July 27, 2007

I hear Starbucks gives benefits to part-time baristas…

Posted in Health care, Medicine, Mental health, Musings at 11:46 pm by The Lizard Queen

THE FACTS:

1. I am a graduate student at a state university, entering my seventh (and final) semester.
2. I had an assistantship for my first six semesters. Six semesters is the maximum length of an assistantship in our department, because that’s the most we have funding for.
3. Health insurance was included in the assistantship.
4. As I am no longer employed by the university, my coverage ends on August 20th.
5. I have another job, but that job does not offer health insurance.
6. I have suffered from depression for most of my life. I first saw a psychologist when I was seven years old.
7. I have been on medication for my depression for the past six years, with occasional breaks. The medication is not a cure-all, but it makes a significant difference.
8. With my insurance plan, I paid 40% of the cost of my medication, and it was still expensive. (The patient’s share of medication costs will go up to 50% when the fall semester begins.) I’m not sure I can afford to pay 100% of the cost of my medication.
9. I’m also not sure I can afford to pay for the graduate student insurance plan out of my own pocket.
10. I thus find myself considering tapering off my meds at a rather inconvenient time solely for financial reasons.

The facts lead me to THE QUESTION:

Can someone please explain to me what’s so bad about universal (socialized) health care?

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4 Comments »

  1. See VA hospitals and the quality of care at army bases worldwide vs. private physicians. End snippet answer.

    I don’t want to make light of this, as I am soon to be uninsured as well if I don’t find a job that provides it. However, as a military brat and having been to both base doctors and personal physicians, I think the private sector way outdoes the government sector when it comes to health care. At the University near where I grew up, the “joke” was that the campus health facility was great if you needed aspirin or a birth control pill. If the government’s health care for it’s soldiers (or a university’s provisions for students such as yourself who are the future of this country) (you’d think it’d be the world’s best) is contrasted with private organizations like the Shriner’s hospital, or even your local hospital, it seems to have a world of difference in the way things are managed and run.

    Having said that, I think a huge problem with health insurance is that many companies pay for a huge amount of their employees health insurance, so there is little incentive to comparison shop or drive down prices. However, I don’t trust government to fix that.

    Reading your article, you would seem to be better off with insurance provided by the government while retaining the option of which private hospital/doctor to see. At first this seems an ideal utopia. On the other hand, several of my children are in the foster system, which means they have government provided health insurance. If you’ve ever had the frustration of trying to find an optometrist that takes such medical insurance, you’ll find that fewer and fewer do. If they lose money or feel it’s not worth their time, they don’t want to hassle with it. It then affects my children’s quality of health services when I have a limited pool to choose from due to the nature of the system. I fear that medicare and medicaid producing this in a small part would create a larger mess if transferred to the whole country.

    Another problem that I have with socialized medicine is that I believe I should (if I am able) pay for my family before I ask you for help. If I can’t pay for my family, how can I pay for you? I.E. if you tax me more to pay for someone else’s medical care and I can’t even pay enough for my own, then where am I? I also would like to spend/invest my money wisely. If I had the choice between a tax dollar going to a government run hospital, paying a dollar to my local physician, or donating a dollar to a hospital like the Shriners’ or St. Jude’s, where will my dollar be best spent? Between my dollar and the government hospital will be the IRS, several beaurcrats paid to route it, and the end result is that a pittance gets to it’s intended target. The donated dollar goes alot further to help others than my taxed dollar would (and due to tax laws, can also reduce said taxes). The dollar I spend on my physician provides me with the best care I can afford (or I need to pick a different physician! 🙂

    Now, back to your plight. My wife has struggled with depression and bipolar for several years now, and we’ve run through a gamut of medications in a desperation cycle where nothing seemed to work. I’ll be praying for you that you will be able to continue to effectively work through this struggle. I don’t have an answer to it, or you’d be asking my opinion and paying me (or I’d be billing the government/your insurance company). Eh, pathetic humor is my trademark. On the other hand, I’m looking forward to meeting you soon.

  2. DavidD said,

    It is a lie when hospitals or individual health care providers say they lose money seeing Medicaid patients. Anyone who knows economics knows that the cost of production of the first unit produced is very high while the cost of the marginal unit (one more unit on top of all the ones that were in fact produced) is next to nothing. The same thing applies to the costs for providing health care. A office-based provider might have expenses close to 50% of what he or she is paid for the care. Then that provider might say he or she loses money if a patient’s insurance pays less than 50% of the standard payment. Yet that’s not true for an individual case. Seeing one more patient does not raise one’s expenses at all. If that’s a Medicaid patient, the profit in that is small, but it is profit. Of course if one’s looking at one’s practice becoming 100% Medicaid that’s different.

    So it’s not about losing money. It’s about individuals needing or wanting to spend their time on more lucrative patients, as I did when I was practicing, or to not have their openings in the office or the hospital filled up with low-paying patients, if one decided to make a pattern of seeing them. I don’t think the problem is one of curtailing such individual freedom. It’s about making sure everyone gets some care.

    I think there are two fears that get in the way of that. One is the fear of the whole system turning into something unacceptable, such as the example of military medicine above. I think that’s a red herring. I get care at Kaiser. I’m confident the entire country could get that level of care for the amount of GDP currently spent on health care, including all those where I volunteer who skip their diabetes and high blood pressure medicines just so they can pay their rent.

    The more specific and individual fear is harder to wave away. People are afraid they’ll lose the doctor who cares for them now, instead winding up with some efficient but less helpful doctor like I have at Kaiser. They’re afraid they won’t have the same telephone access to help or ease of making appointments. Those are realistic fears. But how many strokes among my clients is such convenience worth?

    Maybe most important is how motivated people feel toward those without health insurance. Who cares? Some do, but not enough for there to be universal health care in the US.

    There are only 3 good things to shoot for in health care financing:

    1) Freedom of choice
    2) Lower costs
    3) Universal care

    Robert Samuelson has written a lot in Newsweek and the Washington Post about how at best one could only have two of these. To have all three is a contradiction. The votes in the US have been for those first two, the lower costs only being relative to what the costs would be without any efforts at cost containment, including those measures that led to Medicaid having such poor reimbursement. What are Americans willing to sacrifice for universal care? I think the comment by Mr. Schumm above is typical. I don’t see that they’re willing to sacrifice anything. It would require a powerful leader to take the US into universal health care.

    Conservatives love the simplicity of believing that private enterprise is always better than public enterprise. Leftists love the simplicity of believing that non-profit enterprise is always better than for-profit enterprise. Both positions have some truth in them, but both are misleadingly simplistic. Counter-examples exist to both. Swing voters would listen to those examples. But then they would still vote their fears and their indifference to the poor. Maybe they’re right. Maybe there’s more to social Darwinism than a liberal like me would care to admit. None of my clients are setting themselves on fire in protest or making Molotov cocktails for the coming rebellion. They just find ways to cope, as you will. I’ll write you privately about how to do that.

  3. Sarah said,

    Hey Liz,
    You can get pretty good prescription plans for not too much–it may be worth checking out. A lot of them cost less than 10 bucks a month and can help you save a ton on the cost of filling your prescription. Hope you guys had a nice drive!

  4. Nikki said,

    I’m in a similar situation, and found your post when I did a search on Starbuck’s benefits. I quit working full time to be at home with my 18 month old daughter. I thought I would just buy private healthcare insurance and that would be it. But to my surprise, I’ve been declined for coverage twice. Why? Because I take antidepressants. I have no other health conditions and the plans I’m applying for don’t even cover mental health. I want to spend as much time raising my daughter before she’s in school, so instead of going back to the corporate grid I’m considering grinding coffee. I hate the US healthcare industry. You can read about my struggle with them on my blog – http://logosknitter.blogspot.com/. I wish you the best of luck – Nikki


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