were able to get a reversal from the insurance company, it was too late, her cancer had metastacized all through her body, and she died.

    Neither Republican nor Democrats have done anything to address the 800 pound gorilla that lurks at the center of our medical care crisis – for-pay insurance companies. Whether we institute single-payer, all-inclusive, general-revenue-funded, government-administered insurance system, or return to the era before Nixon’s 1973 HMO solution, when health insurance was provided by non-profit companies that had no vested interest in any profit motive, something has to change.

    The non-profit solution and the universal single-payer solution are based on the idea of cost-sharing (or cost-spreading), while our current system (alone in the developed world) is based on cost-avoidance – and that means billing us as much as possible, paying out as little as possible, and forcing more and more of our health care costs onto our own backs in the form of rising monthly premiums, annual deductables, partial coverage (many companies only cover 80/20), annual and lifetime caps, copays that are steadily rising, and services no longer covered.

    Every insured person likes his or her insurance UNTIL they or a family member gets hit with a major or catastrophic illness or injury. Then, it’s too late to change the system.

  • It will require more than supporting the Green Party. Ever since Bill Clinton and the DLC (Democratic Leadership Council), the Democratic Party’s strategy has been to shift right, fishing for votes among independents and more moderate Republicans. They have ignored, and even harshly attacked their working-class trade unions and their Liberal and Progressive base, figuring that, when push came to shove on Election Day, their Union/Liberal/Progressive base will still have to vote for them simply because they viewed GOP rule as infinitely more frightening. As the Republican Party has shifted ever more to the lunatic fringe of the right, leaving traditional moderate, and even traditional conservative Republicans disaffected, the Dems have continued to fish in waters further and further to the right. Instead of supporting trade unions as the Republicans systematically dismantled them, the Dems, starting with Clinton, began to fundraise the same way the Republicans did – by allying themselves with corporate and financial institutions. Wall Street became the largest financer of Democrats, though, despite Obama’s putting on the fishnet stockings, the FM pumps with the 4-inch heels, and the bright red lipstick, and then bending over the table for Goldman Sachs, et al., the GOP is making them an even better offer (all at our expense), and the Dems now have no unions to fall back on and only a small fraction of the billionaire elite and major corporate oligarchy to appeal to.

    What we have to teach the Dems is that they can’t rely on the “lesser of two evils” strategy anymore. Their base is finally waking up to the fact that, by definition, the lesser of two evils, is still evil.”

    The best thing that can happen for progressives right now (though it risks the chance that 4 more years of Republican rule will succeed in shoving the teetering economy entirely off the cliff), is to withhold our votes from the Democrats in large numbers. Whether we vote Green or any other third-party, stay home, or write in “none of the above,” we need to teach the party, as the right has vividly taught the GOP, that if the party doesn’t represent its core consituencies, it will be tossed on the ash heap of history. It has happened before in this country.

    And, even after 2012, no matter how it turns out, the working-class and middle-class Americans have to start to organize, either a third party that will represent the ordinary people, or start supporting progressive candidates to run to the left of the unprincipled cowards who currently infest the party leadership. Maybe – though I doubt it – these bozos will get the message.