From the E-Mailbag…
A correspondent who asked to be anonymous here writes…
I'm enjoying your memories of your mom. And I share your concerns abut the rising costs of health care. You said this AM: "…admit that Obamacare is a decent starting point and build from there." One of my many worries about Obamacare is that the non-elected rule-making body (the Palin "death panel") would decide that folks like your mom were going to the hospital too often, not getting better, draining the system, and therefore would no longer be eligible for treatment…perhaps urged to "just get it over with…and we have a doctor who'll do that for her." I wouldn't want that to happen to your mom…or you…or me.
And that's just one reason why I think Obamacare is NOT a decent staring point. I think we need to start over on the conversation. I wonder if Roger agrees.
I'm sorry but I think the idea that a government panel would start recommending suicide is ridiculous. Hey, we have a lot of men and women who come back from military service depressed and emotionally-confused. Many are outright suicidal. Has it ever been a problem that a non-elected rule-making body (the Veterans Administration) started suggesting these people put a gun in their mouth and "just get it over with?"
We do in this country have non-elected rule-making bodies that decide who's going to the hospital too often. They're called insurance companies. As far as I know, Anthem and Cigna have never told patients to just get it over with…and unlike a government entity, they would have a profit motive for doing that.
What they do do is cut people off. As I mentioned, my mother had a great health insurance plan. If you were on the same kind of fixed income she had — my father's government pension — you could not buy a plan anywhere near as good today, even with no pre-existing conditions, of which she had many. When she had her cataract surgery a few years back, I literally paid more to park when I went to take her home than she did for the surgery. (Parking was seven bucks. The surgery was a $5.00 co-pay. Afterwards, I took her to an outside specialist — a highly-recommended Beverly Hills Opthamologist — for a second opinion, just to make sure the Kaiser doctors were doing all that could be done for her failing vision. He told me they were…and that if he'd done that cataract surgery, it would have run her $5,000 and he wouldn't have done any better a job.)
But even her insurance was going to run out. The last year of her life, I twice had her in a very good nursing home way down in Torrance. The first time was so she could recuperate from one of her many illnesses after the hospital said, "We can't keep her here any longer" and politely turned her out. The second time was…well, I don't like saying she went there to die but that's not wholly inaccurate. I was pretty sure she didn't have long to live and pretty sure that letting her return to her home — the only alternative she'd accept — would worsen her condition and pretty much ensure that she didn't survive the next attack and that she suffered greatly when it came. So I talked her doctors at Kaiser into putting her into this place in Torrance.
I couldn't get her in there but they could. Also, if she went into any Kaiser-affiliated nursing home on a Kaiser referral, Kaiser would pay the cost of her being there and send around a Kaiser doctor every day to check on her. My plan was that if she got better there, great. Maybe she could at some point go home. Maybe I could talk her into accepting an Assisted Living facility, a notion she'd been resisting with all her might. (I write more about that problem in the next installment of Tales of My Mother, coming soon to a blog near you.)
Kaiser, however, would only pay for X more days. She was allowed a certain number per year and had used up a lot during the earlier stay. So my idea was to keep her there as long as necessary, even though that might well mean me having to pay out-of-pocket once the Kaiser days ran out. I'm not sure how much that would have cost. The least it would have been was $1500 per week but that's without the Kaiser doctor coming around every day. I could add on the doctor for an additional fee but I never found out how much that was.
I wasn't sure how many more Kaiser-paid days she had but I lied and told her there were plenty. I didn't want her worrying about what it would cost me to keep her there. As it turned out, a few days after she died, I received a notice from Kaiser that her days had run out. So help me, she died on the last day Kaiser was paying for.
I've assumed that was a coincidence. As readers of this blog know, I have a lot of those in my life. But I have to wonder if anyone at the nursing home told her that as of the next day, I was going to start paying for her to be there.
As I wrote here on the day she died, I suspected she may well have just decided it was time to go. She was suffering greatly with no hope of getting much better. She was also feeling terribly, terribly guilty about how much of my time and attention she required. It would not have been at all out of character for her to decide enough was enough; time to do us both a favor and check out. She would have had an added incentive if someone told her that she was going to start costing me that kind of money per week for an indeterminate time. I wouldn't have minded it a lot but she sure would have.
Her situation with Kaiser was the kind of thing Sarah Palin was trying to characterize as a "death panel" — but only if done by a government agency. When a private health insurer does it…well, we all understand that businesses have to make a profit.
The folks who want to chuck Obamacare and start over all seem to believe we should get rid of it, then start looking around to see if anyone can come up with something better. Since the Affordable Care Act has been an issue for a few years and its opponents haven't proposed even a starting point for that "something better," I'm inclined to think there isn't one. In any case, nothing is stopping them from finding it now and offering it up as a preferable alternative.
But they don't want that. They want to kill it now, yanking it out from tens of millions of Americans who cannot otherwise obtain health insurance, while we see if anyone can come up with something better, something that can get through a still-gridlocked Congress. If you have a disease and no insurance, you just might not be able to wait until that happens.