Comments on: SO, HOW DO YOU KEEP IT AFFORDABLE WHEN THE PRICE KEEPS GOING UP? by Elmer Freeman

By: dianne

dianne — Thu, 13 Mar 2008 04:08:24 +0000

Betsey, Rebecca and Martha – People are also unable to find a doctor who will take Commonwealth Care members, nevermind waiting. A young woman I know had to call 7 doctors before she could find one who would see her and this doctor was an hour’s drive – one way. It’s hard to feel good about seeing a doctor you never heard of and you can’t get a reference because none of your friends knows anything about that doctor either.

So as a Commonwealth Care member, she now has to take a day off from work when she needs to see the doctor which she can’t afford to do because she is low income and needs every cent she can earn just to make ends meet – maybe. She can’t really afford the premium, nevermind the copays, and the 2 hours round trip uses a lot of precious gas.

The Connector has proposed a 14.3 percent premium increase and doubling several of the copays. Whether they raise her costs and copays the proposed amount or less, she knows she is probably going to have to drop the insurance and pay penalties because heat, gas, food and property taxes are skyrocketing. Therefore, the investment she has already struggled to pay each month will have been wasted.

By the way, Elmer Freeman, when we get our checks from the Feds this summer to spend on consumer goods and services to try to resuscitate the struggling US economy, we are not going to spend that money supporting this ugly law or paying Kingsdale’s six-figure salary. We will probably either pay off part of the heating bill or do something enjoyable that we couldn’t afford to do prior to receiving the check.

Furthermore, how dare you call this a success when at least 300,000 residents are currently paying penalties to subsidize those who get the insurance for free while the penalty-payers now can’t pay their bills and still have no health insurance?

By: CommonHealth

CommonHealth — Wed, 12 Mar 2008 13:49:56 +0000

Hi Rebecca – where are people waiting months to see a physician? Would you mind providing a few more details? Are these people waiting to see primary care docs or specialists?

If you’re rather e-mail me…marthab@bu.edu

Thanks, thanks, Martha Bebinger

By: rebecca

rebecca — Wed, 12 Mar 2008 13:03:25 +0000

As someone who works in a community helath center, while paying for school, life’s expense’s, and is trying to keep head above water, I applaud Betsy’s response. How and where do we begin to stike a balance in a system that has roots firmly planted in soils of profit rather than providing care?
I am a bit perplexed by the lack of discussion regarding increased numbers of those enrolled in care in relation to the wait time to receive care. More and more people are registering for care, but if access to care was a measurement of success in health care reform, I wonder where we stand. On one hand I see numerous people seeking care and having to wait months to see the physian thus utilizing the hospital for care or having the wait time exacerbate the illness. On the other hand, I see people who are unable to see their private physian because they are unable to pay the additional copayment ascribed to their private insurance.
Perhaps discussion on these topics exists and someone could point the way.
Rebecca

By: CommonHealth

CommonHealth — Sun, 09 Mar 2008 02:38:33 +0000

Hi Betsy – don’t stop there. Where would you begin the conversation about “how much health care is enough?” Is there an easy (easier) place to start?

Martha Bebinger

By: Betsy

Betsy — Sat, 08 Mar 2008 20:57:27 +0000

Well, let’s see — I work as a primary care physician. I’m rowing as fast as I can. I spend 50% of the 60-80 hours I work every week doing paperwork to try to get patients the medical care they need. I gross a less-than-six-figure income. I pay $2000 a month in student loans. I have no savings, no assets except personal possessions and a car, no retirement plan or 401K. I don’t think I can row any harder

I care for patients who struggle to pay the copays and deductibles for the medications they need for chronic diseases such as hypertension and diabetes. Some spend $400+ a month on medications even with their prescription drug coverage. Many of my patients who have Medicare decide every autumn whether they will buy their medications for the rest of the calendar year or buy groceries or heat their homes. I have a number of patients who have put off necessary health care because of high deductibles and co-pays. Some have suffered serious or life-threatening consequences as a result. I don’t think they can row any harder.

As I see it, a small number of executives in the insurance industry are pocketing large gains, as it seems that BCBS, HPHC, etc, remain quite profitable despite substantial increases in the cost of health care leading to substantial increases in the cost of health insurance. And most of the employees of these companies are not taking home all that generous salary or wages, while daily dealing with angry providers and consumers. A very small number of “suits” seem like the folks who need to row harder.

The underlying issue, however, is very real. As a culture, we have to ask ourselves how much health care are we willing to pay for, and what limitations are we willing to tolerate? If we do not set limits (and yes, I mean rationing in some form)underlying real health care costs will continue to climb rapidly, perhaps exponentially. “Rowing harder” doesn’t solve this problem. Only a true national dialogue on how much is enough health care for everyone will solve this problem. I don’t see the national willpower to hold that dialogue though. Politicians, whether liberal or conservative, would rather promise us easy solutions, either taxation based or market based, rather than leading us in a real discussion of limits.