Saturday, November 18, 2006

Health. Care.

Darlings. Pretty Lady has a serious request to make of you.

She knows, in general, that all of you dears turn to her at the end of a weary day, for a little Light Relief. She endeavors not to tackle Serious Issues; in particular, she is highly allergic to issues that require, or seem to require, political solutions. Pretty Lady prefers to avoid politics. She is morally opposed to politics as a blanket rule, in fact--but that is a different story.

However, Pretty Lady is obliged to confess to you that she does, indeed, have her moments of Serious Thinking. She is sorry to shock you, but it's true. One of her pet hobbies is busying her pretty little brain upon the problem of Healthcare. That is, the Care of one's Health, and the concomitant systems that have arisen, and might arise, thereof.

And she is devastated to inform you that, bluntly, the 'Healthcare' system we are now laboring under, in her current home country of the U.S. of A., is not. Is not and does not. Period.

You see, what we have, currently, is a system based upon the concept of 'health insurance.' This, at face value, is a bunch of baloney. How in the world does one 'insure' health? Given that the biological facts of the situation are overwhelmingly, that is one hundred percent, stacked against us?

Because we are all, every one of us, one hundred percent mortal. Pretty Lady is sorry if she is the first to break this to you.

Thus, 'health insurance' companies are promising the impossible. For this imaginary service of protecting you against the utterly inevitable, they quite properly charge a hefty fee. Moreover, as soon as one show signs of incipient mortality, the 'health insurance' company, for reasons of excellent business, refuses to insure you any longer. 'Health insurance' companies, then, exist for the sole purposes of taking your money and giving nothing in return.

What, then, is going on in the minds of those hapless persons who are actually paying them?

The fond delusion nurtured by the 'insured,' in fact, is that they are paying for the privilege of receiving astronomically expensive 'health care' upon such occasion as they, most unfortunately, might happen to need it. In essence, they are betting that their health will require care to the tune of more money than they originally invest in the 'insurance.' In other words, they are expecting to get something for nothing.

First law of economics, physics, karma, and simple existence: You cannot get something for nothing.

Ya.

This impossible situation is further confused, conflated, and screwed up by the fact that there are all sorts of attendant industries, bureaucracies, research institutes, professionals, and overtly fraudulent set-ups geared to extract the maximum Something for the minimum Nothing that they can possibly leverage from the screwed-up system. Nobody acts to Bring Down the system, of course, because so many people's very livelihoods depend upon it.

Not the livelihoods of the 'insured,' however; these are the ones which are maximally expendable. Because once the system has bled them financially dry, obviously there is no more use for them.

Ergo this engenders, daily, hourly, nightmare stories like that of Pretty Lady's beloved friend, k.

I hardly ever get the fever and chills any more. But I'm still sleeping around 18 hours a day, partly from allergies. The pain in the foot is still intense. The shin bone is tender, and the ankle too. But the foot itself, internally scarred from the abscess in 2004, is by far the most affected by pain.

If I walk just a few steps, the pain ramps up, and lasts for hours or days.

And I still don't have a working scooter, even for home use. All I can do is sit around with my feet elevated, letting the things I need done go undone, letting my life slowly fall apart around me.

Yesterday, for the very first time, a certain realization hit me full force: If I'd had a working scooter - instead of the defective one delivered in July and never replaced - the infection would probably not have happened. The incompetence of the equipment company and the HMO is the primary cause of this terrible new infection, more permanent damage and permanently increased pain, and almost the loss of my leg.

After the infection, with a working transportable scooter, I wouldn't have been stuck here for a month, unable to go anywhere or do anything. I would not have fainted at the pain doctor's office from the strain of walking 150 feet. I would not have felt the intense pain I do every time I walk from my office chair to the kitchen or bathroom or front door.

My written complaint to the Medicare HMO about the scooter issue was finally addressed, over a week after submission. The person calling me from the complaint department had no idea I was complaining about the durable medical equipment company as well, including allegations of fraud. Even though this was included in the complaint she was supposedly reading, right in front of her.
Although it is a deeply painful experience, more so for those who have known this lovely lady well enough and long enough to feel an abiding interest in her wellbeing, Pretty Lady nevertheless recommends that you go and read a great deal more of what k has to say about health, her HMO, Medicare, and all the rest of it. It is like a thriller and a horror movie and Kafka all rolled into one. You will never be bored.

You will then, as perhaps never before, be convinced that 'health insurance' as it is practiced in the great state of Florida, at the very least, has nothing at all to do with Health Care.

Now, there are two separate issues before Pretty Lady, as the situation now stands. One is the Personal. Pretty Lady happens to Care, Personally, a very great deal for her friend k. This is key. Because Pretty Lady Cares, Personally, for this limpid and inspiring soul, and wishes for her to remain on this planet for as long as possible, spreading her limpid influence, Pretty Lady is urging everyone who Cares for Pretty Lady to go over and offer her friend some support. If you happen to have excess financial resources, there is a convenient 'Donate' button for you to press. If, like Pretty Lady, your resources are constrained, Moral Support will do just fine. K, being rare and radiant, absorbs a great deal of healing from such things.

On the other hand--the hand of International Affairs, the hand of Politics and all Things Grand--what do you think Pretty Lady is going to say? Is she going to call, righteously, for universal Socialized Medicine? For a Compassionate Culture? For the People to forcefully rob the coffers of the rich, and scatter infinite health and wellbeing round the planet, so that everyone lives happily ever after?

The fact is, Pretty Lady doesn't know. She might, eventually. If that's the most judicious option.

But before she makes any such sweeping propositions, she feels compelled to point out a few things.
1) Health is most efficiently nurtured by those who Care most about it. The person to whom one's health matters most is, usually, oneself. Thus, one's Health is, first and foremost, best Cared for by the sussing out, assessing, allocating, and applying of all resources, financial and otherwise, FOR ONESELF. Not by a faceless institution that exists merely to rip one off and usher one silently and efficiently into the grave.

2) Health Care may include, but is not limited to, access to strange, myriad, wondrous, mysterious, and above all, expensive Drugs. In fact, in Pretty Lady's experience, the better one Cares for one's Health, the fewer of these dicey Drugs one is likely to need.

SO, framing "Healthcare" as a system primarily to support the existence of myriad drug companies may greatly assist the drug companies, but it is not necessarily synonymous with Health. And indeed, may be counterproductive to it.

3) Hoary but useful Cliché of the Day: An ounce of Prevention is worth a pound of Cure.

That is, unless one is SELLING the CURE.

Pretty Lady suspects that one very large reason that the "Healthcare System" is so stingy on Prevention is that it is so heavily interested in selling cures. That, and in covering its own butt; there is a reason that doctors these days compulsively order masses of expensive and, in most cases, useless diagnostic tests. They are not nearly so concerned about your financial well-being as their own, and medical malpractice lawsuits cost them money.

All of these truths may seem to be self-evident. The problem is, our current 'healthcare' system rarely seems to acknowledge them, in practice if not in word. Until these obvious truths are taken into account, all efforts at amending a 'healthcare' system are bound to be in vain. They will bankrupt even the rich, before putting a dent in the sufferings of the poor.

Because, darlings, the current 'health insurance' system is simply a spiralling financial sink, spreading misery and ruin among those it purportedly exists to help. One is, like Pretty Lady, almost better off without it. Until one is mowed down by cancer or a bus; then, it seems, it is those who Care who are dragged deep into the vortex, with no escape.

UPDATE: From Desert Cat:

Now the good news! I do believe I have convinced our girl to go out immediately and purchase for herself a scooter that will serve her present needs, while waiting for the insurance issue to be settled in whatever manner it eventually will. I promised her that I had a herd of horses I was holding in reserve to assist her financially with this very necessary step.

She is a bit overwhelmed at the thought, but grateful nonetheless.

Therefore, as the simplest and most straightforward way to make this happen, won't you please trek on over to her website and hit that "Make A Donation" button located on her left sidebar? This way she will be able to purchase the specific scooter that best meets her needs, rather than any of us trying to figure out which one would work best for her.

Her Walter is coming home Monday afternoon (choirs of angels sing!), and I think it would be absolutely fabulous if she had enough cash in her account to go out with him then and purchase the scooter she so badly needs.

Thank you all for your generosity, whatever amount you are able to contribute. And if you are broke, believe me, the moral support you offer her is also very much appreciated, maybe more than you know.


Thwack the button! Thwack the button!

17 comments:

Walrilla said...

Very interesting, Pretty Lady. Very thought-provoking.

prettylady said...

Yes. Think. Then go over and press k's 'Donate' button, please.

Anonymous said...

I agree 100% as health is indeed "un-insurable" but a $2 trillion benefits industry not including any care.
There does exist "Protection" rather than insurance at a fraction of insurance costs without insurance BS.

We have owned such a plan since 2003 and 100% benefits even with a pre-existing cancer condition in the family. We only pay a small monthly fee and are 10% protected from high costs and have access to any benefit from A to Z anytime, anywhere in America.

The solution is at hand.

GOD BLESS

Mark

k said...
This comment has been removed by the author.
k said...

And now, Pretty Lady, your kindness has moved me to tears.

A sudden small shift in perception has made me understand you far better as the healer that you are. It's way beyond the physical, and you know that with everything you have.

Livey said...

Wow. You are so eloquent of speech dear lady. Me, I woulda just said "I'm pissed as hell lets kick some ass!" LOL
But you, you make people actually think! Well done!

prettylady said...

No tears, k, unless you're getting rid of toxins. ;-)

Livey, going and kicking ass has its necessary time and place, too. We all try to do what we're best at.

Desert Cat said...

I can't argue with this. That's pretty much as I see it. I have always wished for a low cost catastrophic insurance policy to be available through my employer rather than the costly "sniffles and boo boos" coverage we currently shell out for.

Insurance makes the most sense when it is for the purpose of cushioning the blow when something big hits. That's what homeowners policies, auto insurance, life insurance are all about. It's about spreading out the cost, and thus the risk.

If auto insurance were run the same as health "insurance", then oil changes, tire rotation and new windshield wipers would all be available for a nominal copay, and people would be agitating to have gasoline and transmission fluid included as benefits too.

All of these things are necessary for the purpose of having a well-functioning automobile, by the way. No doubt about that.

But the premiums would be astronomical, and well above the actual value of benefits delivered. Because a good portion of the cost would go to the herds and hordes of bean counters, meddling and auditing and denying and procrastinating and pretending to be shocked (shocked!) to hear that you are filing a grievance.

"I'm sorry Mrs. Jones, but we can't cover a new battery for your Studebaker. Our records show that we replaced your battery last year, and your policy only allows one battery replacement every three years."

The Aardvark said...

TANSTAAFL.

"There ain't no such thing as a free lunch"

Being currently un-insurable by the Providers Of Succour, but having been schooled in things like Prevention (Remember back when Prevention Magazine WASN'T a whore for Big Pharma?), I'm not overly worried personally. I do SO feel for "k". I have heard similar horror stories, and pray for healing AND justice for her.

The Holy Blue Cross a baddie?
SAY IT AIN'T SO!

PL, sweetness, "universal Socialized Medicine"? All you would be doing is subsidizing the same current mess.

To use a hoary old buzzphrase:
paradigm shift.

Compassionate culture is the answer.
The bad news is that it Requires Effort.
Changing hearts is a job.

Thank you for sharing your friend's situation.

prettylady said...

All you would be doing is subsidizing the same current mess.

That's my point, sweets. That's my point.

prettylady said...

Changing hearts is a job.

Mine! I'm working as hard as I can!

;-)

k said...

Okay then. It's toxins all right. Toxins of BCBS poison, is what.

Thank you all from the bottom of my heart. I truly don't know how to express what this means to me.

Desert Cat said...

It occured to me after I sent that e-mail that some of you may be wondering "where in the sam-hill did he get that 'herd of horses' metaphor??"

Ok, duly chagrined, here: We're all pulling for k, and when we hitch ourselves to a team, we can move mountains.

That and y'all were chomping at the bit. ;)

mitzibel said...

Oh, crap. Health care. A subject near and dear to my rectum. Okay, not that, but just about every other part of my body. Doctors have saved my life G-d knows how many times; once I had one do it for free, 'cause I couldn't pay and he was a Healer, not a Businessman. Hell, I even had Big Pharm give me about 20 grand worth of life-saving chemo for free, but that's just because I made them look really, really good on paper.

My own mother, who is by no means sane, has decided to forgo our current healthcare system and medicate herself via veterinary catalogues; currently she is treating her pneumonia with porcine penicillin. And damned if it isn't working at least as well as Cipro.

But to anyone who thinks we should go Socialized Health, I say spend a year under the care of the V.A. system and see if you sing the same tune at the end of it.

A very thought-provoking post, PL, even to my incredibly hung-over ass.

DanielHaszard said...

My issue is Zyprexa which is only FDA approved for schizophrenia (.5-1% of pop) and some bipolar (2% pop) and then an even smaller percentage of theses two groups.
So how does Zyprexa get to be the 7th largest drug sale in the world?

Eli Lilly is in deep trouble for using their drug reps to 'encourage' doctors to write zyprexa for non-FDA approved 'off label' uses.

The drug causes increased diabetes risk,and medicare picks up all the expensive fallout.There are now 7 states (and counting) going after Lilly for fraud and restitution.

--
Daniel Haszard

Jordan said...

Just a thought:

"Pretty Lady suspects that one very large reason that the "Healthcare System" is so stingy on Prevention is that it is so heavily interested in selling cures. That, and in covering its own butt; there is a reason that doctors these days compulsively order masses of expensive and, in most cases, useless diagnostic tests. They are not nearly so concerned about your financial well-being as their own, and medical malpractice lawsuits cost them money."

My opinion as a physician is this....doctors order many tests for myriad reasons. Often we feel that if we miss one case in 1000 or 1 in 100,000 we are held liable and often blamed for it. To have such a good outcome, diagnose 99.999% accurately you have to order a lot of tests. Even more so since the human body is complex and people can present 1000 different ways with the same ilness.

Also malpractice scares the shit out of us. We all know people who have been sued for such large sums of money that the malpractice insurance doesn't cover it and they have been personally bankrupted for what alot of us would call good care.

As for doctor's financial well being?
I spent 4 years in college
4 years in medical school attending classes and studying around 80 hours per week
3 years in residency (working 100 hours a week)
I now work 60 hours a week scheuled but get countless phone calls around the clock (i get awkoken 2 nights a week between 1-3am).
I have about 2500 (small practice) lives that I feel utterly responsible for.
I often don't sleep at night.
I watch people who I have cared for for years die and mourn for them on a regular basis.
The other day I had to watch a man who I cared for deeply and took care of for a bunch of years die. He had no family and i had to be the one to decide that care was now futile and it was time to stop his treatment.

I do this becasue in my soul this is what I was born to do. I couldn't do anything else.

Most physicians feel this way.

Average salary for an internal medicine physician 120-150 k a year

If physicians are in it for the money then we're dumbasses. Why not be a lawyer or get an MBA. You can make much more money and the stress levels are much less.

Healthcare is making a lot iof money for people...those people tend to be administrators, pharma companies, and insurers

Granny J said...

Up above, I noticed that Big Pharma and "cure" were mentioned in the same sentence. If only it were so! The impression I get these days is that to make it big in the pharma biz, you want to find a condition to be "managed" for the rest of a persons lifetime. Every time I hear the word "managing" a disease, I cringe. There's no bucks in cures -- look at how investments in antibiotics have dropped vs. discovery of "pre- diabetes" or the need for what -- 20% -- of Americans to be prescribed medications for chloresterol.

Nice post, Pretty Lady!