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Thank the AMA

Live in the US? Uninsured? Underinsured? In the Medicare donut hole? Stuck in a job you hate because you need the benefits? Thank the AMA.

Medicare was proposed in the 1930s when Social Security was enacted. You may have noticed that Medicare didn’t actually exist until the 1960s.  That’s in large part because the AMA spent millions of dollars fighting it. Can’t have the government telling doctors what to do, or how much they can charge. It’s an article of faith with the AMA that doctors must be allowed to do their work without any pesky oversight at all.

The AMA was so desperate to keep the government from running medicine that they continued to fight any expansion of Medicare benefits. The original plan, in the 1930s and again in the 1960s, was that Medicare for seniors would be the first step toward universal health care.  That was actually a campaign issue in the 1972 Presidential election – and not just a plank in McGovern’s platform, but in Nixon’s as well.  Instead of expanding Medicare, we continued the practice of giving employer-based health insurance special tax benefits, which helped corporations and those who were employed by corporations and left everyone else, well, out.

For a while that worked kind of OK, at least for the people who counted (employed, financially stable, married to someone who was employed).  Medicare and private insurances paid hospitals and doctors well enough to keep the charity care programs running, too, although the quality of care was questionable. But then there was an explosion of medical technology in the 1970s and 80s. At the same time, the post-WWII economic expansion in the US finally slowed and stopped. Medical costs became a larger and larger part of overall US expenditures. As employment patterns started to change, more people lost insurance and couldn’t afford care at all.

Of course the AMA noticed this; they swung right into action. They fought any attempts to limit reimbursement to doctors. Medical costs spiraling out of control? Don’t blame to docs! Payments to doctors are a small part of the costs!  What they never bothered to mention is that the high-tech testing that made up a much larger part of the cost increases were done under doctor’s orders, and often without any evidence that they benefited patients.  The AMA opposed the development of practice guidelines, too – remember, no pesky oversight.

Then it was the 1990s. Bill Clinton is elected, and he asks Hillary to head a task force on health care. We know how that ended, and the AMA had its hand in that, too.  But then the health care system changed anyway. The AMA had successfully fought off “socialized medicine”, only to find that docs were now dealing with corporate medicine.  And it turns out it’s not just oversight they hate, it’s salaries. When Kaiser started in the 40s in California, the AMA declared that taking a salary ran contrary to the Hippocratic oath. Kaiser docs weren’t welcome in the California Medical Society until the late 1960s. When I chose a Kaiser residency, at least two people told me I was abandoning the ethics of my profession.  My experience at Kaiser was that docs made the decisions. Doc I knew and trusted and worked with. Yes, they have limited resources – but we all have limited resources. At least in the Kaiser system the resource utilization decisions were transparent and made by doctors, for the most part.

No system is perfect. All systems have perverse incentives, and there are bad docs everywhere. Most of us are well-meaning, but we’re all human; we will do what benefits us if we can. At the moment, everyone is losing, and the patients are losing more than the docs. If we had a single-payer system, everyone could have basic medical care. We could put resources into preventive care, screening, prenatal care, health education and risk factor modification instead of trying to rescue people from the ravages of preventable disease.  I could have one formulary instead of trying to remember which insurance company wants me to use Lipitor and which one wants me to use generic simvastatin.  Rich people would still get different care. That won’t ever change. But no one should have to be rich to get care in the first place.

We already have health care rationing, because we have people who can’t afford their medications or can’t get access in the first place and we have people getting too much care. It is possible to do more with less, to get rid of the bloated bureaucracies and the ridiculous competition for cherry-picked insurance pools and use that money to actually provide medication. We’re not doing that now, and if those colors don’t look right to you, blame the AMA.


40 thoughts on Thank the AMA

  1. Whatever medical plan is chosen, it must adapt to the changing practice of medicine. When Medicare started, people feared the cost of prolonged hospitalization — pills were cheap. So Medicare covered the cost of hospitals, not pills. Nowadays, people are hospitalized for the minimum time, and pills can cost thousands of dollars. Medicare was very slow to address that change.

  2. My doctor declared to me a couple of appointments ago that it is now past time for socialized medicine. Yes, my doctor. I hope he’s the wave of the AMA future.

    Got to teach him to call it “extended medicare”, however!

    🙂

  3. Hector, reimbursements and available resources drive utilization. People do more of what they get paid to do. Hospital days have dropped because Medicare (and other insurances) stopped paying for every day in the hospital as a separate entity and started asking doctors to use best practices and keep hospital days down. Less money, fewer hospital days. Before that, there were huge variations in the percentage of people hospitalized for any specific condition. The only statistic that correlated with the variation was the number of hospital beds available in the community. More beds, more hospital days. No improvement in outcomes, just more days in the hospital.

    I have lots to say about drug costs – that’s another post!

  4. RacyT, it’s time I thank my parents for moving to Canada. My dad’s just out of hospital and all it cost him was upgrading to a private room. He’s home now, people often recover better at home as long as there are check ups by homecare nurses and he’ll get that.
    What people don’t get about “socialized” medicine for all is that the government has a vested interest in keeping its population healthy. It can take awhile to figure it out but immunizations, ad campaigns on healthy practices and subsidies for sports programs become part of the government’s recognition that social factors can bring down the costs of socialized medecine. The newest advances may take longer to become common practice but overall the care is whole person.

  5. One Nation Uninsured is a pretty good, quick summary of the history of health insurance in the US, from the labor movement in the ’30s up through the Clintons. It’s a fast read, and only about 200 pages (plus citations.)

  6. Well, now, let’s not leave out the American College of Physicians and the American Academy of Family Physicians!

  7. As an historical aside, there was another crack at universal health insurance: Harry Truman proposed the idea to Congress in late 1945, but it was of course defeated. The AMA was against that plan, too.

  8. Tina, the ACP is my professional organization and they’ve been almost silent on this subject, much to my disgust. They were more outspoken when they were a more academic organization, before they merged with the American Society of Internal Medicine about 15 years ago. Can’t speak to the AAFP. I’ve never been a member of the AMA – my grandfather resigned in the 50s when they started fighting Medicare – but I do belong to ACP, since they publish the best journal in our field. Unlike the AMA, the ACP has at least supported evidence-based guidelines and outcomes research.

  9. You know what I else I thank the AMA for? Selling the prescription information for every single doctor in the country to big pharma so that drug reps can be more effective in pressing doctors to prescribe Vioxx or whatever. Without the AMA-provided doctor code + name index, pharmaceutical companies would have no idea how much and which kind of medicine every doctor provides. I’m pretty psyched that my husband’s hospital has outlawed any and all drug company promos… but then what will those doctors do when assaulted by drug reps in their future practices?

  10. The AMA and other such “professional organizations” are nothing more than trade guilds whose sole purpose is to protect the interests of their members, chiefly from competition. One of the quickest and easiest ways to reduce health care costs in this country is to break the AMA’s medical monopoly.

  11. I’m going to be switching away from Kaiser (So Cal) soon, which makes me sad, because the doctors I’ve had at Kaiser have always been great. Unfortunately, none of the prescriptions that I have are on the Kaiser formulary, so I either have to pay out of pocket or switch to Cigna to get the stupid things covered.

    And we’re talking birth control pills (Alesse) and rosacea medication (Noritate), neither of which are exotic or expensive. But if it’s not available as a generic (or, in the case of Alesse, the generic doesn’t work as well), I can’t have it. Stupid administrators

  12. so the biggest arguments that get thrown at me are waiting periods and doctor/nurse salary. they come in the form of “what if you were pregnant and had to wait 6 months to see a doctor?” (can anyone tell me, brits, canadians, does this really happen?) and “all the doctors and nurses flood to the states to work b/c they know they will actually make money”

    i know that a true socialist health system may not be ideal, i know that the system we have now is fucked up beyond all recognition, there must be a way, somewhere in between, where everyone gets quality care…that is what we need…not some people getting stellar care, and some getting nothing…it makes my head hurt thinking about it…but the current greed of money and power corruption has got to stop…it isn’t helping anyone at all…and i don’t see it getting better

  13. for some reason my comment and info keeps disappearing…so here is the abridged version of my lost comment…

    two greatest arguments i hear against “socializing” medicine, most recently from someone who was once stationed in northern italy, and many others, is waiting periods and doctor/nurse salaries, as in “what if you were pregnant and had to wait six months to see a doctor?” and “all the doctors and nurses are fleeing to the states to practice b/c they can actually get paid”. i don’t know if prenatal care is that bad, i have no real reference other than my canadian friends, but that seems off to me, and anyhow it seems better than no care, which a lot of pregnant women are facing now. also, boo hoo that they all want to get paid more…no wonder costs go up…whoops..that got a little ranty…i guess i am just curious, how does the AMA impact those aspects here, and would a “social” system fix it (or as some would have me believe, make it worse)?

  14. If you think that’s bad, look at how they worked with the tobacco industry to cover up evidence of smoking’s relationship to cancer — and look at how they’re doing it now with plastics and cosmetics.

  15. If we’re doing a roll call on huge organizations that fuck up our healthcare system, it’s also worth bringing up how the American College of Obstetricians and Gynecologists has simply screwed the practice of midwifery (starting in the 1930s). For healthy pregnancies, midwives are stastically better for mom and baby than OBs because they tend to have a more holistic approach (and don’t hand out epistomies like candy on Halloween).

  16. Didn’t it go back earlier than that? I thought they started trying to undermine midwifery in the mid-nineteenth century.

  17. Brandann, in the UK pregnant women with normal pregnancies are generally seen 3x during their 9 months. Beyond that, I know nothing, as because I have mentioned before, I got kicked off a waiting list (after 4 *Y&(%R years) because they changed the rules as to who was eligible (and we were willing to pay for treatment, too). See my About page for more detail.

    As for seeing my GP, I had a great doctor and was usually seen within a week, sooner for emergencies that didn’t require ER care. I miss my GP. Dentistry, on the other hand…let’s just say that I’d hate to have an NHS dentist – assuming you can find one who takes new clients.

  18. Brandann, I’m Australian, and pregnant with my first child. I’m using our Medicare system – going to the local public hospital antenatal clinic after being referred by a Doc in the local medical centre (who is also covered by Medicare).

    I waited 45 minutes after my appointment time to see a random Obstetrician in a crowded waiting room. I am warned almost every time I make an appointment “you may have to wait due to medical emergencies” and I’m fine with that – a woman who is giving birth gets preference over my 15 week pregnant self, and I expect that when it’s my turn to start screaming I’ll be given the same importance.

    Our Medicare system obviously takes into account priorities – anti-national healthcare campaigners who talk about things like waiting six months to see a doc when pregnant sound off their rocker from where I’m standing. I know that under our nationalised healthcare if I ever do have a medical emergency or a condition with a time-frame (like my pregnancy) I can reasonably expect to be given priority over people with benign tumours or conditions that can wait a few days and don’t need attention right now. And I know the price I will pay is if I ever have benign tumours or a condition that doesn’t require immediate attention, I will be asked to monitor the condition and be put on a waiting list.

    It’s not a perfect system, but it does work most of the time.

  19. No question that the AMA is a trade organization. It was created in the mid-19th century to fight the osteopaths. They’re still doing that, too.

    There are waiting lists in England and Canada for elective procedures, and people do indeed complain about that. Justifiably – there’s no perfect system. But outcomes, any way you measure them, are at least as good and in some cases better in those systems, and they spend far less money on health care than the US.

    And yes, doctor’s incomes are lower in countries with single-payer systems. But in many of those countries medical education is either free or lower-cost, so docs have less educational debt. And despite the whining and fear-mongering among my colleagues, I have never seen a doc by the side of the road with a sign saying “will diagnose for food”. Even primary care docs, who are at the low end of the pay scale in every country, make better-than-average money by a long shot. And I’d be willing to make even less than I do now in exchange for never again having to fill out a disability form, or have a patient come into my office the way one did today, saying “I had to come in today because I lose my insurance tomorrow, and I wanted to get my blood pressure checked one more time”.

  20. “all the doctors and nurses flood to the states to work b/c they know they will actually make money”

    Yes, they do make more money here … because our system is so screwed up that we have a MASSIVE shortage of RNs and general practitioners, so we have to import them at a much greater cost than training and paying our own practitioners would be.

    In other words, they’re looking at the end result of really bad policy decisions and saying, “See! That proves that US healthcare is better!”

  21. thank-you all for your answers, and patients w/ my double, redundant posts…ugh…

    these are all things i assumed…but when arguing w/ the anti-national health care crowd, it’s better to CMA w/ facts from knowing persons than to just spout off.

    jay, you rock, b/c these posts you have done are super informative at a time when a lot of us need it most…not that i am lazy, just skeptical of random internet research.

  22. Ooh, Jay. Thanks so much for giving a doctor point of view. I tend to get immersed in birth issues (planning on a midwife career) and am often torn by the knowledge that many OBs, and ACOG, and the hospital system as a a whole, have drunk the Kool-Aid and are hell-bent at preventing good practice getting in their way. At the same time, I know and meet many good docs and nurses who are angry and frustrated at being prevented from actually helping their patients and treating them with dignity.

    Is there, to your knowledge, a growing desire for change among your colleagues? Are any of them organized to this end? Because 2008 will be just the beginning, and part of what needs to happen is more collaboration between those who want to actually create a working medical care system.

  23. emjaybee, I think there are a growing number of docs who are ready for change, but there’s no organized movement. The New England Journal of Medicine has been editorializing for a single-payer system and reform of relationships with Big Pharma for years, but no action has been taken.

    The political complexity is compounded by the fact that docs are also very concerned about the tort system, and the party that wants to reform the health care system is not the party that wants to reform the tort system. My office staff was pleasantly surprised to discover that I’m a Democrat; they assumed (with reason) that all docs are Republicans.

  24. @Winter’s Wrath–I think you’re right about that. ACOG has been knocking on midwives for quite some time, but I think they established themselves as “primary caregivers for women” around the ’30s. I’ll check into it.

    @Brendaan: Up until five months ago, my husband and I were unable to afford even the most basic of health insurances, and pay out of our pockets for everything. This has actually been the case for my entire life, as my parents did not (and still don’t) have any sort of a safety net for health care. As such, until recently, I’ve only visited a doctor that wasn’t associated with the E.R. once, and even then I ended up requiring an I.V. for rheumatic fever-related dehydration. Praying that ear and sinus infections go away is common among my family. We are very lucky we’ve never had anything more serious than a few broken bones (except for my mother’s ectopic pregnancy explosion and recurring thyroid cancers, my brother’s appendix bursting, a chopped off big toe, and my and my brother’s rare Henoch-Scholein purpura).
    My parents are hundreds of thousands of dollars in debt due to diseases we have been told are preventable if caught early. They have also both been diagnosed with severe clincal depression due to these issues.

    It’s true that socialized medicine is not a perfect system, as Orodemniades explained so eloquently in her comments. I can’t imagine being pregnant in the U.K., or trying to get a hip replacements. But having something, even a bloated and inefficient something, is better than some people having all and some (now inching towards most, considering wage stagnation) people, like my family, having nothing. Especially when you consider that the U.S. has lower life expectancies and higher infant mortality rates than many industrialized nations due in large part to a lack of preventative care and health education among the working poor (which I can postulate the AMA has had an indirect hand in somehow).

    As for pregnancies, well, it’s true the people in the U.K. only check in with their doctors three or four times, but that’s because they support, fund, and rely on midwives for most of the prenatal care (feel free to correct me if I’m wrong!). Despite being almost criminal in the U.S., midwifery is actually supported in hundreds of other countries and works fine for them (see again the U.S. having the highest infant mortality rate…). British pain relief is also much more fabulous than our own, imo, because there are a lot of options. Here in the U.S., it’s again, all pain or no pain and a hell of a lot of side effects. Pregnant women also get prescriptions for free in the U.K.–and women who don’t want to be pregant recieve government sponsored birth control (how cool is that?!). High-risk pregnancies are pretty much SOL, true, but that’s due to NHS being bloated. I am now 11 weeks pregnant and am now recieving stellar care in the U.S. due to my husband’s generous corporate insurance. Had I gotten pregant five months ago, I would have had nothing. Considering my own mother’s history of prenatal care, which involved following several old wives’ tales, I see England’s system as better for pregnant women, by far.

    On a somewhat related topic, our “pro-family” president just approved a budget that -will- kick off at least half a million mothers from the WIC program because it does not take inflation into account. Underfunding SCHIP, underfunding WIC… Anyone else seeing a pattern here?

  25. I can’t imagine being pregnant in Canada, excuse me!** 🙂 Canada’s having a lot of problems right now.

  26. cassandra~

    sounds exactly like my life growing up, until i was just preteen and my mother got a job as a correction’s guard, and was able to get BC/BS. we were standard emergency room care people. it sucked…especially when one of us started throwing up in the middle of the night, and we had to sit up there for hours holding buckets.

    when i had a child of my own, i was lucky enough to still be covered by that insurance. afterwards when i was on my own, as soon as i started working gov granholm had to cut my medicaid for my daughter. the cost of private insurance just for the two of us was anywhere from $800-$1000 a month, depending on where i looked. eventually i had to move back to live w/ my grandparents, and take care of the Indian Health Services (IHS) available to my tribe. w/o it, Kid would never have received vaccines, and i was able to get (although outdated) BC pills. w/o those services, my diabetic grandfather would be smothered w/ debt, but b/c of it, he can even get preventative home nurse visits who give him pedicures of sorts to ensure his feet stay healthy. so, given the choice, i would jump on the chance to have UK health care, or AU, or even Canada’s. i read somewhere that 70% of bankrupt people, correct me if i am wrong, are so b/c of health care costs here. and w/ hospitals pushing people out the door, and limiting pregnant women to 5 hours to deliver babies b/f emergency c-sections, i want to throw my hands up and beg for a ride out of here.

    i feel bad, like i am monopolizing the thread here…so if anyone wants to continue this, they can bring it to my site, and even email me from the link there. unless no one here minds.

    thanks again for all the input! it was all so valuable!

  27. Yes, I’m grateful my OB-GYN has a midwife along with two doctors! And I’m grateful that the hospital’s Lamaze instructor is not only an RN, lactation consultan, but a doula as well, one who runs a volunteer doula network (doulas, homebirthing, and birthing centers are very popular in my area). Did I mention she’s a bellydancer and includes that in her prenatal exercise classes?

    I’m also thankful that the major hospital in my state not only provides excellent care from janitorial staff on up, but that they give uninsured patients a 49% discount! My week in that hospital cost less than the 6 hours I spent in the ER of my local hospital and only slightly more than the ambulance transfer up there (w/discount). That was 5 months ago and I still have over $3000 in medical bills to pay, and gods only knows what a regular hospital birth costs – I’m going to remain in ignorance until March, that’s my plan, assuming I make it that far.

    Like most other folks, I can’t afford insurance at all

  28. I waited 45 minutes after my appointment time to see a random Obstetrician in a crowded waiting room. I am warned almost every time I make an appointment “you may have to wait due to medical emergencies” and I’m fine with that – a woman who is giving birth gets preference over my 15 week pregnant self, and I expect that when it’s my turn to start screaming I’ll be given the same importance.

    Honestly, that’s not that different than being in the US. I’ve waited longer than 45 minutes to see a doctor even though I had an appointment.

    That’s what frustrates me about these conversations sometimes: who are these people with insurance who’ve never had to wait to get a doctor’s appointment or to have a procedure done? After I tore my ACL, I waited four months for surgery, and I was lucky to get in that quickly. (They took pity on me because I was getting married in July and I didn’t want to be on crutches, so they scheduled me for the end of April. I’d had my accident at the end of December.)

    We do ration our healthcare here in the US. Only difference is, we ration by ability to pay, not medical necessity.

  29. I waited 45 minutes after my appointment time to see a random Obstetrician in a crowded waiting room. I am warned almost every time I make an appointment “you may have to wait due to medical emergencies” and I’m fine with that – a woman who is giving birth gets preference over my 15 week pregnant self, and I expect that when it’s my turn to start screaming I’ll be given the same importance.

    Sounds about the same as the US–my longest wait for my OB was about 2 hours after my appointment because she had two emergency Cs in a row.

  30. You know what I never understand? How those “don’t let the government run health care… they’ll just fuck it up!” think that socialized medicine could be any more fucked up than the current system.

    Let’s see, what are there complaints/fears? Wasteful spending? In addition to the enormous amount of money spent on marketing drugs, just think about how much is paid to administrators in offices, doing nothing all day long but deciding who to insure and which claims to deny. I can’t think of anything less essential to the task of making sure people are healthy. Long waits? The last time I went to see my doctor of 10 years for an emergency condition (enormous back pain that made sitting extremely painful, a condition that kept me in bed for over a week and was eventually revealed to be sciatica resulting from a herniated disk), I sat in the waiting room for 3 hours while drug rep after drug rep came in and were seen right away, ahead of my emergency AND a waiting room full of other patients as well. Lack of choice? As someone who relies on her job for health insurance, I’m limited by whichever doctors are chosen by my HMO, which program is selected by my employer. So, pretty limited choices right now.

    How do people not see that everything they’re “afraid” will happen under socialized medicine is already happening, and that the only difference is that someone’s getting rich off the current system? (Of course, I’m talking about the people who are sincere about thinking that what we have now is better, not the cynical assholes who perpetuate the myths to keep the status quo).

  31. hp and Mnemosyne: The 45 minute wait was remarkable because it was more than the maximum half hour I usually wait at my regular medical centre for a GP’s attention, without an appointment.

    The stories I hear of the US medical system horrify and confuse me, to be honest – what do people do if only one adult in a family is working in a low-paying, white-collar office job and one of their three children does a normal childhood things and breaks a bone? Or the entire family is involved in a car crash? Does the ambulance and emergency medical attention reappear in their lives in a few months, in the form of a bill in the mail?

  32. Aphie, the emergency attention and ambulance bills are actually discussed before treatment is started in the emergency room. ERs are required by law to treat anyone who presents, regardless of insurance status, but they can try to make people make payment arrangements up front. I’ve had patients refuse to go to the ER for necessary care even when they had insurance because of their copay, which is double or triple what they’re charged if I see them in the office. And I’ve had patients sign out of the hospital against medical advice because of their deductible or copay, or because they were uninsured.

    Then there’s the flip side – people who are uninsured and can’t afford the doctor’s bill, or can’t find a doc who will see them, and thus go to the ER for minor illnesses or routine medical care, like having a school form filled out. The hospital generally has to see them.

    I really don’t understand how anyone can think this system is working, assuming you define “working” as providing accessible, high-quality medical care to the largest number of people.

  33. My doctor declared to me a couple of appointments ago that it is now past time for socialized medicine. Yes, my doctor. I hope he’s the wave of the AMA future.

    My NP, who I use as my primary care provider, is the same way. She says that too many people postpone or forego necessary care, then wind up at the doctor’s office far sicker than they would have been had they gone to the doctor when they should have.

    If we’re doing a roll call on huge organizations that fuck up our healthcare system, it’s also worth bringing up how the American College of Obstetricians and Gynecologists has simply screwed the practice of midwifery (starting in the 1930s). For healthy pregnancies, midwives are stastically better for mom and baby than OBs because they tend to have a more holistic approach (and don’t hand out epistomies like candy on Halloween).

    Fortunately, midwifery is both legal and regulated in South Carolina. (It is illegal in both NC and GA) However, insurance providers only have to pay midwives if they are CNM’s. They do not have to pay licensed midwifes. The reason why is that Blue Cross/Blue Shield has fought this provision tooth and nail because BCBS is run by doctors and hospitals and they hate the competition.

  34. Uhm, yeah.
    I totally ran into the “insured but you want HOW much out of my pocket?” this week. We paid the down payment, our bills and that was my husband’s paycheck. He’s working some bouncing work this weekend so we can afford groceries for the week. We had to borrow $20 to get my pain meds. It’s ridiculous.

    Even with insurance, I’ve had to wait weeks to get appointments with a popular general practitioner or a specialist. I’ve waited hours to see a doctor even with an appointment and had to pay through the nose for the privilege. I have no problem with doing the exact same thing but not having to pay out of my pocket for it.

    I’ve always thought that there are some things that are not ethically correct to be a profit-making enterprise. Prisons, wars, foster care, for example. I put medicine in that category. The health of the population, you know PUBLIC health, is not an ethical way, IMO, to make a profit. Essentially, one is making a profit from other people’s misfortune and illness. Now, don’t get me wrong, I think doctors deserve to make a living, and a good one, for what they do. They also should have enough to pay off college and med school loans (or not have them in the first place, i.e. publicly-funded higher education maybe? Again, having an educated population is in the interest of the state. Just ask Alabama.) The docs shouldn’t be paying for the important new technology required to do their job. Hospitals shouldn’t be run by business people looking for a profit or religious people pushing their brand of morality on the ill.

    Good health, to the extent that modern medicine can provide, is a human right. One cannot exercise liberty or pursue happiness or have a decent life if one is not reasonably healthy.

  35. “[T]he emergency attention and ambulance bills are actually discussed before treatment is started in the emergency room. ERs are required by law to treat anyone who presents, regardless of insurance status, but they can try to make people make payment arrangements up front.”

    @Jay — I try to remain thankful that I have insurance, but as I write, I have a denial of coverage notice from my ‘insurance’ company for about three times my annual net salary, along with a tersely-worded memo about how I “chose” an out-of-network provider and shouldn’t be such a douche next time.

    Which is funny, because when I was unconscious in the back of that ambulance six weeks ago, I don’t remember anyone asking me about PPO coverage and where they could take me to get the best copay.

    I am still reasonably confident all this will be worked out to all parties’ satisfaction, but not without filing grievances on at least two of the five claim notices I’ve received so far, totaling what I estimate to be somehwere north of five times my liquid net worth. What burns me about this whole situation is that I did everything “right” — Republican, Democrat, federalist, socialist, whatever your thinking… I went to college, I got a job, I got my coverage, I invested in my HSA. Everything I was supposed to do to invoke the system to be on my side in a time of emergency. And this is the thanks you get for doing so. Amazing.

    Emergency medical coverage is about enabling convalescence after trauma, not acquiescence to maximizing profit. I see the commenter above is in a similar shocking kind of situation, and I hope that the collective voices are heard on this, not in the “we hear you on the Iraq war” sort of patronage, but driving to real results and changes in the system. This is absurd. Way to go Feministe! Get yer hate on 🙂

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