Sunday, August 9, 2009

Not An Option? -OR- People Say I'm a Dreamer

Start with a cage containing five apes...
(preferably not this one.)

In the cage, hang a banana on a string and put stairs under it. Before long, an ape will go to the stairs and start to climb towards the banana. As soon as he touches the stairs, spray all of the apes with ice cold water.

After a while, another ape makes an attempt with the same result - all the
apes are sprayed with cold water. This continues through several more
attempts. Pretty soon, when any ape tries to climb the stairs, the
other apes all try to prevent it.

Now, turn off the cold water. Remove one ape from the cage and replace it with a new one. The new ape sees the banana and wants to climb the stairs. To his horror, all of the other apes attack him. After another attempt and attack, he knows that if he tries to climb the stairs, he will be assaulted.

Next, remove another of the original five apes and replace it with a new
one. The newcomer goes to the stairs and is attacked. The previous
newcomer takes part in the punishment with enthusiasm.

Again, replace a third original ape with a new one. The new one makes it to the stairs and is attacked as well. Two of the four apes that beat him have no idea why they were not permitted to climb the stairs, or why they are participating
in the beating of the newest ape.

After replacing the fourth and fifth original apes, all the apes, which have been sprayed with cold water, have been replaced. Nevertheless, no ape ever again approaches the stairs. Why not? Because that's the way they've always done it and that's the way it's always been done around here."

It is commonly held belief that the government cannot run a lemonade stand. That free markets are good for everyone. That America is a xtian nation. That greed is still good.

To be sure, there are worries that revamping the health care delivery system in this country COULD leave us, once again, holding the shitty end of the stick. That is NOT inevitable though. What is inevitable is that leaving health care in the hands of FOR-profit corporations will result in millions more uninsured or with coverage so limited by pre-existing conditions that they too will fall off the ledger and onto the dole.

Commonly held myths exist that say that socialism is evil. Yet it's easy to argue that what is best about America is exactly those things that have been socialized.
Sharing the load, forgetting about the scoreboard and just living one's own life.

Lastly, and not to put too fine a point on it, it's the current structure that is the scam.
Our FOR-profit system of insurance and treatment is built to exclude anything or anyone who negatively impacts the bottom line. I've read bulk of two of the bills currently under consideration and find that the pull-outs being used to derail this best and perhaps LAST shot at real universal care for everyone are empty threats.

The fact that "age counseling" is part of the plan speaks to the reality that the largest affected segments of the population do NOT currently see a doctor regularly. Most people don't have a family doctor, they have a "practice" they list on their HMO paperwork, but use only in cases of serious illness or accidents.

As written, the required counseling provides the patient and their family with the spectrum of potentials instead of the currently advertised specials and/or doctor/insurance determined preference. Having MORE information about one's options is, IMO, the proper course of diagnosis, treatment and prognosis.
Having that information before an acute need arises would benefit the individual and his/her family. Too many life/death decisions are currently being made on the fly.
Before other options can be discussed and explored.

It's pretty well established that many uninsured, under-insured and otherwise treatable patients delay treatment and all but avoid regular doctor visits because they fear contracting the dread and deadly "pre-existing" condition which will haunt them at a later date when their health might depend on their insurance coverage. The segment of the population who currently land outside of "allowable" coverages
is the fastest growing segment of the "risk pool",

Employer provided health care is a nightmare for the employers and the employees. The churning job market all but assures that people with current health related
issues will find themselves with another insurer sooner rather than later, arriving at the new job/new insurance with the incurable pre-existing condition. Pretty convenient technicality for the insurers.

Delaying treatment, surgeries and other medical needs until one reaches Medicare age has been a boon to providers who set up assembly line centers to process the steady stream of patients entering their "golden years". This is neither best practice nor in the patients best interests.

Population screenings and counseling are considered by MOST doctors as the best practice approach to preventive medicine. Postponing because of insurance worries can be deadly. I could easily argue that my friend Diana might still be here beebling with us if she believed she could see a doctor without choosing between that and eating. She delayed seeking treatment because she could not afford it and was convinced that it would limit her coverage down the road. This is what MOST people face regarding their health care needs because they've heard the horror stories and believe them. She fretted her co-pays, her prescriptions, her transportation and her "quality of life" instead of concentrating on getting the help she needed; WHEN SHE NEEDED IT. She didn't. She's dead.

Single payer universal coverage for ALL is the only sane, fair approach now and into the future. The private insurers will adapt and adjust providing boutique and Rolls Royce illusionary policies to the people too good or too important to mix with the rabble. Everyone else will be better served in a much more timely fashion, resulting in a healthier general public. And the world, contrary to the astroturf claims, will keep turning. We're not being blasted with ice cold water anymore, there's no need. We're all conditioned to prevent messing with POLICY.

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