I just got over a health
scare. I don’t mean a big splinter under my fingernail or a stuffed nose. To me
a health scare means believing that some serious bodily problem might ruin or
end your life.
The “might” is important. It’s
scary to be unsure if this bad health moment might have disastrous
consequences. So much of health care recommended by doctors and practiced for
ourselves by all of us is about probability.
Some things are certain. The
doctor was certain I had ruptured my spleen playing football when I was 17 and
certain that the internal bleeding had to be stopped right away. That was a
health scare I didn’t know about until afterwards, when the surgeon told me, “You
could have died.” He was just trying to cheer me up.
Lots of medical issues are
more speculative. Doctors consider the probabilities that particular symptoms
mean this specific disorder and that certain medical and pharmaceutical steps
will help this patient. We the patients weigh our options, based on what we
know and don’t know, using our own set of intuitive needs, beliefs, and
probabilities.
My doctor helped me recover
from this current scare by telling me, “Something else will probably kill you.”
He and I both understood the value of frank talk about the future.
My scare was not at all about
money. I knew I’d have to pay something for the visits and tests and more
visits and tests. But I knew it would be affordable, because I have good health
insurance. Like nearly everyone my age, Medicare is my primary insurer, the biggest
health insurance organization in the US. Medicare is bureaucratic, but
reliable. They will not go bankrupt, like my parents’ long-term care insurance
provider did.
Medicare is incredibly cheap.
In fact, coverage for hospital visits, so-called Part A, is free, with a
deductible of about $1300 for each hospital stay. Not bad when the average
hospital stay costs about $10,000.
You only have to pay something per day if your hospital stay is longer than 60
days, meaning the total cost has probably gone well above $100,000. Medicare
coverage for doctor visits, tests, and other services, so-called Part B, is not
free – that costs about $1600 per year for anyone with an income under $85,000,
that is, for most people. That’s cheap, too.
All my probabilities would
change if I didn’t have good health insurance that I could count on until
something else kills me. That puts me in the minority of Americans. Health
problems become health crises for most Americans when they worry, “How are we
going to pay for this?”
My doctors’ recommendations
were based on careful scientific studies of tens of thousands of cases over
many years. My political representatives’ recommendations about health care are
based on self-interest and dogmatic political ideology, designed to misinform
me and everyone else. The discussion of health care and health insurance in
this country is worse than useless, it is often deliberately misleading. How can
average Americans judge health probabilities when our politicians constantly
threaten to upend our health insurance system?
Democratic politicians
created an imperfect system which drastically reduced the probability that an
American family would be uninsured. I think that’s great. Democratic
politicians have been arguing for a long time over whether some version of “Medicare
for all” would be even better for most Americans. We need that debate.
The Republican contribution
to our national health discussion has been, “We will destroy that system and
tell you about a much better system later.” If they really had developed
another system, we would know about it by now.
Conservatives
hated Medicare when Democrats created it in 1965. They have never stopped
complaining about it and have never done anything to make it better. House
Speaker Paul Ryan announced in December that Republicans wanted to cut
spending on Medicare. A few months ago, the White House budget proposed cutting
$554 billion from Medicare over the next 10 years. In June, the trustees of
Medicare, who are mostly Republicans, like Treasury Secretary Steven Mnuchin,
reported that Republican
policies have hurt Medicare’s financial prospects.
Nobody knows what our
President, Cabinet, or Republican majority in Congress will do about American
health care tomorrow, next year, or any time in the future. That makes all of
our health care probabilities worse by increasing the financial uncertainties
of all Americans. Nothing they have done so far has made anyone’s health
better. That is a national health scare.
I hope that something else
kills me before any Republican health care plan goes into effect.
Steve Hochstadt
Jacksonville IL
Published in the Jacksonville
Journal-Courier, July 24, 2018
No comments:
Post a Comment