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Health Care Debate: “Death Panels,” Health Insurance Reform, and the Truth

Amidst all the hysteria surrounding the health care debate, there is a shameless lack of clear thinking. I’ve had the unfortunate experience of seeing our healthcare system up close twice this past year, and let me explain what’s really going on. I think I found the smoking gun on the death panel accusation, and it’s not the doctors or the hospitals…and it’s not about socialism either. It’s about insurance companies who are profiting from deliberately misleading their customers, and the real need for health-insurance reform.

Here are two stories relating to the healthcare debate that illustrate my point.

The first case involves the self-employed husband of a friend. They THOUGHT they were insured, but after a slip on the ice the day before Christmas, they found out they were wrong. He broke his pelvis then had terrible blood clots throughout his whole body. He spent days in intensive care. While being treated for his injuries, the doctors found out he had heart problems. They fixed those. While there may have been times when the doctors could have been reluctant to treat him, knowing they probably weren’t going to get paid, both the doctors and the hospital were under moral and ethical obligations to treat him anyway. And frankly, most doctors are going to find it hard to withhold treatment from a patient if they think it will help, whatever the financial implications. I mean, isn’t that part of the Hippocratic oath or something?

Unfortunately, the insurance company (which, remember, they THOUGHT they had been paying to cover this kind of thing) felt no such moral or ethical obligation. Nor will they ever, if health-insurance reform doesn’t become a reality. The hospital reduced my friend’s bills as much as possible, but he is still obligated to pay the insurance company—which he will probably do for the rest of his life. He’s not young, but he’s not retired, either. And now he and his wife have to give up a lifetime of savings because of fine print on an insurance document.

The second story involves my 80-year-old mother. She is well insured because our company has insured her, and we have a team of experts to defend her from being taken advantage of. But she’s also suffering from her fourth round of metastasized breast cancer. This past December she had a heart attack and spent about a week in the hospital. In full disclosure, I had just joined the board of this hospital—the Lehigh Valley Health Network—so I was paying extra close attention. Here is what I learned: As a nonprofit organization, they are legally bound to provide care for people, even those who can’t pay for it. (My friend who broke his pelvis was in the same hospital.) But more important, doctors don’t ever want to give up on a patient—it’s in their nature to want to cure, heal, or fix somebody. So even though my mother was expected to die from cancer in the near future, the cancer doctors wanted to give her chemotherapy, and the heart doctors wanted to operate and give her the most powerful medicines. Yes, the doctors get paid for doing those things. But they also get paid to give patients options and choices.

My mother chose not to get further treatment. The doctors were a little bit surprised, and nervous, but they respected her decision. And not only has she outlasted their predictions for her survival, she’s done so with a quality of life that would have been totally lacking if she’d chosen the treatments they offered. She’s been able to enjoy her grandkids, eat whatever she wants, and decide for herself how she wants to spend the inevitable last days of her life. Sure, she is mad as hell that we won’t let her drive. But if we’d pushed her to get further treatment, I’m sure she’d be dead by now.

What do these stories show? Whatever side you take in the healthcare debate, we can all agree there are many things we can do as individuals and as a country to improve our health outcomes. Taking self-responsibility seriously, focusing on prevention, and making the right choices for ourselves and our families are key. These things lower the odds of a life-threatening health problem.

But even healthy people can slip on the ice, and people who think they are doing all the right things can still get a diagnosis of cancer. And until we have serious health-insurance reform, that’s where having the wrong health insurance—or no health insurance—makes a huge difference. If you’re like my mother, you get to choose what options to accept and which to reject (even if the system pressures you to take treatments that may lower your quality of life). If you’re caught without coverage—perhaps because an insurance company was deliberately unclear about what exactly they were covering—you hope you’ll get treated anyway. And it’s likely you’ll end up with debts you’ll never be able to pay off.

As the healthcare debate heats up, let’s be clear that nobody’s proposing a death panel to decide who should or shouldn’t be treated. But there currently are “death panels” deciding who should and shouldn’t get paid: insurance companies whose lack of accountability and focus on profits leads them to knowingly and willingly destroy a family’s financial future. That’s why we need health-insurance reform. That’s what needs to be fixed. Fixing that is NOT socialism, it’s our democratic responsibility to make sure everyone is treated equally, and fairly.

It’s a matter of true family values. And if dozens of other democratic countries around the world can do it, and do it better than we do, we should be ashamed of ourselves if we don’t do it too.

Tonight President Obama will address Congress, and the nation, on his plans to overhaul the healthcare system. It’s the first time since the 9/11 attacks that a U.S. president will address a joint session of congress outside of the usual State of the Union and post-inaugural settings. Come to Rodale.com during the speech to see live comments by me and various Rodale editors and observers. Check Rodale.com Thursday morning for more commentary. And, as always, I invite you to post your comments right here on Maria’s Farm Country Kitchen.

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21 Responses to Health Care Debate: “Death Panels,” Health Insurance Reform, and the Truth

  1. Heath September 9, 2009 at 8:39 am #

    It is refreshing to hear a reasonable response to the american health care hysteria. I am a Canadian health care worker, currently living and working in Canada with previous expereince working and living in the US. Even with employment in a healthcare system there were many times when I worked in the US that I had NO health care coverage. It would have been cheaper to get medivaced back to Canada if I was ill. I am astounded at the fear of some people in the US to the idea of health care for all. I really don’t think they understand exactly what their insurance companies are providing them (or not providing them) and the restrictions placed on thier health care. In fact, most US health insurance companies are much more dictitorial, controlling and restrictive than even the most conservative insurance provider in Canada. Sure our system is not perfect, but it is still a far sight better than what is available in the US for the average middle-classed family.

  2. Concerned September 9, 2009 at 11:14 am #

    Can’t your friend read? Everyone that applies for insruance gets a policy. This will tell you what is and is not covered. Or is your friend cheap and didn’t want to purchase a policy that covered anything because he didn’t think “he would ever need it”…”never been to the doctor”….that sort of thing. You get what you pay for and being in the insurance industry we see it a lot. “I don’t need that coverage.” Its the same way with life insurance. “I’m not going to die.” Well how stupid are you? The only thing that the Omaba health care reform is going to do is give more to the poor and take away from the middle class. Soon there will not be a middle class because everything that they have worked for will be stripped from them and given to the poor. The poor need to step up to the plate and work hard just like the middle class has to get them to the middle class. We see people all the time….their fat, lazy, baby makers and just don’t want to do anything but sit on the couch and watch tv and eat tater chips. They don’t take care of their possessions or their kids or even their own bodies. Sure so lets give them more reason to just sit there and do nothing. Their mentality is if I just sit here someone will GIVE me something. It is DUE me because I’m fat and lazy. Then there is the illegal aliens. Okay lets give to them also. Why not? They live here….don’t pay any taxes….the money they make goes back to their families in their home country….but why not GIVE to them too. What do they contribute to society? They don’t speak the language so we have to hire special people for them in the schools so they are not left out. When they get sick they run to the emergency room. In my household if your sick unless it is life threatening you’ll get better. A cold is no reason to run to the emergency room. But the illegals do because guess what we GIVE it to them. Healthcare reform is not the answer. GIVING to everyone all the time will not solve the problems. Taking from those that work hard to give to those who choose not to only takes away from those who choose to work. This country is in the toliet and it is swirling faster and faster because Obama keeps spending all this money. Have you ever thought where is all this money coming from? Hmmmm the middle class? No more bale outs. If you spend all your money and can’t make your business run then you should close your doors. Send the illeglas home to make it on their own in their own country where everyone speaks their language. Make those that don’t want to work get a job. I don’t care if it is digging ditches. All we have done is enable this whole country. And what does the future hold? Look around. A bunch of fat lazy kids following in their poor parents footsteps. Their has to be change but healthcare reform is NOT the answer.

  3. Not Onboard September 9, 2009 at 1:26 pm #

    Thoughtful comments. Ultimately though, anecdotal bashing of the insurance companies, that I know make easy and at times deserving targets, only points out where the reform ought to be directed, not to what should be replaced or scapegoated in the name of reform. Reform should not imperil the personal choice and freedom that your mother so elegantly seems to embody. If advocates for the proposed reform are really interested in where the fear of these measures originate, they must recognize that even if not stated explicitly, the proposals, if adopted, pose a serious threat to those who wish to remain in control of their own healthcare decisions.

    Focus on the uninsured and reforms to the system that protect the insured from manipulation by the insurers. None of this requires, public options, fines levied on individual citizens, or government panels making “recommendations” on treatments.

    Our nation and our free-market, capitalist system has taken a beating in recent years. But what remains unchanged is the fact that no other system in the history of the world has lifted so many people from poverty, provided so much opportunity for underprivileged, and a mechanism for health care, that although not perfect, has established a standard of care that most around the world envy.

    When reform initiatives are directed to curb the excesses or our system and place patient care as the priority, we will see a more unified approach to this issue.

  4. Concerned? Really? September 9, 2009 at 1:44 pm #

    Concerned, I couldn’t disagree more. Have you truly researched what you speak of? Did you know that poverty very often results from low wages – not laziness? Did you know that the average size family receiving welfare benefits is almost identical to the average size US family? Did you know that the welfare system pulls only about 1% of the Federal Budget? I don’t believe that all poor people don’t work hard. As a matter of fact, most of the people I know who don’t have much work long days, in less than ideal conditions, sometimes 7 days a week. There are so many people looking for work right now, employers can afford to pay less because someone will take the job. Skilled laborers are making just over minimum wage. Childcare is through the roof. People who made a good living once are struggling to put food on their tables WHILE WORKING, sometimes multiple jobs.

    I don’t necessarily know what all the right answers are, but I do truly believe that my family is no more important to me than yours is to you. For anyone to suggest that a whole class of people doesn’t know how to “work hard” and deserves to watch their families live on the streets, starve or die from lack of healthcare options is bigoted and irresponsible.

  5. Rufus September 9, 2009 at 2:48 pm #

    Really? You have said it all in response to Concerned!!

  6. fifty two percent September 9, 2009 at 2:48 pm #

    That’s the number…fifty two percent of my income goes to insurance. I have a family of three. My gross income is barely above poverty, I work hard at a job that I hate. I keep the job in order to keep the insurance and to hold my head up as I go the grocery store and use food stamps to buy one third on my family’s monthly food supply. My income is one half what I used to make ten tears ago. There are millions of us out there. Something needs to be done! Health insurance, copays and medications cost too much!!

  7. Chris September 9, 2009 at 2:56 pm #

    I agree that we need health insurance reform. However, government does best when it acts as a regulator/watch dog, and not when it acts as the provider. We need the government to set and enforce better guidelines for insurance companies. Insurance should not be tied to employment. Rather, you should be able to shop around for it just like you do for car insurance, and you should be able to buy across state lines, to increase choices and therefore increase competition among carriers. We do need some kind of stop-gap insurance for those who still are unable to afford it, and perhaps universal catastrophic health coverage would be a good idea. But, given that Medicare is billions in debt, and there are plenty of doctors that probably will never get paid for services they rendered under that plan, I don’t think the government really knows how to properly handle routine health coverage.

    Oh, and let’s add tort reform while we’re at it. Of course a patient should have legal recourse when true malpractice occurs, but there has to be some measure of practicality to it. Take Ob/Gyns for instance. They’re becoming more and more scarce b/c their liability insurance is so high. Since a developmental disability is defined as occuring before age 21, if a woman has a good enough lawyer, she can sue her ob/gyn when her child is diagnosed with a learning disability at age 16! No wonders doctors are afraid of that specialty.

    We talk of people needing to take more responsibility for their health. That’s a great idea. But, now stay with me here, we also need to take more financial responsibility for paying for it. Please follow me on this. The vast majority of people do have some kind of health coverage. That means that the vast majority really have no idea how much their health care costs. You pay the $15 co-pay for a doctor’s visit, the $50 co-pay for the ER, the $20 co-pay for your medicine. But that’s not what it really cost. Let’s look at Lasix eye surgery to explain what I’m getting at. When Lasix first came out, it cost $2000 or more per eye. No insurance covered it. People who wanted it paid out of pocket for it. People shopped around for the best quality surgery they could afford. That’s the true free market. Now, Lasix is only a couple hundred $$ per eye! Health care costs sky rocket when the consumer doesn’t know the real value of it. Whether it’s adding to the national debt or to the personal debt of those individuals (and yes, they are the minority) without any coverage, health costs will continue to escalate as long as the patient never deals with the real cost of it.

    We buy car insurance to protect us financially in the event of an accident. But, we pay out of pocket for routine maintenance. So, the consumer knows the value of the car repairs being done even if he only has to pay $200 if the repair is due to an accident and the insurance pays the rest. So, the consumer can then shop around for the best auto repair shop he can afford for regular maintenance. As a result, most shops are competitively priced. Now, I kow that we are talking a human life, quality of life, and not an inanimate piece of machinery. But, I think the analogy is still sound.

  8. DONNA September 9, 2009 at 3:36 pm #

    Here we go again. This issue will not go away because too many people have it all wrong and too many people aren’t thinking straight because of hot heads. People need to calm down so that they CAN THINK! We have a lot of issues on our plate. One thing leads to another and another and so on. We started out with this immigration problem, that hasn’t been fixed. Let’s try to do that first, because there are plenty of illegals in this country that, unless they have been here for years and someone can figure out “IF” they PAID TAXES, then they should stay and become legal and get the health care the rest of us may get, but ONLY if they contributed to the system. If not, ship them home.

    I am appealing to those of you who have sons, daughters,husbands wives, sisters and brothers in the military. When they come home and you hear their cries in the night from nightmares and pain from being maimed, broken mentally, spiritually,emotionally. When they can’t sleep or think and are extemely depressed, and you can’t get long term healthcare for them,because you failed to help the president reform the healthcare system,so that they will be able to
    forthe rest of their lives have some type of healthcare, for your and their well being. Are you going to listen to their nightly torment, while they writhe in pain daily? Who will you have to blame. You saw what happened when they came home a couple of years ago and got into Walter Reed Hospital. Did anyone take notice? Is anything being done continuously to improve conditions for them who put themselves on the line every day for us? Their very lives for us? Is this how we treat them when they come home? You will do this to them, people whom you claim to love so much? All because you don’t like the president or his so-called liberal ways or because he is a Democarat or a black man? All of you who are against reform should be ashamed of yourselves! How are you going to look in the mirror when you could have done something for them and didn’t? The big pharma needs to be controlled and these insurance companies are crooks. I’ve dealt with them a long time and all they do is take and take and when it comes time for you to use it, they make it impossible sometimes. Not all insurance companies are alike (health insurance), but most of them have that in common.

    Former President Clinton had everyone who was on welfare to find a job within two years or be taken off. Why didn’t that continue? I personally kno of young people on welfare who shouldn’t be on it, having babies so that they can stay on welfare. It’s shameful and I am thinking of turing them in. Using hard working money from the taxpayers to fund their living. They are young and healthy and need to get off of theirduff and work for a change. Stop burdening an already over-burdened system.

    We as a people in this “great country” of ours can only blame ourselves for the things that are happening to us. Where is that fighting spirit we had from the Revolutionary War up until the ’60’s, when we took to the streets if we didn’t like the way that things were headed in this country? Now, almost everyone seems lacakdaisal, just taking elected official’s words for everything. No one seems to use their haed and think for themselves anymore. They listen to their senators and congressmen and worse, Rush Limbaugh, and Fox News. Their word is gospel to most people now.

    How sad we are as a nation to listen to all of this nonsense from people, who again, are just getting rich off of us who tune in to them. We are not seeing a penny of this money they make and they are laughing all the way to the bank, saying “those idiots”, tell them what they want to hear and they’ll follow you anywhere. This happens in a country when things aren’t going well. A person rises up and leads you to hell. Happened in Nazi Germany also. Let us take the power back in our own hands and do what’s right for the nation as a whole. Let’s try to come together with cool heads and clear thinking to overhaul this health care system. We already pay a lot of money. Let’s put it to good use for us all.

  9. Maria (farm country kitchen) September 9, 2009 at 6:58 pm #

    Dear Concerned,

    Dude, my hope is that you are not accidentally caught without insurance one day. If that happens you might reconsider your opinions. Of course, if there is health care reform you may lose your job since insurance companies won’t be able to keep all their current people employed and then you might find out what it feels like on the other side of your current position.

    I’m trying to be polite.

  10. Sharon September 9, 2009 at 8:07 pm #

    To concerned:

    I hope that you never lose your job or insurance because then you will know what it’s like to walk in the shoes of some that are in that situation. I hope that you or your children never need help from friends, family, neighbors or strangers, AND if you do I hope that they help you no matter what your attitude has been.
    In my opinion, you have a very hard heart.
    As far as paying taxes, those illegals pay taxes in some ways. Most of the time you and I see the fruits of their labor but they don’t. Why don’t you take it out on the employers that benefit from the work they do.
    AND I suggest you look into your ancestry to see which county or countries you would go back to because your ancestors and mine were not born in this country unless you are Native American.
    AND by the way, the Spanish settled this country long before the English or any other country. (Just to let you know I am Irish, Scot,Welsh, English and German)

  11. Ralle September 9, 2009 at 8:08 pm #

    I will not take the time to do your research but you may want to look at the book “remaking health care” or “oxymoron: the myth of the health care system in america” but bottom line is two fold: we do not have the best system and the results show it, and 2, if you are a business owner, you are competing against companies in countries which do NOT have to pay the same high costs as our American companies. This is why businesses like WalMart and Safeway and hosts of others want reform, so they can compete.
    Understand, you will have more choice not less with reform.

  12. DONNA September 9, 2009 at 8:08 pm #

    Please read comment from Donna in Delaware WHAT FAMILY VALUES?……………… Rodale.com July 22, 2009

  13. DONNA September 9, 2009 at 8:13 pm #

    Read Philip Nance, WHAT FAMILY VALUES?…………. Rodale.com
    July 25,2009 in comment section and Donna in Delaware August 23,2009.

  14. Ethical obligations begin at home September 9, 2009 at 9:01 pm #

    Maria,

    Don’t you feel any hypocrisy for accusing insurance companies “whose lack of accountability and focus on profits leads them to knowingly and willingly destroy a family’s financial future” when you, leading a privately held publishing company where 100% of the profits go soley to you and your family , have laid off hundreds of loyal, local employees into an incredibly difficult economy, destroying their financial future and health care? Why do you think insurance companies should take losses based on moral or ethical obligations, but you and your company should be exempt?

    You mentioned two stories. Would it help to hear a couple more real stories about people you know, who are going through financial and healthcare hardships you have personally caused them by your decisions? Do you care? Or do you justify it by saying it is more important to maximize profits? How is that different from those evil insurance companies? You don’t even have shareholders to please. Our losses are your personal gain. Is it worth it?

    When you deposit those millions into your bank account, do you ever wonder about how we are doing without health care or jobs? Do you feel any responsibility?

    Before you flaunt your ethical superiority so publicly, you should think about your audience.

    I know you read these posts, would love to hear your response.

  15. maria (farm country kitchen) September 9, 2009 at 9:40 pm #

    I feel incredibly responsible, which is why I am willingly taking over the leadership of the company. Please know that the family has not gained personally from anyone’s losses. We are all in this together and the economy creates massive challenges for us all. But more people will benefit by us staying in business than those who would benefit if we let it fail. Our profits, when we have them, go into investing in our business, developing our employees and very generously giving to our communities. But our business decisions regarding employees should not put ANYONE at risk of not having health care. That’s the whole point.

  16. Amanda September 9, 2009 at 10:19 pm #

    Maria,

    So glad to hear you’re on the board of the Lehigh Valley Health Network. They are a fantastic health care provider, but have destroyed the practice of an amazingly talented Vally certified nurse midwife for defending the rights of a birthing mother. They should be ashamed of themselves. A brief summary of the story that lead to her losing her privileges is here: http://knittedinthewomb.com/wp/?p=376.

    p.s. I’m not quite sure how someone who seems to be a former employee could really equate the structure and characteristics of Rodale, Inc. with the average insurance company. Yes, please, do stay in business.

  17. Joan Weed September 11, 2009 at 8:42 am #

    Concerned: You need a proofreader badly. At least learn the difference between They’re, their, and there. See? Even people who can read make mistakes.

  18. DJ in PA September 11, 2009 at 10:00 am #

    Maria,
    Thanks for the rational and compassionate discussion of health care. We all see what happened to the mortgage industry when it was left unregulated, unsupervised and wholly unaccountable. So too the insurance industry needs serious adult supervision ASAP.

    Anyone at this point in time who still believes that unregulated markets can manage themselves more orderly and fairly than a schoolyard full of thirteen-year-old “Lord of the Flies” wannabes sans draconian adult supervision should be treated as flotsam from a turnip truck and immediately ordered to work as a middle school substitute teacher for a semester. Middle school subbing: where preconceived notions, personal self esteem and sanity go to die. If not in the midst of the classroom, recess or lunchtime brawl, then surely in the teacher’s lounge.

    Good Luck, Mr. Concerned! The kids will just adore you!

  19. Concerned September 16, 2009 at 10:11 am #

    Joan Reed

    Really?

  20. Dan in Georgia September 29, 2009 at 1:31 pm #

    The bottom line is the bottom line. We are broke. We cannot afford anymore government expenditures… period. The government must tighten its belt and let the economy and businesses recover.

  21. Jaylin June 21, 2011 at 10:27 pm #

    Oh yeah, faublous stuff there you!

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