Healthcare in This Country Is Great—Until You Actually Need It

Modern American Healthcare

Everyone has an opinion about healthcare today, and few subjects lead to more raised voices and heated conversation.  One reason is cost. Other than college tuition, no other product category seems to make up its own economic rules to such a large degree. When the economy is good, prices go up. When the economy’s bad, prices still go up. I wish my portfolio had the same growth curve as my health insurance premium.

When options for changing the system are discussed, there’s one argument I can’t understand.  I just can’t relate to someone who says, “I don’t want the government taking medical decisions out of the hands of my doctor.”  Huh?  What health plan in 2011 lets a doctor have much of anything to say about patients’ health care decisions? That ship has sailed.

Health insurance companies dictate what your doctor can and can’t do, and can and can’t prescribe. Health insurance companies even dictate how long it’s reasonable to stay in the hospital after you’ve had surgery or delivered a baby—regardless of what your doctor’s professional medical opinion is on the matter.

Due to a nasty fall this winter, I found myself needing extensive healthcare recently. I’ve been really experiencing the “system” for the first time. My provider is probably no better and no worse than the rest; from what I can tell they’re pretty typical. So I won’t reveal their name, except to tell you that it begins with and A, and ends with an ETNA. 

My injury has left me struggling to regain the use of my dominant hand. The standard of care for a broken forearm and shattered wrist is surgical repair followed by extensive physical therapy. My insurance company covered their portion of the surgery according to the terms of our agreement, even if I was practically shoved out the door into the cold February night shortly after four hours of surgery. 

Here’s the problem: I just learned that I’m limited to 24 physical therapy appointments a year.  My doctor has nothing to do with that. He has no say. My doctor says I need this therapy, but some pencil-pushing suit makes those decisions. An insurance company decision-maker has decided that 24 PT sessions is enough for me, as well as every other policy holder, regardless of their medical condition. 

I guess it doesn’t matter that I can’t use a fork or computer mouse (both pretty essential to my daily life), slice a bagel, or even turn my wrist to a palm-up position. It should matter to them that I can’t fill out and sign the premium checks I send them every month, but I guess they figure my wife can do that. In fact, they’re probably hoping I don’t send a check so they can terminate the policy of someone audacious enough to actually file a claim. They liked me better for all those years I was healthy and injury-free.

Since a huge institution is already dictating what medical care I can and can’t have, how bad can universal healthcare be? (I refuse to call it “Obamacare.” It’s so childish when opponents of something try to sway opinion by giving it a new name.) How could universal healthcare be worse than this?

I don’t need a lecture on the inefficiencies of government bureaucracy. I get it. There will be waste. But it’s hard to believe that the premium I pay for an inefficient government will outweigh the one I pay to ensure huge profits for a company that needs to constantly drive the share price for investors. What’s worse for my wallet—Wall Street or Washington? After years of declining coverage and staggering price increases, I’m willing to take my chances with Washington.