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30 August 2009

Access to Health Care is a Human Right



Universal health care is a moral issue, yet it is currently being treated as a political and economic issue.  Health care should be available to every person in the world, not just those who can afford it.  The Right argues (wrongly) that the single payer health care would result in rationing of health care and the killing off of the elderly.   The current system based on corporate profits, is an effective method of rationing.  Insurance corporations decide whether you will be covered.  Insurance corporations decide whether the treatment ordered by your doctor will be paid.  Insurance corporations decide which doctor will treat you. based on their list of approved providers.  Insurance corporations will drop you from coverage if you become too sick and start costing them money.  Insurance corporations are making money hand over fist while people are suffering and dying.

All too frequently, health insurance companies will not pay for procedures, treatments, or drugs ordered by your doctor.  If you have health insurance check the policy for the exclusions.  Most insurance companies will not cover:
Sexually transmitted diseases
Experimental procedures
Organ transplants
Infertility treatment and services
Alcohol and drug abuse treatment
Pre-existing conditions
Hernia repair

Self-inflicted injuries

Suicide

Have you ever seen those little jars, cans, or buckets sitting on counters of convenience stores?  You know the ones with a hand printed sign asking for donations to help pay for little 2 year old Johnny's liver transplant?

The insurance company stands between you and your doctor when it comes to deciding what treatments the company will cover.  Experimental treatments are almost always denied coverage, even when the treatment is used with regularity and has demonstrated success.  Take the story of Mary Casey as an example.  Her doctor prescribed a drug therapy for cancer that had shown success in previous cases.  Her cancer originated as a sinus cancer for which there are no FDA approved drugs.  The cancer then spread to her lungs.  There is an FDA approved drug to treat the type of cancer that spread to her lungs. The insurance company denied coverage for the expensive medicine because the drug was not approved specifically for her type of cancer.  So what are Mary's choices?  Pay $4,602 per month out of her own pocket, or go on without treatment.  It made no difference to the insurance company that Mary's doctor wrote to the insurance company to explain that the drug had shown promise as a treatment.  In another case, a breast MRI was determined to be an experimental treatment and payment was denied after initially pre-certification of coverage.

While it is easy to get caught up in the emotions when faced with a life threatening illness for which the insurance company denies treatment coverage, we must always remember that the insurance policy is a contract.  The company is bound only by the terms of the contract.  When a patient sues an insurance company to compel coverage, the courts look to the language of the contract.  Often the terms of the contract outweigh medical opinion.  We also must never forget that health care in the United States is an industry.  Industry in a capitalist society exists to make money for the owners and the shareholders.  The insurance industry makes money by collecting your money in premium payments then paying as little as possible or denying claims altogether.

The private health insurance industry is designed to make money, not help people.  When you or your child has been diagnosed with a life threatening illness that  a bone marrow or an organ transplant could remedy, the insurance company will probably not pay for the procedure.  They won't care if you die.  Actually, if you die they will save money.  They get to keep all of your previously paid premiums and never have to pay out for you again.   What would you do if your child was going to die without a liver transplant and the insurance company refused to pay because they claim transplants are experimental?

How can insurance companies continue to claim that organ transplants are experimental when they are performed every day with positive results for the recepients?  How many successful transplants will convince insurance companies to consider organ transplants as generally medically accepted treatment?  My guess is that the insurance industry will not change its determination that transplants are experimental unless forced to do so either by massive public outcry and or legislation prohibiting insurance companies from denying coverage for transplants. Moreover, will insurance companies deny coverage to organ donors?

Chemotherapy, bone marrow transplants, and organ transplants  are performed with regularity in the United States.  It makes no sense that these procedures are still considered experimental by health insurance companies.  In Oregon, it is cheaper for the insurance companies to approve assisted suicide drugs but not chemotherapy drugs.  How is it that the right wing claims that reform will result in euthanasia? It would seem that insurance companies already practice health care rationing and recommend ehthanasia.  I don't hear them complaining about the insurance companies killing granny.

It seems that granny's life is already in peril from the private health insurance industry. Chemotherapy can cost in excess of $4,000 every month., and treatment can last for months or even years The drugs for physician-assisted suicide cost less than $100 and it is a one-time only expense.  It is much cheaper for the insurance company to agree to pay for you to die than to pay for medications which could keep you alive.  It is very cost effective for the insurance corporation to help you die.

How can a civilized people allow greed and profit to determine who gets medial treatment?  How long will Americans suffer the indignity of begging an insurance company to pay for life saving treatment for themselves and their children?  How many tears will be shed at funerals for human beings who would not have died from their illness had the insurance company paid for the treatment? How long will we tolerate obscene insurance profits and keep burying our children?

If health care reform, single payer, or public option does not become the law of the land in the United States, you, me, and every single person paying insurance premiums will remain at the mercy of our insurance company.  The right to life, liberty and pursuit of happiness belongs only to those who can afford it.  It is the system that is sick.



"We are the only Western democracy that has not embraced universal health care as a means of social justice."  Bill Moyers on Real Time with Bill Maher.

Take a look at the Top 5 Lies spread by those who oppose health care reform as listed by Newsweek.

Claim Denied!

Health Reform Fact Check
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