Monday, September 21, 2009

Scam of Ages

Scam of Ages, aimed at me,
Let me hide myself from thee;
Let the sickness and the blood,
From my wounds and years of life,
Be by some miracle then cured,
Saved from bankruptcy assured.

In 1980 my brother died in one of those notorious one-car accidents that plague the nuclear whistleblower set. He'd arrived that afternoon with his wife and three children with U-Haul in tow to start a new life. He and my hubby drove into town to get formula and disposable diapers for his youngest, never made it home. By morning he was dead, hubby was in ICU.

It fell to me to deal with the car insurer and health insurer from his last job as health physics site coordinator at a nuke in Georgia, a job he'd quit two weeks before in order to move his family to New Mexico where we'd found refuge, had a job waiting for him building equipment consoles for radio and television stations. Because his insurance was through a rent-a-tech outfit out of Pittsburgh that often shuffled personnel around to different plants for outages and such, it covered him for a full 30 days between assignments and 30 days following termination. It came with a life insurance rider with a double indemnity clause if he died in an accident - $100,000 for his family.

It was the first time I'd lost someone very close, the first time I'd had to deal with reluctant insurers (we'd previously enjoyed purely socialist health care via the US Navy). I made a deal with the car insurer during a meeting in Santa Fe that if they'd go ahead and pay $1500 for his funeral expenses, they could fight it out with his health insurer for the hospital bills. This allowed his wife to pay for the cremation and an urn, which was only fair.

Hubby had no insurance, but the county of Taos had instituted a sales tax to cover the cost of indigent DFHs and mountain folk that ended up using the public hospital, so we didn't have to worry about that - we never received a single bill. Which was also fair, considering they'd done absolutely nothing for him other than put him in a bed and hook him to a monitor. I was the one who pulled the glass out of his head, cleaned out his holes and butterflied his cuts, the punctured lung reinflated itself, and what can you do for smashed ribs? They didn't even wash the blood off.

The life insurer for my brother balked, but by then we'd left New Mexico. We stayed only long enough for hubby to regain strength and get sis-in-law settled into a cabin, supplied with wood for the coming winter, and hooked up with food stamps and various support groups to help her transition to widowhood. In the end for my sister-in-law it took three lawyers in two states to get the life insurer to pay (how dead do you have to be?!), and they ate up $60,000 of the $100,000 that was supposed to go to his family.

So I got into the habit whenever life insurance salesmen called of asking if the policies they sold came with a legal rider to cover the cost of lawyers it would take to make them pay when we die. That was as effective at shutting them down as showing up to the door in a saffron robe when the JWs came calling!

My next experience with life insurance was as executor for my mother's estate when she died in 2002. She'd worked for Blue Cross Blue Shield of Florida before retiring, had a $125,000 life policy through their offerings that she'd been paying on faithfully even when she couldn't afford medicine. When the paperwork was done I was informed that BCBS's provider had sold the policy when she retired, and the new insurer would only honor $60,000 of it.

Her policy was clear in black and white, she'd never been informed that her coverage had changed, and her payments had never been adjusted. I informed my sisters that it was a complete scam, that we could hire a lawyer and handily win a lawsuit. But it would take at least 5 years and the lawyer would eat more than what the scammers were offering. So of course we had to settle for the $60K, even knowing it was a complete rip-off. That policy represented something my mother had counted on to leave us, so I was glad she wasn't around to deal with this. I reported them to the state Insurance Commissioner, who of course did nothing at all.

Health insurance is no better these days, nor has it been better for a long, long time. In 1992 our 21-year old son was injured in a car accident. We had a small business policy, $2500 deductible but a million overall. They pre-approved everything, including an air ambulance transfer from Louisiana (where the accident occurred) to Florida where we lived. Then, after his remaining injuries were identified and surgery was deemed necessary, the insurance company decided to rescind the policy and the doctors abandoned our son. Simply told us everything was fine and sent him home. He died two months later when the unrepaired rip in his internal carotid gave way and he bled to death. His doctors of record - five of them - refused to accept him into the hospital.

It took two lawyers two years to make the insurer pay the bills for what they'd approved, two more lawyers and seven years to get to trial in a malpractice suit against the doctors who abandoned him to his death for something that was entirely treatable. When it was all over the lawyers made out like bandits and we were out more than $50,000 for that small modicum of 'justice'. The practices that were blatantly unethical and in several aspects illegal in 1992 have since become standard operating procedure. Which is where we are today.

Now whenever someone tries to sell me health insurance coverage I ask the same question - does this policy come with a legal rider to pay for the lawyers it'll take to get you to pay a claim? None of them do, of course.

There's a lot wrong with our medical system in this country, including some extremely serious problems with the delivery system itself I wrote about previously. Rampant malpractice, medical errors, in-hospital prescription errors, iatrogenic disease, pure negligence, etc. And a lot of that is a result of a class-based rationing system that nobody likes to admit exists, but does. Medicare patients get a different quality of care than the well-insured, the marginally insured get less care as well, the Medicaid recipients get genuinely lousy care, and the uninsured get pretty much nothing. ERs don't even stitch cuts or set bones these days, they might butterfly your gash (or give you butterflies to do it with), dispense a pain pill, maybe offer a tetanus shot, and tell you to call a specialist who might fit you in in a month or so. The uninsured are routinely charged twice as much or more than anyone else. Nowdays even the insured are driven into bankruptcy by an accident or illness.

The only rational answer to this ever-worsening situation is universal, single-payer health care. Where everyone has the same necessary coverage and everyone receives what they need as best as can be provided. This is not what we'll get, of course. What we'll get are individual mandates for private scams and exactly zero oversight of the delivery system that all by itself is the third leading cause of death in the U.S., killing about 200,000 people a year who wouldn't have died if they'd simply stayed away from doctors and hospitals.

I read today that by the time "Health Care Reform" (whatever that turns out to be) takes full effect in 2019, things will be much, much worse. If insurers are free to continue raising their policy rates at 4 and 5 times the rate of inflation - as has become the annual norm over the past decade and more - a fair insurance policy from a private insurer for a family of 4 will cost as much as $30,000 per year. If subsidies are available so that premiums, deductibles and co-pays together don't account for more than 13% of Adjusted Gross Income, the government will be paying for all or some of this outrageous cost for every family whose AGI is less than $300,000 a year. How is that in any conceivable economic scheme "reform?" Where is the government supposed to get that much money? IRS fines of $3800 on the few who choose not to buy private $30,000 policies? That wouldn't pass muster in any 6th grade math class!

Insurers are in it for the profits, not to make medical care available to people who need it. They are corporate entities, profit and profit alone is their job. Politicians are owned by the corporate lobbyists who are spending millions every day to make sure their scam remains lucrative. We'll see no real reform. This is all just another huge heist and corporate bail-out, amounting to a $10,000-$30,000 tax increase plus a profits-bailout from the government for those who can't afford the price. Which is the vast majority of us whose income has remained flat for a decade or decreased in the last couple of years.

I am surely not the only person who sees that this is never going to work. So I have grown very impatient with the strange Kabuki that pretends it might.

I might live another seven years and finally get some of that Medicare I've been paying into faithfully since I was 16 years old. Then again, given my strong dislike and distrust of the Amerikan medical system, I might not. That's my karma, I'm okay with it and will take my chances. What I will NOT do is pay a huge chunk of my now nonexistent income so some insurance hack can get million-dollar bonuses for sentencing people to death. Nor will I have the government pay that same insurance hack his million-dollar bonuses FOR me. That might mean the IRS will charge me an extra $3800 on my taxes every year, but since I'm too marginal to pay that much in taxes, so what?

A friend of ours, Gordon Smith, has a good chance of getting elected this November. I'm thinking of trying to interest him in what Taos did way back in the late 1970s, of adding a penny sales tax on goods, a few cents on gasoline, a few bucks on tourists at local resorts and hotels, earmarked to the county hospital to pay for care to the uninsured. Lord knows we've got more than our share of DFHs and mountain folk here too (I'm one of 'em). It worked in Taos, the referendum passed handily even in those dark economic days. I think it would pass here. And it's a much better and fairer way of covering the actual cost of health care than anything D.C.'s been able to come up with.

Labels: , ,

0 Comments:

Post a Comment

Subscribe to Post Comments [Atom]

Links to this post:

Create a Link

<< Home