August 24, 2009. I was waiting outside my hotel in Hamden, Connecticut for a ride to my former husband’s Wake when a car pulled up in front of me and a woman leapt out, waving some papers. “This is terrible! Have you seen what this guy wants to do? This health care thing! It’s awful! “
I guess my reaction was not as powerful as she would have liked, so she went on. “Have you read it?’ Picturing a 3000-page document typical of such legislation, I indicated I had not. “Well, she said, I have – all 119 pages, and it’s just awful!”
At that point Lou’s niece drove up to take me to the wake. I never did find out where those 119 pages came from to which the woman was referring. All I know is, they must have been someone’s summary – oversimplified summary.
May 31 – June 1, 2014 I attended an amazing weekend called “Top Coast Festival” at the University of Minnesota, co-sponsored by Minnesota Public Radio. Someone explained the name came from the fact that Minnesota is neither East Coast nor West Coast, but “Top Coast.”
At any rate, there was so much I’d like to share, but one piece at a time. I’ve included the link to the program in case you are interested/curious.
I try to resist buying the back-of-the-room books. Mostly what my unread books are doing is creating a stack high enough to serve as a table. But there were two I couldn’t resist. This post is based on one of them. The interview was just too fascinating to pass up the author’s book.
Emanuel, Ezekiel J. (2014) Reinventing American Health Care: How the Affordable Care Act Will Improve our Terribly Complex, Blatantly Unjust, Outrageously Expensive, Grossly Inefficient, Error Prone System. New York: Public Affairs
I have actually read 85 pages of the 124 page “Part I: The American Health Care System.” I thought I knew something about it as a practitioner. Now all I can say is “Thank goodness I don’t have to take a test on the hodgepodge that has developed over time as the American Health Care System.” Moreover, I’m impressed with the job our lawmakers have in sorting through the morass.
The data say it all. We do have a “Terribly Complex, Blatantly Unjust, Outrageously Expensive, Grossly Inefficient, Error Prone System” that needs fixing.
All I ask as the purpose of this posting is for people to avoid making uneducated decisions. Oh yes! They have to be uneducated unless one is willing to plow through the history and the data with the kind of attention you’d give if you were preparing for an exam. But please don’t accept the one-liners our political ads and media snippets have to offer.
There are things we can learn if we are willing to make the effort.
monagustafsonaffinito 
Mona, as far as I am concerned the affordable Health care act is unaffordable for me and for many of my hard working responsible friends. I now have insurance through Obama care as my insurance was cancelled and I was FORCED to change. I liked my old insurance. Now I can not afford to go to my Oncologist, my heart Doctor and my dermatologist , they are who I really need. So much for protecting people with pre existing conditions with low income. Time to get a third job!
I am offended by comments from people with good insurance like I USED to have (actually better than I used to have) and paid dearly for for 27 years, (to a person, these folks were not cancelled because they were exempt) they think I should be happy for the country’s new health care system. It is easy to sit back when not impacted and pontificate. This new system is terrible. I do not need to read books by people who feel they have digested the policy and are now profiting on their point of view. Nor do I need to read the entire law to know it is not working for me, or my hard working friends.
All the self employed people I know that have paid for their own insurance completely for years have had their insurance cancelled and gotten a 70% increase in premiums with high deductibles under the new affordable health care insurance. They too hate it. Then there are the people not affected at all by it who love it, the people who never had insurance and probably won’t get insurance cause they really don’t care, that will be penalized for their apathy and the people that can’t afford to get insurance that will get it totally free.
Oh my, Linda. If ever anyone didn’t deserve lousy things to happen! I’m sorry.
Having said that, I’m really delighted to receive this comment. I’m happy to know you’ve been reading my blog. I think of you often, and of your wonderful personally created home. All the things you do so well.
I’ve been bad about following Facebook. Maybe if I’d been there more often I’d know more about how things are going for you. But this one fact does please me — that you’ve been following. I hope your health has moved beyond all crises.
No argument from here. The health care system is out of control – in so many ways. The explosion of knowledge that allows for previously incomprehensible evaluation and treatment. The belief, widely held, that absolutely everything available must be done without regard to cost. The tendency we have to expect positive outcomes and error free service from all aspects of the system and the tremendous cost of prtecting practitioners from potentially career ending suits that result from human error. I would never want to excuse malpractice, yet “blame” has become so much a part of the growing potential for near miracles that we would like to be able to find someone at fault for disappointment and pain – no longer acceptable as part of life. The huge cost of education to prepare doctors and other advanced professionals and their need to get bills paid leading often to chosing specialties rather than the more routine and less lucrative family practice. In an effort to “reduce” costs and dispense with suspicion, the paperwork required to justify care delivered has become so complex and detailed that the need to prepare and hire and pay personnel to assure compliance has added its own expense. And I take issue with the need to review extensive documents in order to understand what protection is available. There are so many people who do not have that ability. The complexity of decision making regarding Medicare is far more than many elderly people can begin to comprehend. Frankly, I who has worked in health care for nearly fifty years, am easily confused. We judge so harshly those who depend on Medicaide, most working so hard just to feed and clothe the family. We make countless decisions to suspend expensive programs and intitutions promising “community service support” and then cut the budgets for those services. We fail to acknowledge or arrange for care for people who are examples of “successful” medical advances – people of advanced age, people with a host of disabilities who who have died years ago were it not for all we can “do to save them”, the risks frequently associated with severely premature infants whose survival depends on extraordinary costs and whose lives often require ongoing social/educational support.
Yes, we are in a huge mess. And I don’t believe the answer lies in reams of paper explaining options, severing relationships with long time doctors and denial of some of the realities of life itself.
We have a long, long way to go and the solution likely lies in letting go of some formerly firmly held beliefs.
I have finished 150 pages of Emanuel’s book, first on the state of the problem and then on the history of attempts to fix it. I hope I can find time tomorrow to blog a bit more about it. All I can say is, the complexities are too much for me to handle, (i.e. I’d fail the test) including all the political stuff that has entered into attempts at solution, along with all the kinds of things you point out based on your experience.
Thanks for taking the time — as if I didn’t know you are bursting with the need to say it. I wish everyone had even a fraction of the experience you’ve had.