Is the Fire Department a Socialist Organization?

Everyone who thinks that all American entities should make a profit, remember this: before we had our current "socialized" police and fire departments, these functions were performed for profit by gangs of street thugs who demanded payment before responding to a crime in progress or dousing a fire. In case of fire, if you hadn't paid off a particular gang or didn't pony up the cash, your home or business would burn, frequently taking the whole block with it. Whichever gang arrived first supposedly got dibs on fighting the fire (and getting the payment), but often several gangs would arrive simultaneously and battle over who was going to get paid. Meanwhile, the fire would burn out of control. This was a major factor in the 1837 conflagration which consumed Manhattan's entire downtown business district, including the merchant exchange and the post office. Some of you may recall this state of things from Martin Scorsese's film "Gangs of New York," about the Five Points neighborhood in the period surrounding the Civil War. There were numerous historical inaccuracies, including the conflation of the Draft Riots and other gang uprisings, but the general lawlessness and misery were not exaggerated.

This is sort of what happens with health care these days, only it's the insurance companies who are fighting not to pay for your care, and they don't have colorful names like the "Dead Rabbits," but soothing marketingese names like "Humana," when they should be called "Inhumana." While you and they fight over who's going to pay your doctor bills, you might get sicker and die before you can sue, or you might give up because you're too sick and tired to fight, or you might just pay up. All of these outcomes benefit the insurance company, which then doesn't have to pay. And now that they've got you on record as having an illness, they can refuse future claims or insist that these must "count towards a deductible," which is always, always the default position on a major claim.

In my experience, I have never had an insurance company cover everything it said it would, including basic care items such as mammograms (deductible), routine annual labs such as pap smears (deductible), ER visits (deductible), and even hearing tests (outright refusal). They always manage to weasel out of paying and threaten my credit history if I don't pay.

The ACL reconstruction surgery I had 15 years ago was preapproved and precertified, and I used an in-network orthopedic surgeon. In return for this, 100% of my costs were supposed to be covered after my co-pays. Instead, I got nasty letters on red paper for five years afterward, telling me that I owed more than $2,000, and threatening my credit rating. At one point, I lost a temp job because I went over my lunch break by two minutes while trying to sort out this problem for the umpteenth time.

Even though I used an in-network doctor and hospital, the insurance refused to pay for the pathologist because they claimed he was "out of network." The pathologist examines the bits that are excised and affirms that the right parts were cut, although if the surgeon has gotten it wrong, it's too late to rectify the situation. I didn't even know a pathologist was necessary until I got the bill; I certainly had no say in who he was, since I was under anesthesia at the time, so how would I have protested? I wondered if I were really supposed to rise up off the operating table in a morphine-induced stupor and ask, "Etthhkyoothe meh. Ith thath an in-nehwuk fpthologst?"

Healthcare Coverage for All Americans

Recently, I got an email from President Obama asking me to sign my name and stand with him in demanding health care reform. He also asked for personal stories about health care reform, so I wrote the following:

I had health insurance through my employer for eight years. When I was laid off, I continued the coverage through COBRA, although I had to pay the full premiums, which went up by 40% a month later. Because my next employer was given to gossiping about her employees' health issues, I did not feel I could continue COBRA through that company, and instead relied upon my previous employer. It took me another year to find a position that offered benefits, so I came within a week of exceeding the 18-month limit on COBRA. The new position ended after six months, and I again elected to continue coverage through COBRA and pay the premiums out of pocket. They were expensive enough at $340 per month for one person, but I just found out that the premiums have risen to over $600 per month! This amount is unreasonable even for a person who is earning a salary, but for a person on unemployment, it's impossible. It would be difficult to get insurance again if there were any lapse in my coverage, but I find myself faced with having to choose between food and shelter and having health insurance. Then I think about my parents, both teachers, who had to give up their health insurance 26 years ago, only to be diagnosed with multiple sclerosis and cancer, and I fear a similar outcome.

I know that my story is far from the most dramatic or tragic, but it is unfortunately very common. The current system punishes entrepreneurs and small businesspeople, who usually cannot afford to provide benefits, and their employees. Why do we deny basic health care to so many of our fellow Americans when this denial bankrupts thousands of families, and enriches the already wealthy? Detractors like to compare the possible reliability of national health insurance to the U.S. Postal Service, but for the sake of argument, let's say they are equivalent. Rich people are welcome to send all their correspondence via private carrier, but I at least have the option of paying 47 cents to send a letter, rather than spending $10 on FedEx every time.

If I and the other 50-100 million Americans without reliable coverage were able to pool our resources and spread out the risks across a common health insurance fund like the one enjoyed by federal employees, it would cost a fraction of what we're paying now, and open a whole new world of possibilities for all Americans.

Companies large and small would no longer be obliged to devote their resources and personnel to providing services unrelated to their mission, and would be able to compete with foreign companies. Individuals would be able to start new enterprises, or pursue careers based on their skills and inclinations, not just on which employer offers health benefits.

If there are people who are happy with their current health insurance, I do not wish to take it from them. If people wish to pay for experimental procedures or extra tests out of pocket, I would not deny them that luxury. But I think everyone has a right to basic, affordable health-care access, and it is criminal that here in America, supposedly the richest country in the world, people--including children--are suffering and dying because they cannot get regular check-ups or preventive care. Tens of millions of people like me are just holding on by our fingernails right now, desperately hoping that this will be the year that American legislators vote in favor of universal healthcare access. We're all in this together, so I beg you to do the right thing and help lift this burden.

Here is the link to add your name to the list. Please write or call your elected representative today and insist on health-care access for all. If you don't know the contact information, Congress.org is an excellent one-stop resource.