Let’s face it, the status quo stinks

By now, most of are relieved that the August fuss and ruckus at the infamous town-hall meetings are behind us.

It certainly wasn’t pretty. Even in hindsight, the visual memories of the televised images of anger and hatred tend to linger like a disturbing dream.

What were people thinking, choosing to fight for the status quo over fixing a clearly dysfunctional marketplace? Wasn’t reform the choice of the majority of Americans in the last election?

What did the opponents of reform know that I, for example, didn’t know? Or vice versa.

Allow me to introduce myself properly. As a former daily journalist, newsroom editor and editor of a monthly public affairs magazine, I often found myself writing or editing stories from the medical, science and health beats. I’ve attended more than a handful of conferences on medical writing and editing. I consume news on a daily basis. I keep up with current events. I consider myself a fairly well-read person.

Yet it wasn’t until I joined Health Access a few months ago that I discovered a vast new, alarming body of health issues about access, affordability and consumer protection. Health and financial matters being fairly personal topics, I had no idea that health insurance as an industry had strayed so far from its intended purpose – or business model.

I mean, I knew from personal experience that my family was paying a lot more and getting a lot less from our doctors. It had even gotten to the point where I calculated I was paying $150 out-of-pocket for a 7-minute visit with my primary care doctor (who didn’t even recognize me.)

“Who prescribed this for you?” he’d ask, as the $21-minutes flew by. “You did,” I’d answer. “Wait three weeks,” he’d say, “and if you don’t feel better, schedule another appointment.”

So that’s the status quo – from my personal experience. That and the fact that my husband’s primary care physician of 18 years refused to speak to us on the phone. Not too bad – it certainly doesn’t stack up to the horror stories that abound when people get really sick.

Take the one about the young woman who was $22,000 in debt after getting the H121 virus and ending up in the hospital. No fault of her own. Or the woman who ended up $73,000 in debt for treatment of a rattlesnake bite. No fault of her own.

Or the homes lost, families shattered, credit destroyed by even larger medical debt. Or the fact that roughly half of all personal bankruptcies are caused by the doctor’s bill, the hospital bill, the refusal of the insurance company to pay up.

That was something I didn’t know.

Or that, from 2002 to June 2009, the six largest insurers in California refused to pay an average of 22 percent of claims their customers submitted. (The worst offender denied 40 percent of the claims filed.)

That was something I didn’t know: Imagine, a total of 45.7 million medical claims rejected from paying customers. Whoa.

If that’s what it’s like to be insured, imagine what it’s like to be uninsured.

Handy for us, the U.S. Census is scheduled soon to update that statistic from 46 million uninsured nationwide to … (fill in the blank) … your guess is as good as mine.

If that’s the status quo, then it’s high time to move on.

In the meantime, starting with this introductory entry, we’ll be
trotting out the status quo – and the amazing facts that expose the need for reform – from time to time in this blog.

Just think of it as a reminder that, when it comes to insurance reform, the status quo is whole lot scarier than the reform to come. Change has got to be an improvement.

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