Are we already rationing health care?

Thursday, September 19, 2013
It's no secret that I am not a big fan of big health insurance and pharmaceutical companies. When you are a young parent with a special needs child, all you know is you want your child to get the best care possible. We have fought a long battle with health insurance companies and providers for over twenty five years now, and the battle is tiring. On their side are endless amounts of 'might is right' and the obviousness of the big stick they carry. They can control who we see, and what care we get.

There has been a lot of sensationalizing about Obamacare and 'death panels'. Even before Obamacare when Oregon passed health care reform there were lists of illnesses that would be covered- and some that would not. Feeling that we are going to have someone dictate to us who we can see and when feels wrong in the light of freedom.

But I'm here to say that I firmly believe this is already a reality in our country. We are already rationing and proportioning health care- and those who are getting the bad end of the deal are the working middle class.

These are real situations I'll use fictitious people to demonstrate.

Jane, a senior on Medicare, goes in for a medical procedure that costs $2,000 in office. Medicare negotiated to pay $300 and change for the procedure- which the provider accepted- writing off close to $1,700.
John, a middle class worker with health insurance, has the same procedure for the same cost. His insurance picks up 80%, or $1,600, leaving a $400 uncovered expense. The provider will turn John into a collection agency if he doesn't pay.

Suzie is a young single mother of three children living on medicaid and assistance. When her kids are ill she takes them to the emergency room as it's easier than waiting for a Dr. appointment. Medicaid pays a very small percentage of the bill (usually less than 25%) and she is asked to pay nothing.
Mark goes into the emergency room with extreme pain. His insurance requires he pay $125 out of pocket and 20% of the bill. They pay the remainder. He ends up in collections.

Greg has tests run by his Dr. who suspects he has a serious medical issue and refers him to a specialist. The specialist refuses to make an appointment with him until his case is reviewed by committee, which takes more than two months.

If you think this is extreme- try calling a specialist office affiliated with any major hospital- and you're in for a rude awakening. We don't want 'national health care' because people in Canada wait months to see a Dr. You truly don't think you'll be asked to wait months to get into a specialist in our country? You'd be wrong. Since when are we no longer able to call a Dr for an appointment because we think we need one? Since when does a panel get to decide if they will even see you or not?

I have an Aunt in a large city that has seen a specialist in cardiology for years. This Dr. now requires her patients pay her a MONTHLY fee in order to be an active patient! Even if you don't need to see her for a year, you're paying monthly for the privilege. No pay - no appointment.

We need to wake up a little here. We are already rationing health care and the cheapest coverage goes to those on government assisted health plans. But to leave the rest of us hanging out here with no recourse, with no pathway to coverage that doesn't run us into bankruptcy- is wrong. And it shouldn't happen. Not in the richest country in the world.


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