Monday, August 24, 2009

Health Care: One sick bed at a time

Update: Since originally posting this, I've come across additional sickbed posts in The Daily Dish. Here are those links first (the titles are my own inventions):
Asthma: The High Cost of Breathing
The High Cost of Breathing: Sophie's Choice

It's been awhile since I blogged about anything having to do with the world outside my own family but at a recent family get together I learned that my dad is in the process of reading the entire health care bill (he was only on page 83 last time I checked.... good luck Pop!). Then recently the topic came up at the dinner table at my in-laws. One impression that stays with me from both of those events is how concerned these people are and how familiar they are with the workings of the current system, a system which works extremely well for them and which affords them better care than they could get perhaps anywhere else in the world. For them the changes under consideration are fraught with unkown costs and ramifications. They are deeply skeptical that costs will indeed be contained, and they fear that their treatment options will be restricted.

Listening to them I have begun to wonder whether there exists any set of "facts" that could reasonably be taken as a common starting point for weighing the need for change, the objectives of reform and the values which ought to animate a reform effort. I've begun to despair that such common ground will be found by appeals to studies, projections of economic and budgetary impacts, analyses of other systems, polls of stakeholders...in short by data-driven mechanisms. The public discourse on health care seems overrun with claims of these sorts and for the layman like myself the effect is either numbing or suspiciously partisan. Don't misunderstand me here. At some point, data needs to be given a central role in any meaningful reform process, but for the general public there needs to be a way to crystallize the issues in a way that makes it clear whether or not the status quo is an acceptable option.

All of which has made me wonder if perhaps a non-scientific though rigorously factual approach in the form of personal anecdotes might not give us the kind of information we need to perceive the outlines of the real problem and thus suggest what the targets of reform ought to be.

To that end, I am posting links to a series of blog posts on Andrew Sullivan's blog The Daily Dish. The series is entitled "The View from Your Sickbeds: A Round Up". Each post is a first person account of someone's personal experience with health care in America. These stories are both interesting and informative. I'm curious to know what conclusions readers will draw from them. My sense is that they argue collectively and singly for the position that the status quo is no longer an option. But perhaps other readers will arrive at a different view. Here are the individual titles with links:

Can You Give Me A Ride?: I Can't Afford The Ambulance
The Baby Isn't Insured
Watching My Costs Skyrocket
Seizures In Public Places: Avoiding The Ambulance
Your Newborn Son Has A Preexisting Condition
My Insurance Company Got A 96% Discount!
Working For A National Insurance Company: The Payment Process
The $10,000 Cyst
Gold-Plated Insurance: Denying Vaccination To Premature Babies

On the same site you'll find links to other posts, essays and reporting exploring a range of issues connected to health reform. Some of the essays argue opposite sides of an issue. Here again are the titles:

A Bankruptcy Lawyer: Opaque Costs Are The Worst Part Of Our Health Care System
Planning A Pregnancy: Trying To Get The Bill Up Front
Electronic Medical Billing Company: Mark Ups For The Uninsured
Authorizing Treatments: The Whole Gory Process
A $15,000 Needle
The $15,000 Needle II: No Incentive For A Surgeon To Save Money
No Incentive For An Emergency Room Physician To Save Money Either
A Small Practice: The Costs Of Getting Approval
Plumbing The Depths of Ignorance: Negotiating Health Care Fees And Health Savings Accounts (HSAs)
HSAs: The Case Against
I Loved My HSA
A HSA Salesman: Separating The Healthy From The Sick
Flexible Spending Accounts (FSAs): Whose Bottom Line?
HSAs: Group vs. Individual Plans
Advance Health Care Directives: I Want To Go Like Mimi Did
At The VA Hospital: In And Out In 45 Minutes
The Underinsured: Between Full Employment And Medicare
Narcolepsy, Drug Costs, And Work: A Catch 22
Approving, Then Rejecting Coverage
Gastric Bypass: Waiting Ten Years
Gastric Bypass II: Don't Blame Insurance?
Bipolar Disorder And Mental Health: Section 14
Tort Reform Won't Fix Health Care: Cont...

Big issue. Lots of reading. It would be nice if we could at least agree on some factual claims. K

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