Re: Socialist healthcare "horror story"
I'm offering the following history in the interest of giving information that might explain (not approve) of the lowered medical circumstances occurring now.
Cigna arrived on the scene in Los Angeles about 30 years ago, it seemed to have been designed for "blue collar" workers, with mostly foreign trained and speaking physicians as the only covered ones. When the communication problems became acute (just a few years after its inception), some effort was made to have interpretors intervene.
It was commonly known in the '80s that if your employer provided Cigna coverage, it wouldn't be an ideal place to work (to put it mildly). However, that time was the last "recession", and you were lucky to have a job. So "the band played on". If you had a choice of Cigna or Kaiser (as teachers did), you chose Kaiser and felt lucky to have that. My best friend, a teacher, had 3 young boys then and a sister-in-law who is a dermatologist.
So when chronic illness occurred, for 2 of the children, the aunt would coach the family about what they needed for good medical care (which was expensive, and not suggested by physicians in Kaiser's system). My friend's husband is an attorney and he would negotiate with Kaiser for the care his sister told him was needed. They got the expensive care.
I was away from L.A. for about a decade and was chagrined to find Cigna had grown tremendously during my absence, with clinics of their own and more English speaking doctors, with even more clients (employers). It seemed to me that the populace had settled for mediocrity or worse in health care.
It seems to me that statistics should be available to indicate comparisons various health care insurers have. That is, stats on lengths of time before correct a correct diagnosis is made and appropriate treatment begun, with patients' compliance in the package. However, no public agency seems to be interested in doing that and the insurance companies themselves have no interest in that project (why should they?).
Instead patient advocacy centers on children and the elderly (mostly helpless, health care dependant individuals). That scratch on the outer membrane of health care has produced much outcry and less solutions. What is it about the USA's population that prevents effective intervention? Well, you might site the money hemorrhage into various battles, fraudulent practitioners who more slowly syphon off more tax money, and a generally healthy milieu whose people have limited energy/interest, due to their other personal battles. Politicians have turned their heads away from growing, mountainous medical costs (not at all consistant with inflation, but more in tune with "what the traffic will bear"; and mounting health care insurance premiums.
Michael Moore's voice of conscience in exposing the shortfall of public medical services, in comparison with other countries' wealth of them was received by doubting, unbelieving Americans. I don't know how much more clear the desperate situation of those lacking insurance (for various reasons) has to be made, to inspire a sense of responsibility of all, for the few who need their tax dollars spent on public health care for all.
I came from a health care system in Canada in the '50s and '60s wherein the responsibility was placed on physicians to bridge the money gap and provide care for the public clinics held by all (private and public) hospitals. In order to achieve a place on the medical staff of any hospital, they had to staff its public clinics.
Hospitals in turn, absorbed the cost of care during admissions of those without funds to pay for it, I don't know if any of it was tax deductible. Finally, with hospital costs rising and physicians claiming that they needed to spend all their time in their own (private) practises, it was foreseen in the early '60s, that more government responsibility was needed. And it happened.
When I arrived in the USA in 1963 and learned about Public "County" hospitals' desperate conditions for the poor, I was appalled, then outraged. I was told that those poor people "deserved" the poor treatment they got. Then it was discovered in Los Angeles (I don't know if it happened elsewhere, but I suspect it did), that surgeries creating infertility (tubal ligations) were being performed without patients' consent (or knowledge of English).
At the same time, public outcry against the hopeless war in Viet Nam was becoming a groundswell effort, and political activism had general approval, when it worked to prevent further loss of life in a war that wasn't ours. Then it was turned on negative reception of those soldiers who survived, as they returned home. The dicotomy of the warm welcome given those Vietnamese who entered our lives at the same time (many of them settled in Orange County in CA, as close to Disneyland as they could) was missed.
What did become evident, was their acceptance of squalid living conditions as natural, our love for their food, and need to compensate for the helpful deeds they performed for our side in their homeland. Many women here became closer to the Vietnamese individuals who gave their manicures, and sympathized with their lowered circumstances. So it almost escaped notice that a whole industry (manicuring services) was taken over by them, due to their ability to make do with less income. There was no complaint from former manicurists, who may have gone on to better themselves (?) in the impending technology revolution.
And "the band plays on", but not tunefully as doctors demand higher and higher incomes, bolstered by the powerful industrious companies that now own many medical practises and require that more patients are seen/day. (I get a picture in my malicious mind of future wretched physician rowers - like the essence of hell in comic books, of multi manned boats, that hopefully will not be physicians' "just desserts").
Health insurance companies have assumed greater and greater influence on life/death decisions and use of procedures that would give greater quality of life; and formed alliances with employers (clients) and providers of newer medical equipment, and pharmaceuticals. Talk about political machines' influence on a society! They will be dictating seniors' eligibilty for joint replacements, heart valves, stints, and other replacements......... and let's not forget penile function.
So now we have the "recession"/depression that dictates scrabbling activities, as those who are employed do whatever it takes to preserve their jobs (usually keeping minds and mouths shut to inequities in working situations). So it's up to baby boomers who have established some form of future support for themselves, to do the work they've been so successful with - protest! Then help create a health care system that works for us all.
We boomers have more time and the realization of being duped by health care providers (health insurance companies) and - yes, our own crazed need for more, more, more. If you are close to one, please inform those individuals that it's time to pay up, with their spare time (after bridge and computer games, of course, or whatever recreation they now feel is their due) for all that their gain has wrought.
Thank you for following along in this ramble.
Lois Klein, R.N., P.H.N.
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