Government health care? NOT A health scare

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With roughly three weeks remaining before Congress hopes to pass comprehensive health care reform, certain truths seem impossible to avoid: 1) Our nation's health care system, if it were a patient, would be lying in bed with a broken back. 2) Three weeks is not a lot of time to fix, or begin fixing, something that has been broken for decades. And 3) A lot of people with vested interests in the Way Things Are will likely say some very scary things about health care reform to the American people. (Actually, I can think of few things scarier than VP Joe Biden opening his mouth about any issue, and when he says "Health care is on track," I'm wondering if it's a runaway train about to hit a busload of senior citizens.)
Health care reform, we tend to forget, was once a very bipartisan issue. The last president to take a stab at universal health care before Bill Clinton? That would be Richard Nixon--the very, very Republican Richard Nixon. We haven't heard the likes of, say, former Sen. Bill Frist of Tennessee open his mouth on the issue, but you can trust him as far as you can throw him: His family made a fortune in the health care biz under the Way Things Are, and at one point his Hospital Corporation of America (founded with his dad and brother) paid more than $800 million in criminal penalties for Medicare fraud.


Perhaps the biggest piece of fear mongering out there goes like this: "If the government gets in the health insurance business at some point, it's going to screw up my insurance plan at work." Well, I don't know about you, but if the government gets involved, I don't see how it can be any worse than what the insurance companies have done to me and my family already. As a Chicago Tribune reporter, I heard many people at insurance companies acknowledge off the record that the system is designed to make people give up and pay up. What should be routine claims get denied on a technicality, often on purpose. And so you fight and fight until you either just decide to pay the bill, or maybe reach a compromise you shouldn't have had to reach in the first place.

Over the past three years, I have had at least one major fight with my insurers annually. The first two I won, though one of those required me going to a third appeal before the claim was accepted. It involved my then 4-year-old son, who has Sensory Integration Disorder, visiting a neurological pediatrician who was out of network. SID is a condition where kids either have heightened sensitivity to stimuli (like the labels on their clothes) or not enough sensitivity (such as awareness of a full bladder). The doctor was out of network because there were no doctors in network to treat this condition, and we had to see the doctor before the principal of our school had my son suspended for what she saw as unacceptable behavior. (A compassionate soul she was.) There was not time for a pre-approval; my wife and I had to act. The insurance company didn't care, though, and fought us every step of the way before finally honoring claims many months later.

Fast forward to 2009, where I've just received a whopping $1200 bill for visits to an ear, nose and throat specialist over snoring issues. With each visit, and these took place months ago, I paid a $35 copay and was not told there would be any additional charges. When a $260 bill came last month, I paid it without question. But now, it seems, the insurance company is playing footise with deductibles, charges it won't cover on technicalities, the fine print. Good thing I am a reporter and can go back, read up, and fight back. But what about all those people not as skilled as I am?

Yes, yes, yes: I cannot foresee government health care that runs smooth as a top. There will be incompetencies and bungling as sure as the clerk at the Post Office puts up the "NEXT WINDOW PLEASE" sign the moment you get to the front of the endless line. But leaving things alone can't work as an option, and having a U.S. president who lives in the city--much closer geographically to the poor than those who hail from country club suburbs--gives me reason to be encouraged. Health care reform can work, if the same scrutiny and accountability is applied to it that President Obama has demanded of the agencies spending federal stimulus money.

He, and all of us, must be patient. No matter how visionary the bill that emerges from Congress this summer, if at all, health care reform will be a work in progress, requiring tuning and tweaking for years to come. Broken backs, after all, do not heal overnight.

Yet the future surely lies in our sights: A vision of it appears in this excellent Huffington Post piece. In it, author Katherine Zaleski recounts a scenario that might give any of us the chills: getting sick in a foreign land. She was in England, and suffered a crippling migraine headache. To her surprise, navigating their national health care system proved easier than anything she could have imagined.

She writes: "It was amazing. I filled out paperwork with my New York address, waited five minutes, met with the doctor, got a prescription, walked downstairs to the pharmacy under the clinic and was back at my godmother's house an hour later. Believe it or not, I didn't have to pay a cent for the visit. I did, however, pay a 'private' prescription price for the medication that added up to about $30 dollars."

Let's hope that once the Health Care Express reaches the station, all our doc stops thereafter will be as easy and worry-free.
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20 Healthiest States for 2009
How healthy is your state? That's what publisher CQ Press reveals in its 17th annual list. Twenty-one factors from infant mortality to obesity to cancer rates are compiled for the rankings.
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AP
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