Fractured health system a drain on us all

My wife’s Ob-Gyn just raised her fees from about $225 a visit to more than $300. And she doesn’t take insurance.

The news was a shock to the system, of course, another in a long line of increasing expenses that seem to impinge upon the alleged freedom of choice we Americans supposedly enjoy.

Yes, we could change doctors, find an Ob-Gyn who is in our plan or one who might charge less, but Annie likes her doctor, feels comfortable and confident in her abilities, so changing doctors seems foolish.

And yes, we will be reimbursed for some of our costs (I can’t remember exactly what the percentage is), but we still have to put the cash out and deal with the personal cash flow issues.

I’m not relating this story to whine, but to explain that the American health care system is failing not only those without insurance but so many of the rest of us forced to rely on employer-provided coverage. The reason is that the system is based on profit and not on care. Every decision made by employers who negotiate contracts with insurance companies, every decision made by those insurance companies about the legitimacy of medical expenses and even many of the decisions made by doctors — including who to see and what kind of services to provide — are made with the bottom line in mind. The idea is to minimize expenses but to maximize price, meaning that we are paying more and more for each visit to the doctor but getting less time with our doctors.

That’s one of the points that Michael Moore has been making as he makes the rounds promoing his film “Sicko” (haven’t had a chance to see it yet). As he told Business Week:

“Do you know of anyone who hasn’t had a problem with the insurance company, or getting some procedure covered?” he asks. “Anyone who sees this film will understand exactly the mess we’re in right now.”

Adds Daniel Vallin:

Moore’s main point is that the profit motive of private health insurance corporations is what causes the problem. The need, codified in law, in fact, to increase profits as much as possible for the benefit of the tiny number of shareholders of the corporations, trumps the concern for adequate health care for the policy holders. The health insurers are institutionally bound, not to care for the sick, but to turn a profit for their shareholders, and thus many who believed their health care costs were covered find that they are cut out from the most expensive healthcare system in the world in order to cut costs for the insurance company.

And we’re not talking about extreme or experimental treatments. We’re talking about regular care in most cases, such as standard diagnostic testing and referrals to some specialists.

So, it’s not just he 43 million Americans without health insurance who are suffering under the current dysfunctional system, though they tend to suffer more than the rest of us. It is all of us.

Marie Cocco sums it up:

We are guilty of national malpractice for allowing the profit motive to drive decisions about who gets health care, and of what sort.

Malpractice is an apt way to describe the problem — though the only court we have in which we can petition for redress is the court of politics.

Of the presidential contenders, John Edwards and Dennis Kucinich understand this best, though both Barack Obama and Hillary Clinton are offering proposals designed to fix at least part of the problem. The GOP plans, where they exist, would do nothing.

But plans crafted in the run-up to elections often fall apart once candidates gain office as high-paid corporate lobbyists — in this case for the health insurance and drug companies — work to preserve the status quo (remember Harry and Louise?).

So it is up to us — the system’s abused consumers — to create momentum for change.

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Preserving the Great Falls

I’ve never been to the Great Falls outside Paterson, but they deserve national park status, and not only based on the arguments made here by the North Jersey Herald News. The falls — and the city of Paterson — are the setting for one of the great pieces of American literature, the multibook poem “Paterson” by William Carlos Williams.

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Runner’s diary, Monday and Tuesday

Two days of running for the price of one! Two days at four miles each with no ankle pain and only modest tightness in the hammies. Monday’s time was about 39 minutes, today’s 37:30. Ran Monday with Mike and Tuesday with Mike and Paul — working on synching our paces for that October distance race we’re training for.

Long Beach Island here we come!

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Conservatives v. Brown

Slate offers an interesting interpretation of last week’s school desegretation case that criticizes the conservative majority for distorting history, but also shows how the seeds of their arguments come directly from Brown v. Board of Education.

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If you can’t do the time,call the president

So a conviction and three appeals later and Scooter Libby is heading to jail.

Check that. Scooter Libby learns that there is no substitute for friends in high places — or, in his case, friends in the highest places.

President Bush said today that he had used his power of clemency to commute the 30-month sentence for I. Lewis Libby Jr., the former top aide to Vice President Dick Cheney, who was convicted of perjury in March and was due to begin serving his time within weeks.

The action, announced just hours after a federal appeals court denied Mr. Libby’s request to allow him to remain free while his case is on appeal, spares Mr. Libby his prison term, but it does not excuse him from stiff fines or probation.

In a statement issued early this evening announcing his decision, Mr. Bush said he had listened to both critics and defenders of Mr. Libby, who was convicted of four felony counts for lying during a C.I.A. leak investigation.

“I respect the jury’s verdict,” Mr. Bush said. “But I have concluded that the prison sentence given to Mr. Libby is excessive. Therefore, I am commuting the portion of Mr. Libby’s sentence that required him to spend 30 months in prison.”

So, to recap. Lie to a grand jury and get a fine. Nice.

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