Healthcare Reform, & the Best Thing About My Bunion Surgery

Since you asked . . .

Dear Representative __________:

We NEED a meaningful public option.

Last year I had surgery on my foot. I had to stay completely off it for a solid month, and my doctor prescribed a knee-walker to help me get around. The manufacturer my doc recommended said they could ship one for under $500 and get it to me in 3 days.

My insurer (one of the biggest in the business) said they'd cover it, but only if I got it through an "in-network provider."

Now, you might think the point of dealing with "in-network providers" would be that the insurer could negotiate cheaper prices; but apparently, no. They gave me a list of over a dozen in-network providers, and I called them all. It turned out only one could provide the item – and it would take at least two weeks, partly because special authorization was required from the insurer, because this in-network provider's price to procure the item was over $1,000.

I called the appeals people at the insurer and I told them hey, we can get it quicker from the manufacturer and you'll save $500. The insurer could not have been less interested. They'd pay the $1,000, and I'd have to wait two weeks. When the knee-walker finally arrived, it was an inferior model from a different manufacturer.

I have to at least ask whether the insurer and its in-network provider weren't splitting the mark-up at my employer's and ultimately all of our expense – i.e., they require me to accept an inferior product at twice the cost, then the insurer recovers the cost through premiums, plus collects a kick-back from the "preferred provider." (Not to mention the delay and other detriment to my well-being).

The VA is running a great single-payer system, and Medicare is running a great public option. I would gladly trade my private insurance for either. (I'd rather have a bureaucrat between me and my doctor than someone who views my illness as a looting opportunity.)

Meanwhile, I'm afraid to speak frankly with my doctor for fear something I say might be used as an excuse to deny coverage.

Our healthcare money isn't lengthening our lives (we in the U.S. pay twice as much for healthcare than people in some 26 other nations, yet our life expectancies are much shorter; see chart here from ucsc.edu).

So, where is the money going?

Private insurers in the U.S. have had decades to show they can provide decent healthcare coverage, and have failed. Surprise! – they won't do it unless they HAVE to.

Theoretically, yeah, government could regulate private insurers into decent coverage. But as any "free marketeer" should concede, that would be the LEAST efficient way to do it! We'd have to actually regulate, we'd have to staff up enforcement, etc.

Clearly, the MOST efficient way is to give private insurers some COMPETITION!

PS: Congressional Dems REALLY need to focus on media reform. So long as conservatives control 98% of the "mainstream" media, you'll be dogged by misrepresentations and hysterics at every turn.

Below right is the chart referred to above (showing that we in the U.S. spend ca. twice what 26 other countries spend for healthcare, for much shorter life expectancies).

You can contact your reps through the "Contact your U.S. Congressional reps" link in the sidebar at left.

PS: The best thing about my bunion surgery was, I learned I could freeze my sig. other's entrées for a month or more in advance. Otherwise, not so rec'd.

UPDATE: My rep., blessed be, is so far standing up for the public option. So I sent her/him this:

I fervently hope you will continue to stand firm in favor of a public option!

Private insurers in the U.S. have had decades to show they can provide decent healthcare coverage, and have demonstrated they won't do it unless FORCED to.

Government could, theoretically, regulate private insurers into providing decent coverage; but as any true "free marketeer" should concede, that would be the LEAST efficient way to do it! We'd have to actually regulate, we'd have to staff up enforcement, etc.

The MOST efficient way is to give private insurers some COMPETITION! If the free market is so dam' efficient, they've got nothing to fear.

Pls, pls, pls, we need you to continue to care for us. We do notice; we vote for you bec. you do. Thank you.