Friday, September 18, 2009

These Aren't Statistics, They're Real People

One of the problems in the health car reform debate is that the dialog too often inbvolves only statistics: X number of people, Y number of dollars, etc. To fully understand what's at stake, we need to understand how the current system affects real people.

I wrote a while back about the young husband and wife who were forced for both economic and practical reasons to decided which one would get a needed surgery. What a choice! How would you like to be the husband who gets the surgery he needs, leaving his wife with her chronic gall bladder pain untreated?

Here’s another case history, sent to me today by a regular visitor to this page:

A little over three weeks ago, forgetting I'm no longer 16, I jumped off a harmless 4' wall, and my right knee gave out. Not a landing Nadia Comaneci would have applauded. Anyway, for 2 days I couldn't walk, but did improve a bit.

I went to our doctor here, and the decision was to wait two weeks and see if it got "good as new" on its own. Two weeks later I reported back and said it had indeed improved a lot, but it still didn't feel stable at all. No pain to speak of, but a sense of weakness and, specifically, a sensation it would bend the wrong way backwards. So my doctor ordered an MRI.

Aetna* refused to cover it. Seems I should have waited 6-8 weeks for “therapeutic effect”, and hadn’t had exercises to strengthen it, etc., etc. A consulting doctor for Aetna reviewed the case and gave that opinion.

I don't dare try to find another carrier. I pay Aetna $566 a month for a policy with a $3,000 deductible and am "lucky" to have that!

So much for having my doctor and me together decide what's the best treatment plan.

How can the people bragging about ours being “the greatest country in the world” allow its citizens to be treated this way?

*Remember the Aetna? Their CEO’s compensation was $25 million last year!


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