The Winds of Stagnation

I know it’s getting old to keep arguing the health care debate.  But what’s even older is having to rehash the same old issues repeatedly.  Since Medicare was enacted in 1965, the only major advances in health care coverage in our entire country’s history has been the Affordable Care Act.  Perfect?  Not by a long shot.  Better than before?  Absolutely.  So of course, like with most programs that have improved the status of our country in the world at large, the current administration is determined to destroy it.

Replace it with something better?  The only thing that would be better would be, obviously, universal coverage for everyone all the time.  It’s common sense; the rest of world already knows that.  More expensive?  In the short run, probably.  In the long run, doubtful.  What we have now is a crippled, patched up mess of a system.  No one person can ever expect to comprehend the ins and outs, ups and downs of a myriad of commercial insurance plans, further complicated by several Medicare plans and innumerable Medicaid plans.  Then throw Medicare Part D prescription drug coverage into the mix, and you can spend days on end trying to get answers to questions.

There are many many health care issues that most people are never aware of until it hits them personally.  I work with patients with End Stage Renal Disease; this means they require either some form of dialysis or a transplant.  Even though having a chronic and potentially terminal disease sounds like a huge burden to bear, it pales compared to the burden of paying for this treatment.  Most people are eligible for Medicare, some for Medicaid and a smaller amount are able to keep commercial insurance coverage.  We have an army of people whose primary job it is to figure out how the bills get paid.  Since I am enlisted in that army, I know whereof I speak.

Kidney disease, cancer, liver disease, bowel disease, fibromyalgia, multiple sclerosis, ALS, Alzheimer’s, pulmonary hypertension, lupus et al.  All require specialized medical care and multiple medications.  Every disease doesn’t get its own army—sometimes it’s just the patients and families that must muddle through.  Sick people can’t work; if you can’t work you can’t get an employee health insurance plan.  Do you know even if you qualify for Social Security disability, you have to wait two years to qualify for Medicare?  If there’s another income in your family, you won’t qualify for Medicaid.  And so it goes, all the cracks we can fall through and end up with indigent patient care—if you’re lucky.

Back to kidney disease—the biggest single issue preventing people from getting organ transplants is money.  I have a spreadsheet from a transplant center that shows how much cash—CASH—a patient needs to have before they can actually receive the organ they need.  That’s even if they have insurance coverage.  Because insurance doesn’t cover all the costs, especially for anti-rejection medications.  A lot of people are told they have to raise as much as $10,000 before they can be considered “on-call” or “Status 1” for a kidney transplant.  Therefore, even if you go through all the exhaustive testing and are deemed surgically suitable, the odds are that by the time you actually have that much money in hand, your health may decline.

I know, I know…. I can preach and educate and elucidate until I’m a lovely shade of ocean blue and not one mind will change.  Sometimes I just need to vent.  So if you feel a sudden draft blowing your way, you’ll know where it’s coming from.