Health Care

A committee of the Senate is meeting today to discuss health care in America. Elizabeth Edwards, who is living with cancer, is speaking before that group right now. I'm not sure what the point of the hearing is, since the Republicans have made it clear that no major changes to the US health care policy will take place under their watch, but I'd like to share a few links here -- a little food for thought.

The current American approach to heath care policy can be summed up with this: don't get sick! Many people -- even educated, employed, comfortably middle class people -- don't find out until they get sick that they are underinsured.

Further, many people in the United States are slaves to their health insurance. I have a friend whose every career decision has been influenced by her Type I diabetes -- the jobs she has taken weren't always her top choices, but rather the ones with the good health coverage. And if you stop to think about it for even a moment, our system of dispensing health coverage through employers is incredibly bizarre. The quality of your health insurance depends on the ability of some middle management suit you've never even met to negotiate with the insurance companies? And since the insurance company is a for-profit business and that middle management suit has to answer to his cost-conscious superiors, what do you think are the chances that your insurance package will be as good as the deal the guys in Congress are getting? It's a system that just doesn't make any sense.

And finally, if you think that we don't have socialized medicine here in the United States, think again. What we do have is the most expensive, inefficient and stupid system of socialized medicine imaginable, but ultimately, the people do eventually pick up the tab when the uninsured, underinsured -- or even insured -- need help.

In the third day of county budget hearings, Erlanger CEO Jim Brexler asked the commission for $500,000 more than the $3 million the hospital has received each of the last three years. [...] Erlanger will pay around $10 million more this year for uncompensated care than it did last year.

Check out this recent story from the Chattanooga Times Free Press, about a young man who had an accident while he was covered by health insurance.

T.J. is covered by his mother's insurance policy, United Healthcare...

Unfortunately for T.J. and his family, having health insurance quite often is not enough.

He speaks slowly and in fragments, and he has relearned how to eat and hold his head up. But his progress toward walking again has stalled: He's waiting to find out whether his insurance will cover more physical therapy.

(By the way, do you think Stephen Hemsley, the CEO of United Health, will ever have to face these kinds of problems?)

Bankrupted by their share of $700,000 worth of medical bills, the Johnsons were forced to sell their home in Soddy-Daisy when they couldn't make the payments to avoid foreclosure.

And even with all that, they're still needing help from the public.

Siskin is not in the network, so it received less reimbursement for T.J.'s therapy, said Siskin spokeswoman Teresa Dinger. At this point, Siskin has absorbed about $30,000 in costs for T.J.'s services and can't afford to absorb more, she said.

Amy Denton, a caseworker at Home Health Care of East Tennessee, said she has some leads on other options for the family and is working with a TennCare caseworker to figure out what the state's managed Medicaid program should cover for T.J., who qualifies for TennCare as secondary insurance. Ms. Denton said TennCare will cover services at an in-network rehab hospital if United denies the visits.

In the meantime, T.J. goes to school at Central High School for an hour a day and has speech therapy there twice a week. TennCare is paying for a certified nursing assistant to stay with T.J. eight hours a day, five days a week.

They're still waiting for van modifications that would accommodate the power wheelchair provided by TennCare, but that's unavailable until T.J.'s vocational rehabilitation coverage kicks in, which won't happen until he graduates and figures out what kind of work to do, said Tennessee Department of Human Services spokeswoman Michelle Mowery Johnson.

Think about that. Do you have any idea how well insured you are? You maybe have insurance, but how much will that cover if you have an accident or a major medical problem? Are you ready to trade your house for medical care? What will you do for insurance if you lose your job? What if you become disabled and can't work?

There is a health care crisis in this country, and it's not just about providing care for the poor. This county spends, per capita, more money on health care than any other nation on earth, and yet the quality of our health care is not even close to making the top of any list. Compared to the people in many European countries, we don't live as long, more of our babies die in infancy, and we're continuing to lose ground. We're fat, hyperglycemic, an accident waiting to happen -- and unless we're named McCain, Cheney or Clinton, we don't necessarily have access to decent health care.

It's something to ponder over -- especially as November approaches. And in the meantime, whatever you do, don't get sick!