Maggie's Farm

Barrister, the Brownstein piece was badly written.

I think that everybody should be obliged to buy themselves at least catastrophic health insurance, just as we are all forced to carry insurance in order to drive. How else to keep all those noble lawyers and insurance company executives in pottage??

I could rant for hours about a loathsome person I know who would not buy any health insurance, claiming poverty, while driving a new Mercedes, living in a house over a million, and zealously trying out every home decorating project on HGTV. Who, when a family member suffered a catastrophic and unexpected illness, stuck their fellow citizens with a half million tab, while hiding almost that much cash. There have always been thieves and moochers. And inefficent government cannot always separate them out from the truly deserving, let alone run efficient programs.

BUT: our private insurers often treat the sick and disadvantaged wickedly. They can be brutal to families trying to buy individual health policies where the parents' work does not provide health insurance thru an affordable group plan. For example, when a kid (or any family member) has a pre-existing condition or a chronic health problem.

Many citizens, rich or poor, hardworking or lazy, are not in perfect health. If your employer does not insure you and you go to buy an individual plan, (if you can get one for the family at all)they may well specifically exclude health coverage for the illness or disability concerned. Got a family member who has ever been treated for depression? Future treatment for it may well be excluded. Got a kid with a developmental disability? Individual health insurance ( and sometimes even generous employer provided plans) will specifically exclude therapy and treatment that is not just restorative (ie: of the type that returns a healthy person whose leg is injured in a car crash back to walking properly). In other words, if someone cannot be made "normal" they are written off and not funded. Unless one is lucky enough to have a generous corporate or governmental health insurance plan that still covers ongoing care for chronic or developmental conditions, one is stuck. Just good business practice, I'm told. Have to protect those shareholders.

Tell me how many hard working middle class parents can exercise their "basic parental responsibility" to cover, say, a three months' hospitalization for a psychotic, suicidal eight year old unresponsive to loving parental care, church prayer, every hideously expensive psychiatric med known to man or woman, therapies galore, etc. when both parents are working for less than 15 dollars an hour in a market that views people over 40 as dead meat and overqualified people as unwelcome hires....Letr alone stay employed when hospitals on a short insurance company leash release the suicidal and violent and psychotic out into the "community" needing 24 hour care by their parents. In our family, one of us lost a job because of employer balking at having their insurance rates raised after a claim or two of ours. Another time, one of us had to quit to watch the ill kid who could not be kept supervised safel otherwise. , The really ill or unnerving ones cannot be farmed out to sitters(even if one were willing to do it, as we weren't) because the sitters quit.Many parents take on second and third jobs to pay for inadequate health insurance that cannot cover their family members' illnesses. In such cases, who else can they turn to but their government?

I grant you that there are many abuses. When my spouse was unemployed and overqualified for everything he applied for, I kept us fed by working a little over minimum wage, despite Ivy degrees. Was glad to find anything. Worked hard, got promoted, survived gratefully. But it made me livid seeing the surcharges on our bills, that we (and not insurance) had to pay in addition to the copays we expected at the local Millionaires' Club hospital. We were told that they were "for the uninsured". We had bought individual health insurance and paid a fortune for it, but the scroungers in the projects drove SUVS, carried cellphones (when they were still new and a luxury) ate steak.Meanwhile, we patched together a car with 220,000 miles on, walked most places, washed and line dried diapers, and ate beans, rice and vegetables grown in a dug up tiny back lawn. I called it my Victory Garden. But the point is, I felt like punching the professional moochers who grew fat and lazy while I did what I could to be a responsible parent.

Where the rubber met the road, when disaster struck, and where government kept us from becoming homeless and declaring bankruptcy, was when, years later, after I had taken a job strictly for the health insurance, the company would not cover the hospital care necessary to keep my kid alive. For that, I had to turn to government, and a state bureaucracy and state hospital that was actually far more efficient, compassionate and got better care for my kid than the world famous teaching hospital (that caved to the insurance company and released kid way too soon), mean spirited private insurance company, and liability obsessed caregivers in the private market. I remember in particular, one weeping foreign doctor at a terrible subsequent private hospital (the only one for hundreds of miles with a kiddie psychiatric bed available at the time) telling me that he had to release the suicidal kid because the insurance company had asked him "Did the patient engage in any suicidal behavior in your sight in the last 24 hours?" "Uh...no" "Then no more care will be authorized."

Not everyone is personable and able to mobilize a smilling community to "Pay for Cute Josie's New Kidney!" Some families are ground down by four jobs between two parents, logistics of keeping several beloved kids safe, educated and cared for, and constant worries that their work will be outsourced by !@#$ole investment types' advice to their employers.

You will doubtless dismiss these overly personal comments as whine, whine, whine. But I met many people in far worse circumstances than we were (after all, couples who stay married, families who have loving churches, people who manage to live frugally, as we did, have an easier time). We were responsible parents. But when things were at their worst, temporary government help kept our kid alive, got kid better, and left us grateful. Entitlement programs like welfare, it's true, have had appalliing unintended consequences. But that does not mean that all governmental aid should be thrown out with the bathwater.

Years later, when things have greatly improved (thanks to a steady job and a generous employer plan, and our family still spending more on annual out of pocket medical expenses than a luckier family would on private school, vacations and a Land Cruiser combined), I feel strongly that there are many cases where government should help those in the bellly of the beast. The sick, the disabled, the elderly, the frail, those needing a temporary helping hand so that they don't give up in despair.

Of course there are abuses. Of course socialized medicine can be a disaster (my parents each died at least ten years earlier than they would have done in this country because they got delayed, inadequate care under socialized medicine of the type that piece on Canada linked to in the blog described....). But a governmental safety net, vigilantly monitored for abuse, is a good thing.