It’s not exactly news, but it still manages to shock me if I spend more than a second reading the headline. Uninsured people self-diagnose, stretch prescription meds or medical appliances beyond their intended usage to save money, go without treatment when possible, or seek medical treatment and end up with thousands of dollars in bills they can’t really afford to pay. Setting aside the social-justice issue, how is this not a recipe for disaster, epidemiologically speaking?
Internet diagnoses, self-medicating and trading prescriptions, of course, come with potentially dangerous side effects. Dr. Barbie Gatton, who has worked in emergency rooms throughout the city since 2002, said she often sees young people who have taken the wrong antibiotics borrowed from friends.
“We see people with urinary tract infections taking meds better suited for ear infections or pneumonia — the problem is, they haven’t really treated their illness, and they’re breeding resistance,” she explained. “Or they take pain medicine that masks the symptoms. And this allows the underlying problem to get worse and worse.”
Maybe the epidemiological angle hits me a little harder because I just finished reading a book on yellow fever. Living in the age of MRSA as we do, I don’t think I’m being too Chicken Little here, particularly when we’re talking about basic health care that everyone, regardless of whether they buy insurance outright or share insurance costs with their employer, should have.
There’s some solid basic info in the article, but I have two quibbles. One, it identifies young adults’ (“invincibles”) risk tolerance as a reason for their avoidance of health insurance costs. Which, frankly, is a load of bull. Sure, young ‘uns are more likely to go flying down a tree-lined hill on a snowboard than older folks, but I’d lay money on the fact that older folks become more averse to that kind of thing because it’s not as much fun to do so with bodies that aren’t as reliable and resilient as they used to be, not because they can identify and tolerate risk of injury any more. I’m only 30, and still, all I can see is muscle soreness I’d rather not have in that scenario. I’m pretty sure I’d have tried it at 20.
Also, I’d lay money on the fact that risk tolerance is intimately, nay, inextricably tied to necessity. I went without insurance for a while after college, and I don’t feel any different now than I did then about the possibility of catastrophic illness or injury. We still cross our fingers that we’ll be able to afford whatever medical emergency comes up, and our insurance is pretty solid as insurance goes. If my tolerance for risk is unaffected by whether we have insurance, that doesn’t tell us anything about the invincibility of youth, it tells us something about the dysfunction of health insurance systems.
The article mentions a plan floated by Gov. Patterson to allow parents to cover children on their insurance up to the age of 29. Which seems sensible enough a band-aid to a massive gaping wound…wait, no it doesn’t. How ridiculous is it that health insurance and housing difficulties, people, health care and housing forces the prolonging of adolescence to such a ridiculous extent that you can’t ever give your parents a freakin’ break, even if you wanted to?
Tying health insurance to employment was a bad idea to begin with. Foisting the costs of health insurance for working adults onto their supposed-to-be-retiring-parents-who-can’t-retire-anyway-in-this-economy is a bad idea. But when the most common-sensical of common-sense provisions get shot down by free market idiots who’d rather see you succumb to either antibiotic-resistant infection or the crushing weight of medical debt than have government medical agencies set guidelines as to which medications work best for what illness, I guess these are minor matters.
Harumph.
But the ONLY alternative is SOCIALIZED MEDICINE LIKE THEY HAVE IN CANADA, you know, where you have to wait 6 months to get your appendix taken out and will probably die before getting treatment.
I love this whatever-you-call-this-thing-that-Rush-tries-to-pass-for-logic:
“The national coordinator of health information technology will monitor treatments that your doctor gives you to make sure your doctor is doing what the federal government deems appropriate and cost-effective,” Limbaugh told his millions of listeners.
Oooh, that sounds soooooo OMINOUS! Its a good thing that insurance companies don’t have a guy working for them doing the exact same damn thing that he worries about the “national coordinator of health information technology” doing, who is answerable to noone except the stockholders and their thirsty desire for profit above all else. Yeah, its a good thing we don’t have something like that!
If you ask me, I’m big on a single payer system because the biggest damn problem in this whole damn equation comes down to pushing around paperwork and checks. And you know who can push paperwork and checks around better than just about anybody on the planet?
The U.S. Federal Government. Don’t believe me? Then cheat on your taxes. Hey the government sucks so bad they won’t catch you, go ahead. I dare you. I’ll even double dog dare you.
One of my favorite meaningful statistics:
* Private insurance companies spend (depending on who you ask) between 13% and 20% of that premium you pay on overhead.
* Less than 2% of Medicare’s funds are eaten up in overhead.
Government works when it’s run by people who want it to work. Unsurprisingly, it fails when it’s run by people who’d rather preserve a Hobbesian nightmare in the hopes that they’re the ones who end up on top.
and this is why everyone should live in canada. just saying.
You wouldn’t mind if Spouse and I moved in with you, then? Great!
What I find especially interesting about this debate is that both single-payer advocates and free marketeers agree that linking health care to employment was a terrible idea in the first place. Yet, while one side seeks to replace our system with a single-payer one that is more efficient, costs everybody less money while guaranteeing equal access, and is the preferred system of health care by almost every single industrialized nation, the free marketeers’ answer is to get rid of employee health insurance entirely so that everyone has to get private health insurance. Private insurance, ya know, the kind that tends to spike in price or boot clients once they get sick, that regularly refuses to cover its clients’ treatments even if they’re potentially life-saving, and that’s even less cost-efficient than employee-based health care.
Do you remember the Medicare Modernization Act that the president who shall not be mentioned signed into law? Not only did it provide terrible, confusing RX coverage for seniors, but in the noble effort to save the Trust Fund, it also pre-planned and paid for another festival of crap for the next administration.
Over the last two years, private contractors have been bidding for one of fifteen Medicare regions of the country (Down from 100+). Looking at the figures of claims per year and total award, across the board contractors are making 30-40% reductions in the operating costs (people) of what was required from the previous year.
New technology can account for a small amount of the efficiencies boasted by these numbers – by far however, it is the result of an intensely competitive environment with desperate companies vying for a scant few contracts and essential administrative functions being left out of the contracts. NOT that Medicare was rampant with extraneous spending.
Rather than giving Medicare the decent shag she deserves, Congress is politely asking her to fuck herself.
CMS.hhs.gov
Fedbizops.gov
Poor Medicare sounds like she could use a really good date. And also greater exposure. I know we’re all swamped with trying to figure out what the hell is going on with banks and credit and whatnot, but not once have I ever heard anywhere on radio, TV, or print news and analysis about the effect of reducing the number of Medicare regions/contracts. It seems like a gross oversight the way you put it.
I always wonder about the antipathy to single-payer systems versus the insistence on maintaining the “free market” in medicine. Like the people who are making the policy, and the people who support the policy like their lives depend on it, are they worried about what they’re going to invest in if management of medical services gets turned over to government rather than companies you can count on for stock and profits? I know lobbying turns in a lot of money and potential earnings for congresspeople and wonks, but there are only so many slots to fill in PR and lobbying.