Medicare and Senior Drug Programs
I may have posted what follows earlier in the history of this blog. I’m posting it again as an aide memoir for those who have forgotten how really terrible our health delivery system can be.
The point is this: If I understand it at all (and if I don’t I’m sure someone will post a correction) our conservative masters plan to give us help with our drugs (except, of course, the really fun ones) on the condition that we leave Medicare as we know it and sign up with an HMO.
Let me tell you, as one old guy to another, this is just another shabby trick to put a stake through Medicare and any possibility of any single-payer National Health Insurance.
This was written four years ago, and published in the Desert Leaf
Goodbye My HDO
I rode home from summer vacation to discover that my HDO, my Health Denial Organization, is planning to cut me loose.
This was really surprising because they and their co-conspirators in the insurance biz had spent a lot of money lobbying Congress for a piece of my kind of health dollar. For that matter they must have spent a pretty penny lobbying me. You probably remember their big ugly billboards with the pretty messages.
They’d always be there for me. They were "chock full o’ docs" standing by to help, and there were nurses, and specialists, and neat hospital connections… and they were all at my beck and call.
So a bunch of geezers signed up with them, and the Medicare folks sent the HDO hundreds of bucks a month for each of us to guarantee our health care. We all got along splendidly. It was just what the billboards promised until some of us actually began to beck and call.
And then it turned out that the HDO guys were business men and not medicine men. Worse, they were poor business men. If you think it’s a bad deal to have an insurance company in charge of your health, just imagine what happens when it’s an incompetent insurance company.
Normally these people live and die by statistical tables, and all manner of mathematical tools for analyzing risk. But somewhere along the line my HDO gurus stepped on their…um…ties.
There was a disconnect between the actuarial department and the marketing wizards. Surely the actuaries must have understood that old folks get sick more than young folks and that eventually the cash flow for that group was going to go negative. But if your national CEO is getting millions of bucks a year maybe you decide to just wing it. Hell, let’s pray for an epidemic of the healthies.
For a while a kind of medical Ponzi scheme must have worked. Get lots of new geezers each year before they fall into sickness and decline and their premiums will offset the cost of the older clients. In a pinch you can use your docs as a bank and stiff ‘em for months before they’re paid.
Finally, when all else fails you get out of Dodge, and do business in counties where most of your clients don’t have giblets that are swollen and inflamed.
Let’s be honest, here. What did we expect? Did we really think that because an insurance company called itself a health provider that it was interested in our health? Fiddle-dee- dee and shame on us. If we’d had the wits God gave a goose we’d have known from the get-go that in a capitalist business system a profit making corporation exists to make a profit, and increase stockholder equity.
It doesn’t give a rat’s left leg about anybody’s health but its own. It shouldn’t surprise us that it cuts its costs by reducing or discontinuing services.
The health care problems we face as a nation are compounded by the fact that we have lost track of the real cost of delivering medical services to all our people.
Doctors and hospitals have to hire squads of clerks, accountants and insurance claims experts in order to collect their fees. Knowing that they are only going to get paid a percentage of those fees, they have to inflate them. Patients fall into the trap of thinking that the five or seven buck co-pay is the real cost of a visit to the doctor.
Drug manufacturers do far more than simply cover all costs for the development and marketing of drugs. Like the insurance companies they are in the "profitcare" business.
It’s time we began to treat the national healthcare debate as a problem in medical ethics and ask whether, as a people, we think it’s moral to allow corporate profit motives to dictate the delivery of health care services.
