Saturday, July 21, 2007

I'm extremely lucky. So why does that not sit well with me?

This is a healthcare diary. A story about what happened to me today – a day when I woke up with what I immediately recognized as kidney stones (no, that isn’t the lucky part). The lucky part is the treatment that I was able to get for something that was once described to me as “the male counterpart to giving birth in terms of pain”.

The unsettling part is the fact that tens of millions of Americans would still be doubled over in pain – neglected or ignored, or even worse – unable to pay for a basic level of service that should be available to all Americans.

My stance on healthcare, as well as my wife’s (and in contrast to other people who I am otherwise close with), is that a certain standard of care should be available to all Americans. I don’t want to digress into a discussion about “legal” or “illegal” Americans – let’s just say “Americans” here. Unfortunately, I know this is not held by nearly as many people as it should, and that the standard of care is pretty much directly related to your ability to (1) afford insurance and (2) pay for the services. There is an alternative, as our own Dear Leader said the other day – just go to the emergency room. And wait. And wait some more. And then maybe receive a basic level of care.

I really hesitated before writing this diary – I didn’t know how it would sound or how it would come off. At the outset, and after reading the myriad of healthcare diaries posted here by nyceve and many other kossacks, I am almost ashamed at the level of care that I have access to, yet I know how very lucky I am to be in the position that I have this level of care available to me. Throughout the day, I couldn’t help but think about why the most basic of services are what I'll call "selectively available", and why so many others suffer over a cold, a sprained ankle, kidney stones or any other ailment – serious or minor.

What I did today is nothing that sounds out of the ordinary – I had a medical issue, I found the appropriate people to treat it, and I got the treatment I needed, with a promise that if (gasp) surgery or anything else is required, I can get that too – as soon as tomorrow. I didn’t need a referral, I didn’t have to pay for anything today (other than $22.00 for the pain medication) and I was able to get my initial appointment pretty much immediately and a CAT scan scheduled for a few hours later.

Why is this the case?

Well, for starters, I have a job. One that has health insurance. That is the first problem. Having health insurance should, in no way, be predicated on not only having a job, but having one that offers health insurance. As long as this system is in place, then the major hurdle to any meaningful overhaul in the healthcare system is also still in place. This obviously (at least to me) impacts employers with higher health insurance rates, employees who have to pay for specified plans as opposed to something that may be more applicable, and more so to those who don’t have insurance or a job that offers insurance.

Secondly, I have one of those “high deductible health plans” that allows me to use pre-tax dollars to pay my out of pocket costs. We did it mainly because my not-yet-pregnant wife wanted to go to the doctor she wanted to go to, but we do have to pay $2,600 or so (or maybe we EACH have to pay $2,600) out of pocket before the insurance kicks in. Quite a large chunk of change, and again, something that should not be so cost prohibitive to tens of millions of Americans who would like to see the doctor that can best help them without jumping through hoops or cutting through the massive amount of red tape. So far, we have been lucky there too, as we are relatively young and in good health, and therefore haven't had many medical expenses to pay.

An alternative would have been to take Bush’s advice and just “go to the emergency room”. But why do that and take away the opportunity, however minor for someone else to get the proper healthcare for whatever reason they were at the emergency room. Why should I be able to get a basic level of treatment for something that is extremely painful (although the missus told me that if I bring up “the kidney stones line” when she is giving birth, she will jump up from the table and punch me in the face) – with absolutely no muss, no fuss and so many others can’t?

I am not special. I don’t deserve this level of care any more than the person next door, down the block, in the next town, or 5 states over.

What does it say about this country when the standard of care received is based predominantly on luck? Today, I saw just how lucky I am.

Everyone else should be just as lucky. And it is total crap that it isn’t the case.

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