That is a sad article. It seems to me the "American way" is to get a paying job with health benefits early, and then worry about being generous and giving back to society later, if ever.
I don't know much about liver cancer, or if catching the cancer two month earlier would have made much difference, and I hesitate to argue with the bereaved, but I guess I will.
I have had colleagues with excellent medical coverage and excellent medical care (Mayo Clinic) who have died from cancer in their early 40's. Sometimes there is just so much medicine or government or insurance can do.
I haven't followed the badger family saga in great detail. Academic Coach and Bitchphd know more. I do know that in important areas of palliative care their insurance (which she got through school--it wasn't employer based) ran out and that a collection fund had to be taken up to get the family into palliative care (hospice). profgrrrl might know more, since she linked to it on her blog. A transplant had been recommended, but it wasn't covered.
Do you really think that the employer-based system is adequate? What about the freelancers and the self-employed? In Massachusetts, we've got community rating, and California has guaranteed issue for individual insurance, but in a lot of places it's medically underwritten, and the insurance companies will reject you for even the tiniest reason.
Do you know what your remedies are if your employer-based (self-insured) plan wrongly denies you a treatment? It's the cost of the treatment. So, if you wind up permanently disabled because of a stroke which could have been caught with a medically necessary test, you can not sue under state malpractice laws. You can not get consequential damages. So there is no incentive to prevent the insurer from denying your claim.
Tripp, yeah, I had thought about that; it's certainly a possibility that their having health care coverage wouldn't have saved Mr. Badger's life. Still, though, this current system has put Badger in a lot of debt and cost her far too much time and worry at a time when she already had so much to deal with, as bostoniangirl explains. To be sure, I understand that you sympathize with Badger and her family's plight and are just pointing out what might have been an unavoidable and unfair fact. The whole situation is just heartbreaking.
Lost respect for Gladwell there. $20 copays aren't a big deal to him, but they're a big deal to poor people. Co-pays aren't about making people smarter shoppers, they're about rationing healthcare so poor people can't get it.
My point is, as always, if the pain, suffering and humiliation of medical care aren't incentive enough to get you to shop intelligently for medical care, why would money do it? Given a choice, wouldn't you rather waste money unnecessarily than have your chest cracked open unnecessarily?
The assumption is that a lack of proper motivation on the part of patients that explains why they get bad medical care. But it's obvious that patients are PLENTY motivated--they're not the problem. THe problem is a totally screwed up system in which every other player isn't motivated enough to give them the best care.
Co-pays are just healthcare rationing by cover charge. If you can't pay the cover charge, you can't get in the door and go to the all-you-can-eat buffet. Nice deal if you're well-off.
This thread is old, but I don't want to spam the others. For those of you in Massachusetts who are interested in expanding access to health coverage, please consider signing the MassACT petition to get an expansion on the ballot in 2006. The goal is to goad the legislature into acting on legislation put forward by Health Care for All of Massachusetts.
It will expand MassHealth, restore coverage of dental, eyeglasses and smoking cessation tools.
It will expand the insurance partnership program which helps lower-income folks pay their portion of a private premium.
It will remove the surcharge on private insurance which currently funds the free care pool.
New revenue will be raised through a 60 cent increase in the tobacco tax and by assessing a 4% payroll tax on employers up to 100 workers, and 6% for larger employers (the 1st $50K is exempt) which will be refundable upon a showing that you have spent that much on employee healthcare. Most employers who provide healthcare spend around 20% of payroll on health benefits. This just means that those who currently spend nothing will have to pay toward the cost of covering their workers.
Theora, I think Gladwell thought that $20 was okay for things of dubious clinical value. People will go to chiropracters for fun.
Okay, I realize that I forgot to provide the link. If you want to sign the petition, you can download it for yourself and then mail it in from this site:
And how does Ogged have a linkless quote from an e-mail to Kaus? Have we ever seen them together?
Posted by Matt Weiner | Link to this comment | 09-12-05 3:56 PM
[You tell me. --ed.]
Posted by ogged | Link to this comment | 09-12-05 3:58 PM
At least I still have Kaus.
Can ogged both have and be Kaus?
Posted by slolernr | Link to this comment | 09-12-05 4:06 PM
That conjures up a sad, sad image of Ogged/Kaus hugging himself in his lonely bed....
Posted by Matt Weiner | Link to this comment | 09-12-05 4:18 PM
No wait, I've seen pictures of Kaus. Replace "sad, sad" with "deeply hilarious."
Posted by Matt Weiner | Link to this comment | 09-12-05 4:18 PM
Actually, when you're poor $20 co-pays can be a lot. There's some research showing that some people drop healthcare even at that level.
Posted by bostoniangirl | Link to this comment | 09-12-05 4:20 PM
Here is an important post about the devastating consequences of our health care system. (Her husband passed away on 29 August 2005.)
Posted by Clancy | Link to this comment | 09-12-05 4:52 PM
Argh.
Posted by ogged | Link to this comment | 09-12-05 5:14 PM
Clancy,
That is a sad article. It seems to me the "American way" is to get a paying job with health benefits early, and then worry about being generous and giving back to society later, if ever.
I don't know much about liver cancer, or if catching the cancer two month earlier would have made much difference, and I hesitate to argue with the bereaved, but I guess I will.
I have had colleagues with excellent medical coverage and excellent medical care (Mayo Clinic) who have died from cancer in their early 40's. Sometimes there is just so much medicine or government or insurance can do.
Posted by Tripp | Link to this comment | 09-13-05 9:04 AM
Tripp,
I haven't followed the badger family saga in great detail. Academic Coach and Bitchphd know more. I do know that in important areas of palliative care their insurance (which she got through school--it wasn't employer based) ran out and that a collection fund had to be taken up to get the family into palliative care (hospice). profgrrrl might know more, since she linked to it on her blog. A transplant had been recommended, but it wasn't covered.
At one point the pharmacy benefit ran out, and the pharmacist only dispensed just a couple of morphine pills.
Do you really think that the employer-based system is adequate? What about the freelancers and the self-employed? In Massachusetts, we've got community rating, and California has guaranteed issue for individual insurance, but in a lot of places it's medically underwritten, and the insurance companies will reject you for even the tiniest reason.
Do you know what your remedies are if your employer-based (self-insured) plan wrongly denies you a treatment? It's the cost of the treatment. So, if you wind up permanently disabled because of a stroke which could have been caught with a medically necessary test, you can not sue under state malpractice laws. You can not get consequential damages. So there is no incentive to prevent the insurer from denying your claim.
Posted by bostoniangirl | Link to this comment | 09-13-05 9:47 AM
Tripp, yeah, I had thought about that; it's certainly a possibility that their having health care coverage wouldn't have saved Mr. Badger's life. Still, though, this current system has put Badger in a lot of debt and cost her far too much time and worry at a time when she already had so much to deal with, as bostoniangirl explains. To be sure, I understand that you sympathize with Badger and her family's plight and are just pointing out what might have been an unavoidable and unfair fact. The whole situation is just heartbreaking.
Posted by Clancy | Link to this comment | 09-13-05 10:08 AM
Lost respect for Gladwell there. $20 copays aren't a big deal to him, but they're a big deal to poor people. Co-pays aren't about making people smarter shoppers, they're about rationing healthcare so poor people can't get it.
My point is, as always, if the pain, suffering and humiliation of medical care aren't incentive enough to get you to shop intelligently for medical care, why would money do it? Given a choice, wouldn't you rather waste money unnecessarily than have your chest cracked open unnecessarily?
The assumption is that a lack of proper motivation on the part of patients that explains why they get bad medical care. But it's obvious that patients are PLENTY motivated--they're not the problem. THe problem is a totally screwed up system in which every other player isn't motivated enough to give them the best care.
Co-pays are just healthcare rationing by cover charge. If you can't pay the cover charge, you can't get in the door and go to the all-you-can-eat buffet. Nice deal if you're well-off.
Posted by theorajones | Link to this comment | 09-15-05 8:17 AM
This thread is old, but I don't want to spam the others. For those of you in Massachusetts who are interested in expanding access to health coverage, please consider signing the MassACT petition to get an expansion on the ballot in 2006. The goal is to goad the legislature into acting on legislation put forward by Health Care for All of Massachusetts.
It will expand MassHealth, restore coverage of dental, eyeglasses and smoking cessation tools.
It will expand the insurance partnership program which helps lower-income folks pay their portion of a private premium.
It will remove the surcharge on private insurance which currently funds the free care pool.
New revenue will be raised through a 60 cent increase in the tobacco tax and by assessing a 4% payroll tax on employers up to 100 workers, and 6% for larger employers (the 1st $50K is exempt) which will be refundable upon a showing that you have spent that much on employee healthcare. Most employers who provide healthcare spend around 20% of payroll on health benefits. This just means that those who currently spend nothing will have to pay toward the cost of covering their workers.
Theora, I think Gladwell thought that $20 was okay for things of dubious clinical value. People will go to chiropracters for fun.
Posted by bostoniangirl | Link to this comment | 09-21-05 1:27 PM
Okay, I realize that I forgot to provide the link. If you want to sign the petition, you can download it for yourself and then mail it in from this site:
MassAct
Posted by bostoniangirl | Link to this comment | 09-21-05 1:29 PM