Broken back and a broken health care system

Lying on the floor last night after my back seized up and gave out on me again, I had time to contemplate my options (or more accurately lack thereof) in between Lamaze-type breathing exercises to focus during the pain.

In 2003 I ended up on the floor in very much the same fashion. I couldn’t get up. Yep… in my 30s I had fallen and couldn’t get up. Long story short, I went to a hospital and after about six months of physical therapy, pain medication, and whatever else my docs told me to do I ended up in an emergency microdiscectomy with partial laminectomy. My primary care doc, Dr. Daniel Lumien (best GP I’ve ever known) and my neurosurgeon, Dr. Roderick Lamond were stellar. I was also fortunate because back then in 2003 and 2004 I had health coverage. Quite a luxury.

Dr. Lamond explained, among other things, that this surgery would buy me up to ten years. But another surgery was inevitable because, as he put it, my lumbar spine was collapsing like a row of dominoes. We discussed this as we both looked over all my x-rays and MRIs. At that time, I was on my way to medical school, so I was full of questions and Dr. Lamond was gracious enough to answer them all.

Well here I am in 2010 and again I find myself on the floor. I’ve been through all this before. I know the M.O. Only this time… I’m one of the approximately uninsured 46 million Americans. So here I am on the floor knowing the clock is ticking, my spine is collapsing, my discs are disintegrating, the pain is blinding and….. I’m f—ed. Because there’s not a damn thing I can do but wait until it’s so bad I can’t take it and have to make another uninsured trip to the emergency room where, no doubt, I’ll get pain meds but surgery to correct the problem is out of the question.

So how did a former anatomy, physiology, and general biology instructor for the University of Colorado – Denver, a former English as a Second Language and Spanish instructor, a former med school candidate, a former deputy sheriff for Sacramento County get here you may ask? I had drive, I had commitment, I had goals, I graduated top of my class with honors. I was going places. And yet, here I am — one of the uninsured.

So, it’s with great interest (but zero hope) that I watch the health care debate. And woke this morning to a New York Times article entitled “Obama Details Plan to Expand Health Care to Uninsured.” The title of the article sounds great. But it’s always the fine print that destroys the facade.

Here are my initial thoughts after reading the article.

The article states, “The White House projects that the bill would extend coverage to 31 million people who are currently uninsured…” So what about the other approximately 15 million uninsured? Namely self-employed that this health care reform doesn’t include.

Obama’s proposed plan includes “expanding coverage to the uninsured while driving down health premiums and imposing what the White House calls “common sense rules of the road” for insurers, including ending the unpopular practice of discriminating against people with pre-existing conditions…” and will provide regulations to stop insurance companies from raping consumers “by cutting spending and reining in waste and fraud.”

Again, in theory, this sounds great. But what is the reality here? There will still be millions uninsured.

…”the White House would help all states absorb the cost of the Medicaid expansion from 2014, when it begins, until 2017.”

So, we’re looking at at least four to five years AFTER any type of new legislation is passed before even seeing any initial tentative results in the health care industry overhaul.

“[Obama] opted for the Senate’s proposal to create state-based insurance exchanges, or marketplaces, rather than a single national exchange as proposed by the House.”

I recently listened to a great show (via podcast) hosted by Ira Glass, “This American Life” from Chicago Public Radio about why insurance company competition in this fashion will cause more problems rather than providing a solution.

Generally speaking, more competition means higher quality goods for less money, right? Not in the case of health coverage from competing insurance companies. Listen to Ira Glass’ show “Someone else’s Money” to understand why. “Someone Else’s Money” originally aired 16 October 2009 and is available via podcast, or by the iPhone app “This American Life.”

So now what?

I think it’s inevitable that, unlike the valiant attempt during the Clinton administration, health care reform will be passed this time in some iteration. But it will be a far cry from being anything useful and it will take many years, maybe even a couple more decades before significant changes are seen that actually benefit the American people, insured, underinsured, and uninsured. But perhaps that’s all we can hope for, tiny, unsure, speculative steps hopefully in the right direction.