To the Editor:
In the last week or so I have come across a true life incident right here in Lincoln County that illustrates the absurdity of our current health insurance system.
A friend who recently turned 50 was referred by his primary care physician to a surgeon for a colonoscopy. The referral was for a routine, age-related screening for pre-cancerous polyps and the like, and the screening would be covered 100 percent by the patient’s health insurance company.
But during the patient’s first appointment with the surgeon, the surgeon inexplicably changed the reason for the colonoscopy from a cancer screening to an examination of a supposed chronic condition. The change meant that the health insurance company would cover the colonoscopy only 90 percent. The colonoscopy would essentially be the same, but the patient would now have to pay several hundred dollars out of pocket.
Neither the patient nor the patient’s primary care physician think the change was justified on any grounds, but the surgeon will not even hear any appeals. There is some question now whether the patient in question can ever get a routine cancer-screening colonoscopy and have it fully covered.
Think about it: same patient, same procedure, same venue, same doctor, same appointment time–but different insurance coverage, arbitrarily in favor of the insurance company. The point here is not whether the surgeon is wrong or right. The point is that our current health insurance system is strange and exploitive in the extreme, and not geared towards maintaining the health of the populace.
Consider this local incident along with other situations here and in the rest of the U.S. Locally, our school boards spend an inordinate amount of time and energy monitoring and trying to cut the cost of teachers’ and staff members’ health insurance. They are caught in the bind of doing right by their employees while knowing that many townspeople pay dearly for health insurance or cannot afford it at all.
Regionally and throughout the country, large companies such as auto manufacturers are being crushed by “legacy costs,” especially retirees’ health care.
People with longstanding treatable “pre-existing” conditions lose their health insurance coverage when their employer changes health insurance carriers. Primary care physicians are often underpaid and overworked.
Nationally, conflicting rulings leave up in the air whether federal employees can have same-sex partners covered by their health insurance policies. Nearly 50 million Americans have no health insurance.
Through cost-shifting, the current system ultimately makes middle-class people alone carry the burden of supporting the treatment of the uninsured. Proposals to cover health care costs through medical savings accounts would just perpetuate the status quo.
All these problems–all the inequities, all the angst, all the unnecessary loss of time and energy, all the exploitation of the middle class–would disappear if the United States had universal health care. We would be paying far less collectively, and the experience of Western Europe, in particular, shows that we can have health care that is better.
Far from being a socialistic undertaking, it would be the most pro-business thing we could do, by removing the burdensome and frequently prohibitive administrative costs of employer-based health insurance. Let businesses do that which they do best, which is providing products and services to customers, not providing health insurance for their employees.
The best way right now to “promote the general Welfare” of the nation would be to provide high-quality health care that is free and accessible to all.
Eivind A. Boe, Nobleboro
