Letter: Response to MacKenzie health care letter

By on October 1, 2009

I read Jeff MacKenzie’s letter on Sept. 17 in the Elburn Herald and would have a hard time finding anything as negative as what he wrote and in fact, had a hard time reading it period. His statements below are in quotes.

“Migration to the government price—a profoundly lower price—is exactly what I need.”

Obama has never shown us concrete premiums for his plan. But a possible comparison is the Illinois insurance plan CHIPS. It’s state insurance for people who can’t get insurance elsewhere. Yes, that’s right, there already is government health care available.

But a family of four, parents in their 40s, two children under age 19, would pay $870 per month, with a $5,000 deductible each. My husband and I, both age 62, would pay a total of $1,624 per month with a $5,000. deductible. This gives you a factual premium cost of a healthcare plan run by the government.

Obama says the insurance will be paid for by those who use it, not out of taxpayer’s money. First of all, we know taxpayer money is already earmarked to be used.

And hurrah for you, Joe Wilson, yes Obama lied. Nothing will change with a government plan because those who can’t afford it still won’t be able to pay for insurance coverage. Except now they’ll be fined by the government for not buying it. We all know that government red tape will make it just about impossible for someone to prove that they can’t afford the premiums and avoid the fine.

“Pricing”: Jeff said doctor income needs to be substantially reduced. I have a friend who’s a doctor, and with the participating provider deductions from insurance companies, his income has consistently gone down over 25 years of practice. In other words, the more expertise he has, the less he gets paid. Doctors go through a long period of education before they can start making money. If the doctor is good, and especially if at times our very lives are in their hands, they deserve to be paid very well.

One year ago, I had cervical spine surgery in which the surgeon cut through the front of my neck, moved my esophagus and vocal cords to the side and filed down deformed bone that if left alone, would have possibly severed my spinal cord and paralyzed me from the neck down. A good orthopedic doctor found the problem and besides him, I consulted with two excellent neurosurgeons, before choosing the doctor who did my surgery.

There was no choice in the matter if I didn’t want to risk paralysis, and I had to trust that my doctor, the nurses and support staff, including a second neurosurgeon who assisted at the surgery, would bring me through. I had to trust that the anesthesiologist whose hands I was in would know what to do if I had a reaction, since I am extremely sensitive to medications and had never been under general anesthetic before.

The total bill for everything was $99,278.12. I can’t visualize what every minute of my five-hour surgery entailed and I don’t want to. No one involved received 100 percent of their share of the $99,278.12. My main surgeon’s bill was reduced by Blue Cross by 31 percent for his 35 years of expertise working around my spinal cord for five hours.

His “assistant” neurosurgeon received less than $1,000. If he’d had to step in for any reason, or simply because he “assisted,” he was worth a lot more than that.

I never experienced a headache or vomiting from the anesthesia mix that the anesthesiologist designed. He was paid $1,887 for keeping me alive for five hours.

My physical therapist restored all movement to my arms, shoulders and neck after the trauma of the surgery, and Blue Cross reduced his and his facilities payment by 50 percent. The nurses at the hospital stayed by my side, administered medication and checked on me every 10 minutes from the moment I hit my hospital room. For their excellent care, the use of pre- and post-surgical rooms, the operating room and all medications, including two nurses who stayed with me 100 percent of my time before, during and after surgery, the hospital’s bill was reduced by 29 percent.

The radiologists, labs and pathologists charged a total of $313.70 for their services, but only received $71 total. A total of $67,812.65 was written off by Blue Cross as a PPO reduction. I would say that doctors income has already been substantially reduced.

“The general public trusts their doctors—I’m not sure why.”

If a doctor has been successful in making you well or has handled a successful surgery, why wouldn’t you trust him/her?

“Medical liability should be eliminated.”

Here’s an example of why it shouldn’t: My husband had a friend who died of cancer at age 24. He had a growth on his thigh the size of a baseball. He was in a car accident and the surgeons needed to do a bone graft in his back. They took bone out of the leg with this baseball size growth and put it in his back. He died a short time later when the cancer therefore spread like wildfire. His young wife was left with medical bills which she figured she’d never pay off in her lifetime. What happened to him was not a simple mistake—it was gross negligence and his wife should have been able to sue and get some help with those bills.

Any doctor can make a mistake, just like any office worker can. But when something turns out to be gross negligence by a doctor, the injured patient or their remaining family have a right to compensation. Where the courts have failed us is when they’ve allowed huge payments on minor or non-negligence suits. The ones that, however, are justified, deserve to be paid.

“The pharmaceutical industry would have us believe that their high prices are necessary to support research. Far too little of their spending is on research” and “Pfiser has a single drug from which they get $68 billion a year.”

Please inform us of the drug’s name and how you got this information so I can research it. C’mon, Elburn Herald. When I did research for a letter in which I commented on building an Aldi’s near my house and included several hours of research on area stores that I carried out, you refused to publish the research as “you had no way of knowing if it was true.” But you publish an outlandish figure like $68 billion on this guys word?

“Healthcare costs the average American more than $10,000 per year.”

Again, show me where you got this statistic. I’m 62 years old and never in all my years of illness and minor and major surgeries have I ever paid out $10,000 in one year.

“A short time ago I voted for Democrats.”

Ah, finally we know where the problem is.

I’m a former employee of both a pharmaceutical company and a hospital, and a patient who has had several surgeries and here’s what people need to think about.

1. Let’s say you have a brilliant daughter who gets a masters degree in chemistry and biology. She’s hired by a pharmaceutical company as part of a team to work on a cancer drug. What should she and her team members each be paid? What is the cost of lab space, equipment and support staff (such as me, who sat for hours typing drug reports for the FDA)? The team works for seven years minimum. Finally the drug is approved by the FDA for human testing. In the cross section of people who offer themselves as guinea pigs, only 1 percent suffers a serious side effect and so the FDA approves the drug. The public loves the drug company at this point.

Once on the market, a larger percentage of patients experience the serious side affect, or new ones appear, and the company decides that it would be cheaper to take it off the market than to pay lawsuits and to risk anyone else from having the side effects. They now have no profit whatsoever on the drug and the people who could have benefited no longer have this drug available.

Now the drug company is an evil monster. (Read the excellent book “The Killers Within,” by Shnayerson/Plotkin, to see the costs to fight the current antibiotic-resistant bacteria problems. The Chicago Tribune’s business section recently wrote that Baxter Labs is investing $435 million into Alzheimers research.)

Let’s say they work several more years on this drug, and the serious side effects have been addressed. At this point the drug company has made no profit. And let’s say the drug company must now charge $100 per month for the drug in order to cover costs and make enough of a profit so that they can now work, for seven years on other promising drugs.

But countries with socialistic medicine, such as Canada, decide $100 is too much, and will only let them charge $80. To make up the difference the company must charge Americans $120. Thus our higher drug costs.

President Bush understood this and was vilified as siding with the evil drug companies when he tried to make it illegal to buy drugs in other countries.

The drug companies are trying to help us, not hurt us. Over the years they have created thousands of drugs which have made life easier and saved lives. When they release a drug, there is always the fear a side effect will rear its ugly head. All the side effect warnings on the package inserts need to be taken very seriously before you pop any pill, including an innocent seeming aspirin, into your mouth. They cannot control how each individual body handles a drug. These drugs are, in fact, very expensive to create and manufacture.

2. The insurance companies may be profit makers but they are not the devil. Why are we so against a profit when that is exactly what we wished all the companies like AIG had produced?

By offering lifetime payout limits and not covering pre-existing conditions immediately, insurance companies can offer cheaper plans to employers. This is how they stay competitive. Obama says he won’t allow insurance companies to have lifetime payout limits and that they’ll be forced to cover pre-existing. This sounds good in a speech before Congress and the nation, however, where will the money come from as the insurance companies costs skyrocket? How will employers pay the higher price for this? And Obama never tells you that they will cover a pre-existing condition after a waiting period, usually six months.

3. Few people know that when Congress enacted President Bush’s Medicare drug program that private insurance companies were no longer allowed to offer drug policies to Medicare patients. The government program couldn’t survive if it had private competition. Government backed healthcare will have the same problem.

4. That illegal aliens wouldn’t be able to buy Obama’s insurance only leaves them in the same place—ER visits where they can’t be turned away. We will all continue to pay their expenses. Since they are illegal, the government won’t even be able to fine them for not having insurance.

5. A solution: When your children graduate from high school or college and are no longer covered on your plan—get them their own individual coverage immediately while they’re still young and in good health. There are many different plans available through Blue Cross alone that can be viewed at www.bcbsil.com.

If they never let it lapse, they will never be without coverage despite an illness or job loss. My son has had three jobs. Two of them didn’t offer any insurance at all. The one that did offered an insurance policy that wasn’t as good as the individual policy he took out immediately after college. Through 14 months of unemployment he had full insurance coverage. We need to get our young people on individual policies immediately

6. Having worked as an insurance verifier at a hospital, I saw the number of people who didn’t have adequate insurance, or who had Medicaid that paid very little. I spent a great deal of time fighting with insurance companies so they’d cover patients. The hospital was often underpaid for their actual costs. That in turn, goes on others bills so they can afford to stay open. What happens when the government reduces all payments?

I also saw how, despite their discounts and PPO reductions, insurance companies usually do pay for necessary surgery. I saw that HMO’s are often flawed as they often deny patients much needed care because their primary doctor makes poor decisions.

When you think of Obama’s health plan, think HMO. And think that the government will find a way to reduce all payments to the point where expert doctors and their staffs, can no longer afford to do what they do so well. Our healthcare system will decline.

I’ve heard of people from countries with socialized medicine waiting months to get a doctor visit or medications, or being denied tests that were crucial to a solid diagnosis. A nurse at the hospital at which I worked brought her mother here from Ireland because their socialistic medicine could not supply a life-saving drug for six months, but she could get it here in one day.

This is because of the current healthcare that is, in fact, so good here. Some writers have claimed that other countries pay 13 percent of their income for healthcare and that it is a lower rate than we pay here. You have to look at all of their taxes. On the Internet, you’ll find that countries such as Norway charge as high as 75 percent of income for their socialism. Who’s to say what part of that goes to healthcare? My husband doesn’t pay anywhere near 13 percent for our insurance.

7. Finally, a note on Medicare. I see the government trying to chip away at it. Medicare was created because all people who retired were suddenly without health insurance after leaving their jobs. This left a vast amount of people who had earned their way suddenly in a dire situation.

Every legal American currently living has paid into Medicare, (along with, actually, many illegal aliens). The actual costs for co-payments and deductibles aren’t cheap once you get it. And when people say that the elderly cost so much more than everyone else with all of their medical problems, I want them to consider all of the health and accident issues caused by young careless drivers and anyone who is drug and alcohol addicted. Take a look at your medical insurance and you will probably find that insurance covers more for drug and alcohol addiction that it does for someone seeking help for other mental conditions.

What about babies who would have never survived before but now do because of expensive medical procedures? Get off the backs of senior citizens, whose age-related issues you will inherit one day. Age discrimination is rampant in the healthcare discussion.

Obama constantly brings up the inflated figure of 30 million people without insurance. A Google search shows that about 250 million Americans do have insurance.

The recent protest against our president’s speech to schoolchildren shows that more and more Americans are now distrusting a man who they should have distrusted before they voted him into office. Just because he can go on TV and have the last word doesn’t make that word truthful or right. People at town hall meetings are screaming for the same reason we all do—you scream when you aren’t being heard.

The fact that even Obama’s democrats are having a problem with his health plan shows that they either truly see all it’s faults or that maybe, just maybe they’re finally hearing us.

Paula Coughlan