March 3, 2010--Happy With My Coverage
I was talking with Vince the other day. He needs hip replacement surgery but can't get his insurance company to authorize it. They say he has a preexisting condition--two herniated lumbar spinal discs. His doctor claims that the two conditions are not related and that the preexistence of the disc problem has nothing to do with his severely arthritic hip that has nearly immobilized him.
Vince does not have Rolls Royce coverage much less Cadillac, which have been so much in the debate about national health care reform. He has a Humana plan with a co-pay, or deductible of nearly $5,000! He couldn't afford a higher-end plan but is able to scrape enough together to pay the first $5,000 it would cost to replace his hip so that he can get on with his life, including returning to work. He'd put it on a credit card.
But neither he nor his doctor is making any headway. Humana is dug in and it is looking as if Vince will have no recourse but to borrow the rest of the money to pay for the operation. He then will be just steps away from personal bankruptcy. Exactly the kind of person who was frequently cited the other day at President Obama's health care summit.
Vince was more than a disinterested party and watched all six hours of it. He's basically apolitical and thus didn't have a partisan rooting interest. To him it was simply personal. But he was not impressed by the Republican's talking points. As he said to me over coffee, "The Democrats see health care as a right. The Republicans as something to be earned."
That seemed to me like a pretty good two-sentence summary. "When you dial 911," Vince added, "they don't ask if you have 911 insurance. They simply dispatch a police car or fire trucks. When it comes time to send your kid to school, they don't ask if you have education insurance before putting him in a class. So why is health care any different? Why should there be a profit motive associated with it? No one makes money from putting out your fire or educating your kid."
I couldn't disagree with any of this. "And further," he said, "all of this business about people being happy with their health care coverage is baloney. I could use a stronger word but there are ladies present."
"What do you mean," I asked, "don't all the polls show overwhelmingly that people are satisfied? That's one of the things that was noted during the meeting the other day as a reason why it's so difficult getting a comprehensive reform bill passed by Congress--people like what they have and are worried about losing it."
"Yes and no," Vince said. "Even up in Massachusetts where they voted for a Republican who said he would be the 41st vote against the Democrat's plan, more than 60 percent of the voters said they favored this kind of health care reform. Like the kind they have in Massachusetts."
"I read that too. About Scott's voters. That they went for him because he wasn't Coakley and felt to them more of an outsider than she did. But what about the national polls that show about 70 percent of Americans are happy with their coverage? There was a recent CNN poll about this." (It is linked below.)
"Here's how I look at that. It's an example of how statistics can distort the truth if not out-and-out-lie."
"What do you mean?" I was eager to hear what he had to say.
"Simple. Nearly 15 percent of Americans are 65 or older. Right? They have Medicare. A form of a public option that they pay very little for. Pretty much all of them like it but have been mobilized by Republicans to fear that their benefits are threatened. They are angry about that possibility--though it is untrue--because they like what they have."
"OK," I said, "that's one segment of the population who are happy with their coverage. But what about the others?"
"I was so worked up the other day that I did a little research. Assuming that people who are younger and therefore feel invulnerable are less concerned about their health than older people--and statistics show that more than 80 percent of what is spent on health care is for people during the final years of their lives--I looked at what percentage of the total population is younger than 44. I chose 44 because that's the way the Census people divide up the population. I was surprised to learn that about 56 percent of Americans are younger than 44. Assuming most of them are happy with their health care--most haven't had to use it yet--that leaves only 23 percent of the population between 45 and 65."
He was on a roll. "And?" I said.
"What percent of that 23 percent has to be happy with their coverage in order for 70 percent of the entire population to be satisfied with theirs?" He paused to take a breath and for another gulp of coffee. "I'm not too good at that kind of math and realize I'm oversimplifying things, but my guess is that the vast majority of these people (and that includes me--I'm 53) are unhappy with the way they get treated even if they, like me, are fortunate enough to have any coverage at all."
I was impressed. I try to follow these things but haven't heard anyone in the media or Congress, or in the White House for that matter, unpack the data the way Vince did. Someone should because the way the debate, if one can call it that, is proceeding the mood and views of the public are being both misrepresented and ignored.
Vince does not have Rolls Royce coverage much less Cadillac, which have been so much in the debate about national health care reform. He has a Humana plan with a co-pay, or deductible of nearly $5,000! He couldn't afford a higher-end plan but is able to scrape enough together to pay the first $5,000 it would cost to replace his hip so that he can get on with his life, including returning to work. He'd put it on a credit card.
But neither he nor his doctor is making any headway. Humana is dug in and it is looking as if Vince will have no recourse but to borrow the rest of the money to pay for the operation. He then will be just steps away from personal bankruptcy. Exactly the kind of person who was frequently cited the other day at President Obama's health care summit.
Vince was more than a disinterested party and watched all six hours of it. He's basically apolitical and thus didn't have a partisan rooting interest. To him it was simply personal. But he was not impressed by the Republican's talking points. As he said to me over coffee, "The Democrats see health care as a right. The Republicans as something to be earned."
That seemed to me like a pretty good two-sentence summary. "When you dial 911," Vince added, "they don't ask if you have 911 insurance. They simply dispatch a police car or fire trucks. When it comes time to send your kid to school, they don't ask if you have education insurance before putting him in a class. So why is health care any different? Why should there be a profit motive associated with it? No one makes money from putting out your fire or educating your kid."
I couldn't disagree with any of this. "And further," he said, "all of this business about people being happy with their health care coverage is baloney. I could use a stronger word but there are ladies present."
"What do you mean," I asked, "don't all the polls show overwhelmingly that people are satisfied? That's one of the things that was noted during the meeting the other day as a reason why it's so difficult getting a comprehensive reform bill passed by Congress--people like what they have and are worried about losing it."
"Yes and no," Vince said. "Even up in Massachusetts where they voted for a Republican who said he would be the 41st vote against the Democrat's plan, more than 60 percent of the voters said they favored this kind of health care reform. Like the kind they have in Massachusetts."
"I read that too. About Scott's voters. That they went for him because he wasn't Coakley and felt to them more of an outsider than she did. But what about the national polls that show about 70 percent of Americans are happy with their coverage? There was a recent CNN poll about this." (It is linked below.)
"Here's how I look at that. It's an example of how statistics can distort the truth if not out-and-out-lie."
"What do you mean?" I was eager to hear what he had to say.
"Simple. Nearly 15 percent of Americans are 65 or older. Right? They have Medicare. A form of a public option that they pay very little for. Pretty much all of them like it but have been mobilized by Republicans to fear that their benefits are threatened. They are angry about that possibility--though it is untrue--because they like what they have."
"OK," I said, "that's one segment of the population who are happy with their coverage. But what about the others?"
"I was so worked up the other day that I did a little research. Assuming that people who are younger and therefore feel invulnerable are less concerned about their health than older people--and statistics show that more than 80 percent of what is spent on health care is for people during the final years of their lives--I looked at what percentage of the total population is younger than 44. I chose 44 because that's the way the Census people divide up the population. I was surprised to learn that about 56 percent of Americans are younger than 44. Assuming most of them are happy with their health care--most haven't had to use it yet--that leaves only 23 percent of the population between 45 and 65."
He was on a roll. "And?" I said.
"What percent of that 23 percent has to be happy with their coverage in order for 70 percent of the entire population to be satisfied with theirs?" He paused to take a breath and for another gulp of coffee. "I'm not too good at that kind of math and realize I'm oversimplifying things, but my guess is that the vast majority of these people (and that includes me--I'm 53) are unhappy with the way they get treated even if they, like me, are fortunate enough to have any coverage at all."
I was impressed. I try to follow these things but haven't heard anyone in the media or Congress, or in the White House for that matter, unpack the data the way Vince did. Someone should because the way the debate, if one can call it that, is proceeding the mood and views of the public are being both misrepresented and ignored.
posted by Steven Zwerling at
5:52 AM
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