[Alumni-chat] Re: Alumni-chat Digest, Vol 7, Issue 1

[J. David Coldren]

Pam,

Before responding at greater length to the post below, I need to get some
information. 

You said: " Surgery is not the only health care issue.   And, of course,
even life-saving surgeries are denied if people can't pay for them.  It
blows my mind that people will get on TV and try and raise money for
life-saving treatments because they don't have insurance or insurance won't
cover a new "unproven" treatment.  We just let them die."

As you can imagine, I've heard that kind of statement before and when I've
tried to track down the facts of a specific case, I have never yet come
across a case where "we (society) just let them die" because they don't have
insurance or because an insurance company won't approve a medically (FDA)
approved treatment. 

My sample size over the years is probably about sixty cases that my staff
and I ran to ground because there was the possibility of criminal behavior
involved and certainly huge civil liabilities for the doctors, hospitals,
and insurance companies. So one of the questions we asked was: did the very
litigious Illinois personal injury bar get a referral of the case and did
any attorney actually pursue damages and get either a settlement or verdict?
If I recall, in two cases the insurance companies settled on behalf of the
doctors and hospitals almost immediately for reasons we think were based on
faulty diagnoses (the settlements, of course, were sealed) so that wasn't a
case of the proximate cause of death being denial of appropriate medical
care. A third case that comes to mind but I don't think we actually got
enough hard data to make a conclusion one way or another had to do with a
patient who died while being transported from a hospital not on the
insurance company "network" to one that was because, ostensibly, the patient
could not afford the co-pay or whatever at the out-of-network provider. The
patient signed a consent for the transfer, but we didn't get any further
than that. I don't think "we just let them die" applies there either.

So, since I don't have any interns or researchers hanging around the Farm
these days, here's what I'd like: do you have any personal experience where
a hospital or doctor just let a patient die because they didn't have
insurance or because an insurance company (NOT Medicare or Medicaid - I
concede the point here) disallowed coverage? I know you're covered by
personal privacy issues and I'm no longer able to tip-toe around those, so
I'll accept an anonymous anecdote from you and I'll trust you to have your
facts straight. How about it?

You also wrote: "I've been cancer free for 7.5 years.  I still can't get
insurance without it costing me a fortune, and thanks to Managed Care, I
can't afford it."

First of all, congratulations on being a cancer survivor! I hope the cure
continues and I hope you got the treatment in America and were satisfied
with it. 

My mother got cancer late in life, but her major medical insurance covered
nearly everything that her regular teacher's health insurance didn't. She
got the major medical policy shortly after my father died and she became the
titular head of the family. To the best of my knowledge her insurers never
disallowed the very expensive treatments she required and none of her
policies were cancelled because she had survived cancer. Were we just lucky
as a family? Or prudent?

Without being too personal, did you have health insurance before you were
diagnosed that they cancelled after you were diagnosed? Or was it a problem
getting a new policy at a price you could afford after the diagnosis? If
it's the former, I'll join you in denouncing the insurance company by name
far and wide; if it's the latter, then I am sympathetic but I also know that
the actuarial tables don't favor cancer survivors. (Or me, for instance,
since I have diabetes and I can't get long-term care insurance because I
didn't enroll prior to the diabetes diagnosis.)

Finally, you wrote: "Face it, David, your philosophy is a theory."

Au contraire, Pam. My philosophy has been reality since Ben Franklin started
selling insurance and concocting potions in Philadelphia. America has
contributed more to the world's health through innovation, pharmaceuticals,
and other medical inventions than any other country in the world (when did
you last get a patient/client with Polio? Or smallpox?) and it will continue
as long as we reject further erosions of freedom and liberty. And I'll
freely admit I am concerned about our Nation's future because of the looming
threats to liberty.

Threatened by confiscatory taxes and a hostile, rapacious legislative
environment, the pharmaceutical industry, hospital suppliers, and investors
have begun shifting their business investments offshore. Doctors are leaving
their practices in big cities and states that don't have reasonable limits
on malpractice suits because they don't want to practice in such a hostile
situation with sky-high insurance premiums. Other doctors and nurse
practitioners are finding that they can't keep their offices up to date and
their skills current when their practices become too heavily weighted with
Medicare and Medicaid patients and reimbursement levels as set by the
Congress and the state legislatures. How much longer can we expect our
healthcare professionals to work for "love" and "satisfaction" in lieu of
reasonable fees/salaries and working conditions? Has anybody noticed that
each year a smaller percentage of the people we trust with our lives are not
Americans by birth or education? People vote with their feet. That ought to
tell us something. 


J. David Coldren '65




-----Original Message-----
From: alumni-chat-bounces at w3.antioch.edu
[mailto:alumni-chat-bounces at w3.antioch.edu] On Behalf Of Pam Olsen
Sent: Saturday, September 01, 2007 3:56 PM
To: alumni-chat at w3.antioch.edu
Subject: [Alumni-chat] Re: Alumni-chat Digest, Vol 7, Issue 1




> 
> You're wrong. But don't worry in a few short months, you'll have
Hillarycare
> and we can all relax and enjoy the benefits of that. Between now and then
> you're welcome to use Canada's socialized healthcare system since it's so
> muich better than ours. I feel sorry for the thousands of Canadians who
are
> "simply uninformed" and come to the United States for "the worst health
care
> in the world." Gosh, maybe their Surgeon General needs to put up a sign at
> the border: 


David,  As for HIllary care,  of course, we don't know what would have been
if she had been able to do what she wanted to do, instead of finally caving
in to insurance companies and creating "managed care".

As for Canadians coming to this country, I have dear friends who live in
Quebec, who came to help me work on my house in February.  I asked them
about their healthcare.  They said it is excellent.  The only surgery they
have to wait for is elective surgery.   I live only 100 miles from the
Canadian border.  I have friends at church who drive up there every six
months to get her Tamoxifin.  Here, it would be $100 a month.  THere, it is
$24 for six months!  It is worth the trip!

i lived in Switzerland as an exchange student in high school.  I was from
what might be called a lower middle class family.  I'd not have been able to
go without my grandmother paying the $600 for the year--upfront (same for
Antioch).  My Swiss family was very poor, even by Swiss standards.  All four
of the children became professionals:  two engineers, one physician and one
architect.  They all now have beautiful homes, take long vacations every
year, have travelled the world, have excellent health care, are in good
health in their 50s and 60s (except for some sports accidents--they're all
avid sportspeople), and look forward to secure retirements.   They don't
have to worry about losing everything they have to a medical crisis, unlike
this uninsured cancer survivor.  I've been cancer free for 7.5 years.  I
still can't get insurance without it costing me a fortune, and thanks to
Managed Care, I can't afford it.  So I just do my best to stay healthy.

Surgery is not the only health care issue.   And, of course, even
life-saving surgeries are denied if people can't pay for them.  It blows my
mind that people will get on TV and try and raise money for life-saving
treatments because they don't have insurance or insurance won't cover a new
"unproven" treatment.  We just let them die.

Are you aware that the most recent dietary quidelines put out by the FDA
were essentially dictated by the sugar and meat industries, rather than by
nutritional research?  Read The China Study, esp. the appendices.

Face it, David, your philosophy is a theory.  I have been billing insurance
companies for 24 years.  I live with the results of such a theory every day
of my life.  I know beyond a shadow of a doubt that our health care system
is not there to serve the people.  Patients are not getting good care,
providers who try and be available to everyone, not only the rich, are not
getting fair payment.  While the CEOs and employees of the insurance
companies are making it big, and bigger all the time.   Health care for
profit was a dumb idea.

We all know what Big Business has done for the environment.  And look at
what it's doing to our democracy.

It has been in the news a lot lately that the rich in our country are
getting much, much richer, while the middle class is getting smaller.  This
is not the case in European countries, where the middle class is increasing
in size.  

In my opinion, the data is in.  Your theory hasn't worked, except to make a
small percentage of the population a whole lot richer.

Pam 

    

_______________________________________________
Alumni-chat mailing list
Alumni-chat at w3.antioch.edu
http://w3.antioch.edu/mailman/listinfo/alumni-chat
Visit http://www.Antioch-College.edu today!