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Has the health care system failed you?

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  • Posted by Jo Easton
  • on July 30, 2009 1:25 PM

That question might count as leading the witness, but it’s a compelling one. We’re assuming there’s something wrong. With more than 45 million Americans lacking health insurance and millions more struggling to pay for decent care, it doesn’t seem too controversial.

How (if at all) has the health care system failed you? Click here to share your experience with Marketplace.

Congress is racing to make progress on health care legislation before leaving for summer recess. The debate about what to do, and the proposals Congress is working on, are hard to follow for even the savviest news consumer. (I’ve been reading letters from doctors in the Public Insight Network saying they don’t even understand their own health plan!)

So we’ve teamed up with ProPublica (an independent, nonprofit investigative reporting newsroom) to engage you in explaining what’s happening by connecting your day-to-day health care concerns with the policy proposals being discussed in Washington.

We want to learn whether the proposals on the table will solve the real problems you deal with in health care. Click here to share your story, your concerns, and your questions.

Discussion: 14 Comments

  • Posted by ib on August 5, 2009 7:26 AM

    Even if you have insurance, when you grow up (lose coverage under Mom and Dad) or change jobs (change insurance coverage) your existing health care provider may not be participating in the new insurance. So, you’ll still have dis-jointed, incomplete or duplicative health care that is expensive and ineffective.

    Add to that the issue that many health care providers are so hurried that they will jump right to prescribing (since they are on commission with the pharmaceutical companies). Trying to find a doctor who is genuinely interested in uncovering and resolving the root cause of a health issue - is very difficult. Most consider a “diagnosis” to be when they tell you the medical word for your symptom - and give you a drug to treat your symptom. The sicker you are - the more money they make.

    To be clear - I’m not convinced that anyone needs health INSURANCE. I am certain we all need health CARE.

  • Posted by deanne on August 7, 2009 10:39 AM

    yes. There is too much emphasize on drug treatment. Health care should look at the whole person-lifestyle,nutrition,activity,etc. but health insurance dictates what is covered and what is not. So the doctors and health care providers cater to the insurance industry so they can get paid. This insurance money making machine is NOT what I would call healthcare!

    I suffered two conditions that “traditional” medicine could not cure. It wasn’t until I sought non-traditional or holistic treatment and paid out of my own pocket that I got cured. I received acupuncture for a neck injury and went to a holistic doctor who spent more then 15 minutes with me, actually a whole 45 minutes, and easily diagnosed celiac disease. He did not accept insurance because they did not pay him adequately.

    If I pay for health insurance I should be able to go to any doctor. It they do not accept the insurance I have then the insurance company should reimburse me for the amount they allow. The same should apply for any treatment I wish to receive. Allowance for any treatment should be one of the reforms the government includes. This would be a start at reforming healthcare because more options would be available and the medical industry would need to be more competitive.

  • Posted by w2slow on August 9, 2009 2:11 PM

    Yes, every year premiums are more expensive and provide less coverage. Health is a business and that’s the problem. Health should be a public matter like water, air, and education.

    We are treated like cattle by the Insurance companies. We need a a Public option health system.

    So, it is time for the Health Insurance companies to go away and hopefully we’ll remember them like the dinosaurs, scary and obsolete creatures. ;-)

    Response to w2slow
    Posted by CT Davis on August 10, 2009 11:29 PM

    The simple question that needs to be asked is this: Do we need a health care system that is designed to make money for a few large corporations or do we need a health care system that is designed to keep people healthy? The answer to that question points down a pretty clear path.

  • Posted by kamschron on August 10, 2009 7:46 PM

    My wife and I have fairly good health insurance through my employer. So far, the contribution that I have to make is low, but the cost to my employer has continued to grow higher at an alarming rate. My adult children do not have insurance of their own and are too old to be covered by the plan that I get from my employer.

    My wife has pre-existing conditions that would keep her from getting private insurance if we needed to find insurance on our own. I know other people with serious health conditions who would have a very hard time meeting their health care needs if they did not have the good fortune to have employer-sponsored health care.

    A few years ago, when we had the PPO option of our group plan, we had to look for new doctors because our medical group quit participating in HMO and PPO plans after negotiations with insurance companies broke down. I decided to move to the HMO plan in order to reduce the risk of large out-of-pocket expenses in the event that anything major went wrong. On one occasion, when my wife had an allergic reaction to an unknown food ingredient, she called her primary care physician as required and was instructed to go to the nearest emergency room. Because the symptoms were determined not be be life threatening after all, the insurance company denied coverage for the emergency room visit.

    In 1948, the United States was one of the original supporters of the Universal Declaration of Human Rights. Although Article 25 includes a right to medical care, the United States has refused to ratify the International Covenant on Economic, Social and Cultural Rights, for fear that it would lead to actual implementation of rights that we recognized over six decades ago.

    In the last few days, I have submitted comments about why I think universal health care is needed to two conservative blogs. The main participants seem to think that I am a complete idiot for considering anything that would diminish the right of successful individuals to hold on their hard-earned cash. In my opinion, a solution that provided universal health care through voluntary contributions would be morally acceptable, but I have a hard time believing that people without major health problems will be able to recognize the depth of the need and voluntarily contribute enough to meet the need that exists. Many people with good health and means to pay for the own insurance will not even choose to do that, let alone contribute the supporting others without the means.

    Response to kamschron
    Posted by kamschron on August 10, 2009 7:48 PM

    I meant to say “contribute to supporting others” but clicked the Submit button too soon.

    Response to kamschron
    Posted by kamschron on August 11, 2009 3:55 AM

    My wife and one of my sons both have had excellent primary care physicians who have left the medical groups where they were working and have moved to concierge medical practices in order to be able to work in a situation where they are allowed to spend an appropriate amount of time with each patient.

    In addition to providing the care that is needed, it is appropriate for health care systems to have limiting costs as one of their major concerns. An ideal solution would deliver the treatment that is needed, would teach patients to help in caring for themselves, would avoid wasteful use of health care services, and would minimize the bureaucratic burden on patients and providers. None of the systems that we have, private or public, for-profit or non-profit is perfect or will ever be perfect, but working toward an adequate solution is a better response than pretending that we don’t have a problem.

  • Posted by CT Davis on August 10, 2009 11:19 PM

    I’m lucky enough now to have insurance through my employer. That has not always been the case and during those times, there was always a nagging fear that I would get injured and end up living in my car. Stories abound of people losing their entire life savings in one episode of ill health. Even with our decent plan through work, the employee contribution has kept rising year to year.

    Clearly the marketplace given free rein has made the problem worse. The profit motive steers them toward avoiding paying for sick people’s bills, when we all agree that the purpose of any health care system should absolutely be caring for sick people, not profit. We need change and we need it now.

  • Posted by RLC on August 11, 2009 7:04 AM

    Has the health care system failed me? Not yet, but I’m sure it will.

    Since I finished grad school I’ve been stuck temping - and that means my health insurance is whatever I buy myself. It hasn’t failed me yet, but in it’s current state I’m sure it will. Thank god my health is decent.

    But I’ve seen how it fails other people. When my father had a stroke that prevented him from working for over a year, his insurance refused to continue covering him. This meant my mother was forced to go find a job just to get health coverage for herself and my siblings that were still minors, and because she hadn’t done enough “quarters” to collect social security on her own. Finding a job with health coverage is hard enough (10 years out of grad school I still haven’t done it). Finding a job with health care with only a year of college, after almost thirty years as a homemaker, and trying to deal with a disabled spouse was a nightmare.

  • Posted by Esteban Colberto on August 11, 2009 10:39 AM

    The year is 2025…

    If you commit a crime, you don’t go to jail, your punishment is complete removal from government systems.

    Car accident? EMT arrives,does a quick chip scan. If you don’t have a chip or the chip says you have been convicted of any crime, they leave you in the street where they found you.

    By ending the industrial prison system, and removing a large chunk of marginal contributers to the tax base, the US Government realized that it could fund just about anything needed that is related to “healthcare”.

    In 2025 there are 2 systems.

    1. The tax-supported government sanctioned system, comprised of only private run facilities, that is exclusionary if you violate the civil code.

    2. Socio-economic tribes that are exclusionary based on paid membership.

      • Corporate Multinationals
      • Religious based
      • Private Equity (wealthy business tycoons, the mob, gangs, NGOs)
  • Posted by GregRobin Smith on August 14, 2009 9:46 AM

    Our health system fails me mostly because so many people are out of it. There is so much spent for less than world standard effectiveness. There are millions around us (Mexico, Haiti, etc.) who are without even the most basic health care. We must improve our home situation and help improve health care around us as well. I have great insurance, myself, but cannot be satisfied because my situation is OK. As a citizen of this country and of this planet, when so many millions are without health care, it means I must work to improve it and encourage my representatives to do so as well, resisting the fear and hate and doing what is right. There was similar effort to derail a major change in the way things were done not so long ago. Fear, Hate, Screaming, Shouting, & blood in the streets over it. It was when our Constitution was adopted, but the representatives did what was right and we have all benefited from that. I support the work to change our broken system now and the civil discussions that will continue to improve that work.

  • Posted by Kristian on August 14, 2009 3:32 PM

    In my opinon, the biggest problem in the healthcare system is the way health insurance is structured. As long as my health insurance is paying, I don’t care what anything costs. It’s like going into a car repair shop and giving them your repair insurance card. You could care less if the guy is honest, if the problem gets fixted and somebody else (insurance company) pays. If we had higher deductables and the ability to rollover the before tax money we put into our health savings account year after year we would start caring about what things cost and would seek the lowest cost/most effective treatments. Doctors and Hospitals would actually have to compete for our business. Laser eye surgery is a great example of free-market medicin. The hole national health system idea, sorry to say, has already been tried. This WSJ artical is a must read, written by an NHS doctor. http://online.wsj.com/article/SB10001424052970203517304574306170677645070.html

  • Posted by Dave Ihnat on September 9, 2009 5:02 PM

    The health care system is totally loaded in favor of the insurance companies and drug manufacturers.

    When I went indpendent in 2004, I lost any health care coverage after my COBRA expired. I contacted Blue Cross/Blue Shield, as I had good feelings about them as the provider for my previous employer.

    What a horrible experience.

    They demanded deep, detailed health histories, which I provided for myself, my spouse, and my son. With subsequent clarification as requested. The finally issued a policy with stiff, but fair, pricing.

    THEN, my spouse went in for a normal health checkup; this generated requests for more health records, which we’d already provided.

    THEN, my son went in for a normal health checkup. Same thing.

    THEN, I received a notice that due to “previously undisclosed conditions”, they were cancelling my insurance after several months. They never explained what these conditions might be, and thank all the powers that be that we’d not had any health issues over the covered period—they returned our premiums minus any pay-outs, which in our case were just checkup fees. God help us if one of us had developed a serious condition in the coverage period. It seems, buried in the 11+ page contract, they had a clause that allowed them to unilaterally cancel coverage in the first 13 or so months.

    This is asinine. We’d provided all the information they requested, and nevertheless they decided to bail out on us. Essentially, we would have had to not use any medical services for the first year and a half of our coverage to have a chance of keeping our coverage—and I’m not sure even then they wouldn’t have found a way to welch on their commitment. I had to help my spouse create a “group policy” for her four-person firm to get any sort of coverage, and that is hideously expensive even so.

    There’s no doubt in my mind that a profit-based insurance industry is a disservice to both business and individuals.

  • Posted by Zoe on September 12, 2009 5:19 PM

    My son needs a kidney transplant. As his mother I am a matched donor. We are unable to coordinate the care to get this transplant done. The head of Mayo Clinic’s transplant psychiatry dept. actually told my son he needed to see a psychiatrist but he couldn’t see one at the Mayo Clinic in Rochester, MN. “It is too far to drive” we were told. We live in Minneapolis, MN. My son has no way of finding his own transplant psychiatrist. Very few people could.

    Lack of integrated healthcare has lead my son to have been hospitalized two times for undiagnosed congestive heart failure (while on dialysis), once for hyperkalemia (too much potassium), once for dialyzer sensitivity and hypertension. No doctor has ever explained how to handle these issues before they became serious enough to land him in multiple emergency rooms.

    He has seen 41 doctors since September 2008, been hospitalized 5 times and been to the ER 9 times in 4 hospitals. Incidentally, most of these doctors didn’t know how to get an appointment with a transplant psychiatrist either. We asked!

    There is a serious lack of coordination and responsibility in the system.

    This lack has caused my son to become so weakened that he is now almost completely dependent on me for care. I have not worked full time for over a year. We are in foreclosure and bankruptcy with no transplant date in site. Now we all ought to see a psychiatrist!

    Being the living would-be donor, parent, caregiver, sole provider and advocate for my son is like having four fulltime jobs with no pay.

    If my son were famous like the lovely Natalie Cole he too could have had a transplant five weeks after appearing on Larry King Live. I’m guessing, without having to find her own transplant psychiatrist first!

    What is an outrage is the amount of money being spent for his dialysis and emergency care when a transplant is available! The State of MN would save not only $100,000’s of dollars but his life.

    Apparently the intrinsic value of life in our healthcare system depends on who you are or who you know. This “value” doesn’t even make financial sense!

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