We all have health care stories

March 8, 2018 | G. Michael Dobbs

I have a kidney stone. It’s not my first stone, but according to my doctor this is a whopper 7mm rock, as estimated by an ultrasound.

I required surgery a few years back for a stone measuring 4 mm. I was really looking forward to what this thing would do to me.

To get a better idea of what was lurking inside me, my doctor sent me to my urologist who in turn told me I had to get a CT Scan to get a more definite look.

I went for the CT Scan and happily found the technician was a Reminder reader and thankfully wasn’t someone who hated my editorials or me.

(Luckily for me the stone is now estimated to be 3 to 6 mm in size – still large enough to put me on the floor writhing in pain, but apparently with better odds that surgery is not required.)

After the CT Scan I received a letter from a company called National Imaging. I assumed with a growing level of annoyance this was some sort of third-party bill for the scan. It wasn’t.

Instead it was a copy of letter sent to my doctor indicating that my insurance company had sent his request for a CT Scan to this company for scrutiny and they agreed it was necessary. What would have happened if this company had decided the CT Scan was unnecessary?

This, ladies and gentlemen, is a small example of why our health insurance system is immensely messed up.

I’m sure you have your own examples. Our previous health insurance company denied a prescription my wife was given by her doctor because their panel of doctors had determined she didn’t need it and recommended she go back to her doctor for an alternative this panel would approve.

Who are these people who second-guess doctors and why they hell do they have so much sway over our lives?

Of course, nothing is going to be done to correct any of these characteristics in our health insurance system. The bills being discussed by Congress earlier this year were all about the Affordable Care Act, not health insurance in general. Only the handful of legislators considering a single payer plan not unlike those of other countries offered any possible reforms to health insurance in general.

Our problem is we have a for profit system that will take steps to make that profit. In many ways I can’t blame companies designed to make dough to view the need to cut costs or to shift as much of those costs as they can onto someone else, such as the subscriber. It is the American way.

The reform issue has two large thick layers. First, we have legislators unwilling to truly rock the boat either because of ideological reasons – socialized medicine is un-American – or because they are in the pocket of the health and pharmaceutical industries.

Have you seen many reports about any health insurance reforms lately? Not much is happening. Little reforms may be implemented as a way to keep the American public from revolting, but large scale re-thinking seems to years away. It would appear that health insurance reform is a dead issue.

The second layer is the American voter who seems incapable of putting people into office who would actually address the health insurance issue. A poll on the website Vox (https://www.vox.com/policy-and-politics/2018/3/5/17070920/democrats-president-congress-priorities-health-care-immigration-guns-climate-change-poll-survey) indicated the 31 percent of American voters want the Democrats to make health insurance reform – and then guns – its main issue if it captures the White House and the Congress by 2020.

We have to wait until then? We can’t talk about it now? Apparently so.

No system appears to be perfect. There are plenty of people who speak about horrors in the Canadian or British public health insurance systems.  We need a discussion, though. We need to seek consensus about some of the major issues. We need to act, not in 2020, but now.

In the meantime, I’m taking an herbal remedy that is known to shrink stones just so I can avoid surgery and the out-of-pocket expenses that go with it. Thankfully I didn’t have to run this decision by my insurance company and its third-party vendors.

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