Tuesday, July 28, 2009

A Case for Universal Health Care

Back when Bill was in office, and Hillary was trying to bulldog through universal health coverage, I was agin it. Mainly because Hillary was associated with it, but partly because it seemed a little socialist to me, and therefore suspect. That has all changed.

As the more learned among you know, Karen and I moved to Italy in 2008, and since that time Karen has become a citizen. As a citizen, she has a God-given right to be in the health care system here. As a hanger-on, I have the same right. We jumped through the necessary hoops and got ourselves hooked up.

A while back I developed some symptoms that I diagnosed as a hernia. I went to our doctor here, and he confirmed it. Although at first he didn't want to do anything, as it was a small hernia (“there is nothing to do now – it will get worse and worse, and then we will operate.”) he kindly allowed me to go see a surgeon. The surgeon confirmed that there was a hernia, and told me that someone would call me withing about 90 days to set up an appointment for the surgery.

After a while I got the call and a date was set. A short time later they called to change it. They actually would have rescheduled it earlier, but I was busy that day, so it was set about two weeks later. They told me to bring some PJ's, some slippers, and someone to take me home at the end of the day. Karen and I posted at the appointed hour (7:30 a.m.), and after a short wait we were taken to a hospital room with three beds in it. They said I would be first.

There was then some prep work to be done, which the nurse accomplished with a dry safety razor. It actually worked painlessly, but the final result was the ugliest thing I have ever seen. I returned to the room and was instructed to take off all my clothes and to wrap myself in the sheet that was on a gurney they had wheeled in. I did this, and within a few minutes was wheeled off to the operating room.

Everyone there was very nice, and they knew what they were doing. They put an I.V. in my arm with no trouble; I didn't even bruise. (When I had had a colonoscopy in the U.S., the woman putting in the I.V. brutalized me with a needle for half an hour before finally giving up and sticking it into my hand - I ended up a sickening bruised mess). Here, however, they talked to me nice, and made me feel better about whole thing.

Now you must realize that what they were about to do was to cut into my lower abdomen, put my guts back where they belonged, and stitch me up. Not exactly open heart surgery, but it was gonna leave a goddam mark. So my first real moment of horror was when they told me they were going to use local anesthetic. I was looking forward to getting some real nice drugs, and waking up to Karen's smiling face when it was all done. I did not want to be awake. I did not want to feel them pushing my innards around, or hear the clanking of surgical instruments. I wasn't worried about hearing what they said, because they were all Italian, and my Italian at the moment could best be described as rudimentary. I also had a concern that the anesthetic would not be as effective as your humble and pain averse narrator would like, or that I would actually be able to see the butchery. Nevertheless, instead of the horrified NOOOO that I wanted to scream, I squeaked out an “ok.” But now I was scared.

They then used an ingenious contraption to slide me from the gurney I was on to another gurney in the actual operating room. When I got to the operating room there was a big giant lamp over me, a couple of doctors and a few nurses. They hooked me up to the usual vital signs gizmo, and rigged up a blind so I could not see what the doctor was doing, thank God. They gave me a big shot of what I presume to be novocaine with a needle I could not see, but which I envisioned was as big as a clown might have in the circus – one he could shoot other clowns out of.

After a few minutes they went to work. After cutting into me the doctor kindly asked if I had any pain. So far, so good. Then a little while into it I felt a pinch and jumped a bit. Then again. One of the nurses looked around the blind and told me that the doctor says I should hold my body still. I did, of course, realize that the good doctor had sharp cutting tool of some kind in the immediate vicinity of my guts and other parts, and that laying still was not a bad idea. But I informed her that he was now cutting into a place that was not so numb. Within a few seconds a nurse produced a lovely syringe and put something into my I.V. Then another. After a few minutes I remember seeing the room upside down. It looked like they had the operating table standing upright. And I could not see anyone in the room. I asked “where is the doctor, and why was the room upside down?” (I don't recall any reply). Now this is what I'm talkin' 'bout - this is all I wanted all along. Was that so hard?

The next thing I remember is waking up in the room near the contraption they used to move me from one gurney to the other. I heard them bring some old man in with the contraption, screaming his fool head off. Then I heard him again howling when they put him on the operating table. “Wussy,” I thought.

They wheeled me out where I was met by Karen, who was happy to see that I survived. I recovered for several hours in my hospital bed, they made sure I could walk, and they sent me home.

Now here's the punch line: It cost me a total of about $75 in co-pays. From seeing the doctor in the first place (free) to seeing the specialist (18.95 euros) to the operation itself (36.15 euros). It went smoothly, was timely, they treated me nice, and it was a pleasant experience (considering that it was an operation).

There is no reason that a system like this cannot be implemented in the U.S. Who is gaining from the present system? The patients? No, they are paying through the nose for insurance, if they can afford it at all, and are at the mercy of the insurance companies. The doctors? No, doctors will tell you it's harder than ever to earn a decent wage. The insurance companies? Ding Ding, Ding Ding. All of the reasons I have heard put forth against universal health care, such as it takes too long to get treatment, that you'll lose several “freedoms,” such as the freedom to choose a high deductible (which nonsensical argument I read in a Fortune Magazine*, or that it's socialist, are all clearly propaganda by the insurance companies. It increases taxes? Well, you need to pay for it somehow, but what are you paying now? What is your premium? What is your deductible? What are your co-pays? Do you even have insurance? And that is really the point – how can we run a country where only the richest can afford even basic health care. Those of you who do not have insurance should rally in your millions and make sure this gets done.


*This article so parroted the insurance companies that its author and the magazine should be embarrassed.

6 comments:

Unknown said...

Michael,
I am glad that you have seen the light about the need for a more equitable health care plan in the US and I hope you have fully recovered from your surgery. I too am going to need that surgery but it is going to cost a lot more than you had to pay.

Michelle said...

Hi Mike-
Glad your surgery went well. And glad you have seen the light, so to speak...and glad it wasn't the "other" one.
I too recently had surgery (hysterectomy) here in the US. I'm one of the lucky ones with insurance...my copay for the hospital and surgery was $580USD but that is not including the copay for each visit leading up to the surgery or the copays for the follow ups or the cost of parking at the doctor's office and hospital. And yes, I pay a monthly premium.
I would gladly pay that premium in taxes if it meant more people were covered and I didn't have to pay anything for care.
I'll be back in Venice in March 2010. My friends still drool over the pictures I took on my tour with you.
Michelle
Seattle, WA

Unknown said...

Hi Michelle - glad to hear you are returning to Venice. Let me know when so we can say hello.

Michelle said...

Hi Mike-
I'll be in Venice from the afternoon of March 23 to the morning of March 28. Email me and I'll give you the address and my Italian phone number. Hopefully the phone will really work as I have been promised.
This is a quick trip to meet up with some friends before meeting up with other friends in Rome.
Michelle
Wow, not sure this gives you my actual e-mail. If not I'll go through the Venice Experience website enquiry.

Unknown said...

Michelle: I don't get your email address with these comments. Please go through the website.

Ciao

Dianne said...

And in this whole healthcare debate, no one talks about tort reform. I was listening to a debate on NPR the other day and someone said that the "greedy doctors" should charge less. Well if it wasn't for our propensity to sue at the drop of a hat, perhaps they wouldn't be paying outrageous malpractice insurance premiums. I know that some people are really injured by bad medical practices but I also know that a lot of people try to game the system. I once temped for a law firm who defended suits for one of our major auto insurance companies. I remember a suit where a couple on a motorcycle had been hit by one of the policyholders. This couple was not really hurt but the guy's "designer sunglasses" were ruined and his girlfriend, a fitness instructor, had a scar the size of a quarter on her thigh which "impeded her ability to earn a living." These kinds of nuisance suits are usually settled without a fight by the insurance comapnies because it costs more to litigate than to settle and you and I end up paying for it. I think the same thing is happening with healthcare.
Anyway, glad that you are feeling better. I enjoyed meeting Karen when I was studying Italian in Venice during May and love reading your blogs -- reminds me of that beautiful city.