Rant Warning

I said I wasn't going to get into politics, and I'm not directly, but what I want to talk about is something that is in our political discourse. That's one of the things about having a blog. You can write what you want to write.

I'm about to have surgery to handle a cataract. It's my second and when it is done my vision will be about as good as it was twenty-five or thirty years ago when I just needed reading glasses some of the time. I'm looking forward to seeing movies without glasses. The surgery is one of the modern miracles and I am glad I can have it done.

What I am not glad about is the screwy system we have for healthcare in this country. I went to get the prescriptions needed to follow up the surgery (totalling some $400 plus) and was told that my insurance company required a "preauthorization" despite the fact that the doctor's office had in fact been the ones who called them in in the first place. Last week while getting my presurgical physical I was aked to fill out a questionnaire for Medicare and was told that it will have to be done every 90 days so "they" can check the consistency of the answers. I suspect it has to do with trying control fraud.

Those of one persuasion will take the latter as evidence of why it is wrong to have the government involved, but in fact the system is screwed up not because of government but because of the insurance industry. (BTW, it was the insurance industry which wrote the laws now disparaged by the wingnuts as "Obomacare.") The scream is "Socialized Medicine!" but the facts are that it is Corporatized Medicine run by the insurance industry for the benefit of the insurance industry.

You think not. Get yourself copies of the various plans available for "Medicare Advantage," read them and try to figure out what you are being asked to pay for. BTW, Medicare "recipients" do pay for it, and if they want/need the drug coverage, they pay for these supplemental plans offered by the insurance companies. Most of you reading this know this, so I'm preaching to the choir.

The "OMG Not Socilaized Medicine" crowd doesn't recognize that someone besides them already "governs" the medical system--the insurance industry. They scream about "death panels," and refuse to believe what is already patently true, that the insurance companies already decide who can get what treatments under what conditions and at what costs, and effectively already ration healthcare, Each of those companies is its own bloated bureaucracy serving its own and not the patient's interest. Consider the company in my state (which will go unnamed) which decided that it should go public and issue an IPO, the primary purpose of which was to enrich the executives. Fortunately the state insurance commissioner put a stop to it.

And the wingnuts are all panicked about government "getting its hands on my healthcare."

There are as many different bureaucratic hoops for doctors and patients and pharmacies to jump through as there are insurance companies. I switched plans last year because the one I was on required a referral from my primary physician before I saw one of my specialists EVERY SINGLE TIME. I pretty much manage my own healthcare and I have 3 specialists I see routinely at least once a year--my skin doc, my urologist, and my eye doctor. That unnecessary work was not mandated by any government agency.

Going back to the form I filled out. I understand that fraud has been a problem with medicare. My guess is that there are more openings and opportunities for it due to the complexities in the system set up to allow multiple companies in multiple jurisdictions to have their own idiosyncratic procedural requirements.

Then of course they will start up on "tort reform." Funny thing how the lawsuits that are "frivolous" are the ones where it is not you or your child who has been injured. Saw an interesting documentary recently which showed several examples of awards which had been limited by state "tort reform" laws. In one case a family had been given an award by a jury intended to cover the lifetime costs of caring for a severely injured child, who despite the injury would be likely to outlive her parents and require continuing care after they were gone. The state law sliced the award to a one-size-fits-all $500,000 or so.

[Same film showed how all those things you sign when you sign up for a phone contract or internet service include clauses that surrender your right to seek redress for damages in court, requiring you to accept binding arbitration with arbitrators whose business comes from the companies. Personally, I think I'd rather have big bad awful government involved.]

But back to the primary issue. Nobody I know who has to deal with the system regularly is happy with how it has been, how it is now, or how it is about to change--not the docs offices, not the pharmacists, and not this patient for one. When I made the decision to get off of my plan in 2010 I called each of my doctor's offices and asked for the business managers. I asked them which of the insurance providers was easiest for them to deal with. None got rave reviews, but one seemed to be better for them so that's what I chose. Alas, it seems to throw some curveballs at my pharmacist. His comment: "You only have to deal with it once a month. Try having to deal with it every day."

As long as we shape our medical system to fit the needs of corporate interests it will remain screwed up, and as long as corporate money is the major force in politics, the system will be shaped to meet corporate interests. Parties left or right will remain irrelevant. And all the screaming about "Socialism" or "Death Panels," will be music to the ears of those who want us focused on the side show while they put their hands in our pockets.