Tuesday, August 25, 2009

Dear Mr. Collier,

I read about you in the New York Times and I have to say I am truly perplexed.

Your situation as you describe it would seem to position you as one of the fiercest advocates of health reform. Your wife's experience with the system is nothing if not exemplary of everything that is flawed in it: your insurer denied payment for your wife's radiation treatment because they were deemed "experimental" (even thought they are pretty much the standard of care for breast cancer as far as I know), presumably to avoid paying for the $63,000 bill (which you ended up not having to pay only because of the kindness of Emory Healthcare). Your insurance premiums have been going up 15% per year - I would imagine much faster than your income - and your deductibles have quadrupled. More importantly, God forbid the cancer were to recur (and in the best case, there is about a 10% chance it will) and you happened to lose your job, your wife would be uninsurable, due to her pre-existing condition.

And yet, you oppose health reform which aims to control the growth in cost of care, prohibit insurers from discriminating among people based on pre-existing conditions, and would give you a safety net to fall back on in case you lose your job or your employer simply decides to no longer provide health coverage for employees, or their spouses (it's a recession, after all).

What I don't understand at all is your reasons for fearing health reform. You say about Obama "he wants to centralize everything. He wants to take over the car companies. He wants to take over the banks. Now he wants to take over health care." Leaving aside the fact that the government didn't simply decide to take over car companies and banks (they begged for and survived thanks to government intervention), I simply don't get what about any of the current proposals says anything about the government taking over health care. And even if it did, why is that necessarily a bad thing compared to what happened to you? You worry about the government rationing care and skimping on the elderly. Instead, you prefer to be in a system, where your insurance company can simply deny payment for a procedure which, according to medical research lowered recurrence risk of your wife's cancer by more than 50%, because it is considered "experimental", even though your doctors recommended that treatment. If that isn't rationing and intruding into medical care decisions made by your doctor than I don't know what is. But I guess having those life-threatening decisions made by a for-profit entity at least feels more American?

I suppose I can understand one reason why you want to keep the system as it is - that against all odds and thanks to a combination of luck and other people's charity, you got what you need out of it. Your wife is OK now and, however expensive it may be, you have health insurance. In other words, the system sort of works for you, so why mess with it?

All of which is to say, go read James Surowiecki's brilliant article in the New Yorker about why we tend to want to stick with things that suck.

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