How US Healthcare Humiliates the Best of Us

Today I feature a guest blog from my friend Donna Smith. Like myself, Donna grew up in the Chicago area and is a former newspaperperson.

Several years ago both her and her husband got seriously ill (cancer and heart disease) and were driven to bankruptcy by medical bills. And they HAD health insurance! Like millions, they were hounded by insurers and providers until they lost their house. Their story was featured in Michael Moore's film "Sicko."

Today Donna lives in Washington and is fighting with every breath to usher in health care reform as an organizer for the California Nurses Association. I had dinner with her a few weeks ago when we were in Washington, when she was working with other like-minded folks to push for a single-payer plan.

Before you start getting worked up about "socialism," "the government telling me who my doctor should be," or "waiting in line for care," keep in mind that a single-payer plan means personal choice. YOU choose your providers. The government only pays the bills to privately employed doctors, nurses, hospitals, etc.

One of the current proposals is to allow Americans to choose which plan they would like: private insurance or a public plan, perhaps offered through the federal employees program or Medicare. Both would compete side by side. Since private insurers spend heavily on marketing and administration -- costs they pass along to their customers in the form of higher premiums -- it's doubtful if they would be able to compete effectively without reining in their expenses. In either case, there would be true national competition for the best insurance at the lowest cost. If I was to choose a name (actually my wife came up with this) for the best kind of plan I would call it "iChoice."

Congress is vetting many proposals right now, will have a template for discussion soon and may even vote on a plan before the end of summer. Let your congressional representatives know how you feel. Do you have an insurance nightmare you want to tell them? Now's the time. Whatever emerges, it will need to end the widespread discrimination and humiliation of anyone who has the misfortune to get really sick.

Here's Donna's recent piece.

My Harry Winston Diamond and My Healthcare

by Donna Smith

Maybe I am getting old as I look to the past for some better times, but maybe I have grown a bit wiser about recognizing what quality is and what it is not. When it comes to my health, I pay much more than I ever did for care and I get far less -- and what I am able to afford is often of far worse quality than it used to be. I do think about how healthcare has changed in my lifetime and all that my children will never know is possible. And I remember one little engagement ring and how its story foretold my healthcare journey as a once middle class, American wife and mother.

It's not that I long for the good old days - but I do think many Americans still just want simple quality and value in healthcare, and in our current system we certainly have complicated and convoluted many issues at the expense of not only our human compassion but also our American common sense.

When I was a young bride, my husband and I walked by the jewelry counter at our favorite JC Penney store and saw a small but elegant engagement ring. At $199, it seemed expensive to us, but the salesperson told us it was a ring with a tiny Harry Winston diamond - with beautiful facets - and it sparkled on my finger like nothing I had ever worn before. And we stood at the beginnings of our now-33 year marriage with great hope and all the deep passion and love that our young relationship could hold.

Soon, I would give birth to our first child. In the months leading up to our baby's birth, even as my little Harry Winston ring grew a bit more snug on my finger, I saw my doctor for regular pre-natal care and routinely spent 15 or 20 minutes with him as we discussed my pregnancy and my health. His charges for the full seven months of care and the delivery of my child were set in advance, along with the routine lab work. And, because my labor was so fast and my good doctor did not make it to the hospital in time to actually attend the delivery, a nurse delivered my beautiful son and my doctor adjusted his set fee to reflect missing the delivery. Hmm...

When I left the hospital after three days of terrific nursing care for me and for my baby, including lots of wonderful advice from maternity ward nurses, my husband checked me out through the hospital administrative office, but I never worried once about being slammed with financial issues either while in the hospital or upon discharge. As a patient, I was able to focus on my care and my baby's start in life. What a marvelous time for me as a wife and mom. I recall small bills but nothing onerous or crushing - and certainly nothing that robbed me of my own well-being or threatened my child's health in any way.

Fast forward 33 years. I avoid the doctor whenever possible. I hate going to the doctor as it is unpleasant and humiliating to be checked out financially and made to pay my portion of the bill before anyone even provides one moment of service or any healthcare at all. My healthcare insurance costs - for myself and my husband - have escalated far faster than my income. And I never plan to seek care before I gauge if I feel sick enough to warrant the expenditure from the family budget. As my story was already told in SiCKO, everyone knows I lost my house, went bankrupt and gave up nearly everything I owned even though I had insurance - and lots of insurance.

I have a lot of skin in the game, as the popular saying goes. And I never see a doctor for more than a few moments at a time any more. Cancer check-ups be damned, it's a whole day off to get one test done.

I let chronic pain linger. I let symptoms wait. I take huge amounts of over-the-counter medications in the attempt to avoid any interaction with the healthcare system. I don't want to ever take time off work for being sick or worse yet for a family member's illness, and I cannot remember the last time a doctor called me in response to a simple question or test result - I always have to be assertive to even get a response. And many times, healthcare providers seem truly annoyed when having to deal with any patient follow-up at all.

Let it not be said that Americans don't wait for care. We wait for weeks before we go to seek care. We wait in waiting rooms and business offices for forms and insurance benefits to be scrutinized and co-pays and deductibles to be collected brashly and crudely as our financial transactions are open for everyone in the waiting room to hear. We wait inside the doctor's office or exam room - often in some state of undress with no word on approximate time for a doctor to come in. And then we wait for scripts and follow-up appointments. Question any of those waits, and we are often subject to verbal scolding or fear that our daring to speak up might slow the process even more. Healthcare in America? For an average, insured woman like me in 2009? It is to be survived when absolutely necessary only.

If I could avoid being in this mess of a system until I just die in my sleep some day, I'd be happy.

But that's not likely. The healthcare system is a monster of profit-making potential and force now - for not only our healthcare providers but also many of our political leaders. I am incidental to their feeding frenzy. I am only needed as a payer of premiums, co-pays, deductibles, prescriptions and all the other high costs for my husband and myself. I get expensive tests and procedures not always because I need them (though I may not know that) - I get the tests that my insurance says I am allowed to have and that have been deemed profitable by some business folks wheeling and dealing behind the scenes. If I am deemed worthy financially, I get care.

Listen to those who testified yesterday for the Senate Finance Committee as they talk about us as metrics and how to mold and shape our healthcare system - listen for any hint of humanity in these talks.

Don't be fooled by the double-speak you hear. Having a national health care system is not the same as allowing the government to control your healthcare. In fact, giving over your power as a patient to an insurance company because the insurance industry bought and paid for health reform that forces us all to buy their for-profit, financial product is not healthcare but is the highest form of control you can give away - control over your own body.

It doesn't have to be this way. It could be a just and responsible system. It could be a sound, caring and competitive system in which we all pay fairly into one public pool, we all get care when we need it and we all are allowed to choose those private or public doctors, hospitals, clinics and other providers that deliver the kind of care we want to receive.

I want a publicly funded, privately delivered system in which I choose my care and my provider. And so do more than 60 percent of my fellow Americans. My choice. My care. My life. My nation's system.

So, what happened to my little Harry Winston diamond? It went the way of our healthcare system. One cloudy afternoon about 15 years ago when my husband was in the hospital and needing more medication, I sat in a pawn shop office and bargained for $120 in cash for my engagement ring. I left the pawn shop shaking and beaten-down but drove to the pharmacy where I picked up my man's meds.

Donna Smith is a community organizer for the California Nurses Association and National Co-Chair for the Progressive Democrats of America Healthcare Not Warfare campaign.