Donna Inversin: Fixing the healthcare problem

Once​ ​again​ ​the​ ​Republicans​ ​have​ ​failed​ ​to​ ​destroy​ ​the​ ​Affordable​ ​Care​ ​Act​ ​(ACA​ ​or​ ​Obamacare).​ ​I’ve​ ​lost count​ ​of​ ​the​ ​number​ ​of​ ​attempts​ ​and​ ​I’m​ ​beginning​ ​to​ ​wonder​ ​if​ ​their​ ​goal​ ​isn’t​ ​just​ ​to​ ​keep​ ​everyone​ ​distracted enough​ ​to​ ​keep​ ​Congress​ ​from​ ​doing​ its ​job,​ ​i.e.​ ​fixing​ ​the​ ​problems​ ​with​ ​the​ ​system​ ​we​ ​have.​ ​I​ ​still believe​ it’s​ ​time​ ​for​ ​the​ ​United​ ​States​ ​to​ ​join​ ​the​ ​rest​ ​of​ ​the​ ​developed​ ​nations​ ​and​ ​offer​ ​our​ ​citizens​ ​a national​ ​health​ ​system.​ ​But​ ​in​ ​the​ ​meantime​ ​the​ ​ACA​ ​is​ ​a​ ​good​ ​beginning,​ ​despite​ its ​problems.

After​ ​more than​ ​40​ ​years​ ​as​ ​a​ ​registered​ ​nurse​ ​working​ ​in​ ​numerous​ ​areas​ ​of​ ​healthcare,​ ​including​ ​working​ ​for several​ ​insurance​ ​companies​ ​as​ ​a​ healthcare risk manager, quality assurance specialist and appeals nurse specialist, ​I​ ​believe​ ​I​ ​can​ ​provide​ ​some​ ​insight​ ​into​ ​the​ ​problems​ ​and​ ​solutions.

The​ ​standard​ ​response​ ​has​ ​been​ ​to​ ​blame​ ​the​ ​greedy​ ​insurance​ ​companies,​ ​or​ ​the​ ​currently​ ​sick​ ​(those​ ​with pre-existing​ ​conditions),​ ​or​ ​the​ ​poor.

Let’s​ ​first​ ​address​ ​the​ ​sick;​ ​the​ ​attitude​ ​appears​ ​to​ ​be​ ​​it​ ​must​ ​be​ ​their​ ​own​ ​fault​ ​they’re​ ​sick​ ​and​ ​so​ ​why should​ ​the​ ​rest​ ​of​ ​us​ ​have​ ​to​ ​pay​ ​for​ ​their​ ​care?​ ​Yes,​ ​some​ ​of​ ​the​ ​sick​ ​have​ ​conditions​ ​they​ might ​not​ ​have developed​ ​if​ ​they​ ​had​ ​lived​ ​cleaner,​ ​purer​ ​lives.​ ​But​ ​can​ ​any​ ​of​ ​us​ ​actually​ ​claim​ ​to​ ​have​ ​lived​ ​clean,​ ​pure​ ​lives or​ ​that​ ​we’ll​ ​never​ ​get​ ​sick,​ ​or​ ​old?​ ​No,​ ​you​ ​pay​ ​for​ ​insurance​ ​now,​ ​to​ ​cover​ ​those​ ​who​ ​need​ ​it​ ​now,​ ​so​ ​when​ ​it​ ​becomes​ ​your​ ​turn​ ​to​ ​need​ ​it,​ ​you​’ll​ ​have​ ​it.

Also​ ​of​ ​note: A​s​ ​a​ ​counterproductive​ ​measure​ ​there​’s​ ​a​ ​strong​ ​movement​ ​to​ ​remove​ ​all​ ​preventive​ ​coverage from​ ​the​ ​current​ ​plans​ ​as​ ​a​ ​cost​ ​saving​ ​measure​ ​now,​ ​thereby​ ​insuring​ ​more​ ​sick​ ​people,​ ​with​ ​more​ ​costly illness ​in​ ​the​ ​future,​ ​and​ ​around​ ​and around ​we​ ​go.​ ​So​ ​to​ ​sum​ ​up,​ ​no​ ​one​ ​can​ ​guarantee​ ​they​’ll​ ​never acquire​ ​a​ ​chronic​ ​illness,​ ​or​ ​have​ ​an​ ​accident​ ​resulting​ ​in​ ​costly​ ​and/or​ ​extensive​ ​care.

And​ ​now​ ​the​ ​poor. A​gain,​ ​the​ ​general​ ​attitude​ ​seems​ ​to​ ​be​ ​​if​ ​they’re​ ​poor​ ​it​ ​must​ ​be​ ​their​ ​own​ ​fault,​ ​so​ ​why should​ ​we​ ​take​ ​care​ ​of​ ​them?​ ​In​ ​the​ ​past​ ​we​ ​tried​ ​not​ ​taking​ ​care​ ​of​ ​them.​ ​Having​ ​people​ ​dying​ ​just​ ​outside​ ​the doors​ ​of​ ​hospitals​ ​got​ ​enough​ ​good​ ​people​ ​so​ ​upset​ ​Congress​ ​passed​ ​a​ ​law​ ​against​ ​refusing​ ​them​ ​care. So​ ​be​ ​assured​, we​ ​pay​ ​for​ ​care​ ​for​ ​the​ ​poor​ ​one​ ​way​ ​or​ ​another.​ ​It’s​ ​just​ ​much​ ​cheaper​ ​and​ ​much​ ​better​ ​for society​ ​to​ ​get​ ​them​ ​covered​ ​under​ ​insurance​ ​and​ ​give​ ​them​ ​preventative​ ​care​ ​then​ ​it​ ​is​ ​to​ ​have​ ​them​ ​get​ ​really sick​ ​and​ ​spend​ ​months​ ​in​ ​the​ ​hospital.

On​​to​ ​the​ ​young​ ​people.​ ​There​ ​has​ ​been​ ​a​ ​lot​ ​of​ ​talk​ ​about​ ​how​ ​young​ ​people​ ​shouldn’t​ ​be​ ​penalized​ ​for​ ​not having​ ​health​ ​insurance​ ​and​ ​they​ ​should​ ​be​ ​allowed​ ​to​ ​buy​ ​cheaper, ​more​ ​limited​ ​plans.​ ​Again, ​we​ ​pay​ ​for insurance​ ​now​ ​for​ ​those​ ​in​ ​current​ ​need​ ​so​ ​it​ ​will​ ​be​ ​available​ ​for us​ ​later​ ​when​ ​we​ ​need​ ​it,​ ​because​ ​we​’re all​ ​going​ ​to​ ​need​ ​it​ ​at​ ​some​ ​point​ ​in​ ​time.​ ​And​ ​what​ ​a​ ​scam,​ ​offering​ ​the​ ​young​ ​cheap​ ​plans​ ​with​ ​​limited coverage,​ ​then​ ​when​ ​they​ ​get​ ​sick,​ ​or​ ​injured,​ ​and​ ​need​ ​the​ ​care, ​it​ ​runs​ ​out​ ​quickly​ ​and​ ​then​ ​they​ ​have​ ​a pre-existing​ ​condition​ ​and​ ​aren’t​ ​eligible​ ​or​ ​have​ ​to​ ​pay​ ​outrageous​ ​premiums​ ​to​ ​get​ ​insurance.​ ​Sounds​ ​to​ ​me like​ ​a​ ​bait​ ​and​ ​switch.

So​ ​what​ ​is​ ​the​ ​answer,​ ​why​ ​are​ ​health​ ​care​ ​costs​ ​so​ ​high?​ ​Is​ ​it​ ​greedy​ ​insurance​ ​companies?​ ​They​ ​do​ ​have profit​ ​margins​ ​in​ ​the​ ​double​ ​digits.​ ​But​ ​how​ ​about​ ​the​ ​pharmaceutical​ ​companies,​ ​Durable​ ​Medical​ ​Equipment(anything​ ​from​ ​a​ ​cane​ ​to​ ​a​ ​fancy​ ​MRI​ ​machine)​ ​companies,​ ​their​ ​profit​ ​margins​ ​are​ ​in​ ​the​ ​triple​ ​digits? And​ ​even​ ​hospitals​ ​(especially​ ​not​-​for- ​profit​ ​hospitals)​ ​their​ ​profit​ ​margins​ ​are​ ​third​ ​in​ ​line​ ​after​ ​the pharmaceutical​ ​companies​ ​and​ ​DME​ ​companies.​ ​The​ ​insurance​ ​companies​ ​actually​ ​run​ ​a​ ​distant​ ​fourth​ ​after the​ ​big​ ​three.

Talk​ ​about​ ​a​ ​vicious​ ​cycle,​ ​these​ ​companies​ ​earn​ lots ​of​ ​money,​ ​so​ ​they​ ​can​ ​afford​ ​high​ ​priced​ ​lobbyists,​ ​who can​ ​convince​ ​our​ ​representatives​ ​to​ ​pass​ ​laws​ ​to​ ​further​ ​protect​ ​them,​ ​so​ ​they​ ​can​ ​make​ lots ​more money.​ ​Guess​ ​who’s​ ​been​ ​getting​ ​the​ ​short​ ​end​ ​of​ ​the​ ​stick?

Want​ ​to​ ​know​ ​why​ ​your​ ​premiums​ ​keep​ ​going​ ​up​ ​and​ ​up​ ​and​ ​up?​ ​The​ ​tendency​ ​is​ ​to​ ​blame​ ​the​ ​insurance companies,​ ​but​ ​think​ ​about​ ​it.​ ​Pharmaceutical​ ​companies​ ​not​ ​only​ ​charge​ ​outrageous​ ​amounts​ ​for​ ​their medications,​ ​they​ ​also​ ​run​ ​ads​ ​to​ ​convince​ ​us​ ​we​ ​need​ ​more​ ​medications​ ​and​ ​we​ ​should​ ​ask​ ​only​ ​for​ ​their brand name​ ​drug,​ ​You​ ​can​ ​listen​ ​to​ ​an old ​​This​ ​American​ ​Life​​ ​segment​ ​from​ Oct. ​16,​ ​2009 at https://www.thisamericanlife.org/radio-archives/episode/392/transcript​.​​ ​You’ll​ ​not​ ​only​ ​learn​ ​about​ ​how​ ​drug companies​ ​trick​ ​patients​ ​into​ ​insisting​ ​on​ ​unnecessarily​ ​expensive​ ​drugs,​ ​but​ ​also​ ​several​ ​other​ ​insightful​ ​tidbits still​ ​relevant​ ​to​ ​the​ ​problem.​ ​DME​ ​companies​ ​advertise​ ​their​ ​expensive​ ​equipment​ ​in​ ​an​ ​effort​ ​to convince patients​ ​they​ ​should​ ​demand​ ​the​ ​fanciest,​ ​latest​ ​tests​ ​and​ ​the​ ​newest​ ​interventions​ ​(such​ ​as​ robotic surgery)​ ​regardless​ ​of​ ​real​ ​need.​ ​And​ ​hospitals feel​ ​like​ ​they​ ​have​ ​to​ ​buy​ ​the​ ​fanciest,​ ​latest​ ​gadgets,​ ​and​ ​the showiest, ​facilities.​ ​The​ ​insurance​ ​companies​ ​have​ ​to​ ​pay​ ​for​ ​all​ ​that​ ​and,​ ​of​ ​course, they’re​ ​going​ ​to​ ​pass​ ​that on​ ​to​ ​the​ ​customer,​ ​you.​ ​Just​ ​like​ ​any​ ​other​ ​good​ ​business​ ​would​ ​do.

So​ ​what​ ​can​ ​we,​ ​the​ ​consumer,​ ​do?​ ​Well​ No. ​1,​ ​turn​ ​off​ ​the​ ​sound​ ​bites.​ ​This​ ​is​ ​a​ ​complicated​ ​issue​ ​and you​ ​will​ ​never​ ​get​ ​the​ ​information you​ ​need​ ​to​ ​make​ ​informed​ ​decisions​ ​based​ ​on​ ​a​ ​30​-second​ ​sound​ ​bite.​ ​Too much​ ​trouble​ ​or​ ​to​o ​confusing​ ​to​ ​do?​ ​Well​, ​it’s​ ​your​ ​dollar,​ ​your health,​ ​your​ ​life,​ ​what​ ​is​ ​that​ ​worth​ ​to​ ​you?​ ​Look for​ ​information​ ​from​ ​non-partisan​ ​sources.​ ​A​ ​good​ ​place​ ​to​ ​start​ ​is​ ​with​ ​such​ ​sources​ ​as​ ​Steven Brill’s​ T​​ime Magazine​​ ​article,​ ​“The​ ​Bitter​ ​Pill,”​ ​from​ ​March​ 4, ​2013. You​ ​can​ ​find​ ​it​ ​online​ ​at http://content.time.com/time/subscriber/article/0,33009,2136864,00.html. And​ ​his​ ​book,​ ​​America’s​ ​Bitter​ ​Pill: Politics,​ ​Backroom​ ​Deals,​ ​and​ ​the​ ​Fight​ ​to​ ​Fix​ ​Our​ ​Broken​ ​Healthcare​ ​System,​ ​you​ ​can​ ​get​ ​this​ ​through​ ​the Carson City​ ​Library.​ ​Also​ ​look​ ​for​ ​the​ ​documentary ​​Escape​ ​Fire:​ ​The​ ​Fight​ ​to​ ​Rescue​ ​American​ ​Healthcare, which​ ​can​ ​be​ ​found​ ​on​ ​YouTube,​ ​Amazon​ ​Video,​ ​and​ ​other​ ​sites.

No. ​2,​ ​by​ ​living​ ​that​ ​cleaner​ ​healthier​ ​life,​ ​simple​ ​changes​ ​like​ ​a​ ​30​-​minute​ ​daily​ ​walk,​ ​eating​ ​more​ ​fresh fruit​ ​and​ ​vegetables,​ ​getting​ ​at​ ​least​ ​seven ​hours​ ​sleep​ ​a​ ​night​ ​can​ ​have​ ​a​ ​profound​ ​effect​ ​on​ ​your​ ​health.

And​ No. ​3,​ ​write,​ ​call,​ ​email​ ​your​ ​representatives​ ​and​ ​ask​ ​them​ ​if​ ​they​’re​ ​willing​ ​to​ ​sponsor​ ​and/or​ ​vote​ ​for bills​ ​that​ ​will​ ​remove​ ​the​ ​protections for​ ​the​ ​pharmaceuticals​ ​and​ ​DME​ ​companies,​ ​remove​ ​nonprofit​ ​status from​ ​hospitals​ ​earning​ ​large​ ​profit​ ​margins,​ ​and​ ​to​ ​pass​ ​a​ ​law​ ​limiting​ ​all​ ​segments of​ ​the​ ​industry​ ​to​ ​a reasonable​ ​profit​ ​margin! ​Let​ ​them​ ​know​ ​you​ ​want​ ​to​ ​keep​ ​your​ ​health​ ​insurance​ ​and​ ​your​ ​preventative​ ​health care.​ ​You​ ​just​ want healthcare​ ​to​ ​cost​ ​everyone​ ​less.​ ​And​ ​if​ ​they​ ​don’t​ ​do​ ​it,​ ​vote​ ​them​ ​out​ ​of​ ​office​ ​and​ ​vote​ ​in someone​ ​who​ ​will.​ ​And​ ​keep​ ​doing​ ​so​ ​until​ ​we have​ ​enough​ ​representatives​ ​in​ ​Congress​ ​to​ ​truly​ ​represent​ ​us.

And​ ​just​ ​to​ ​get​ ​ahead​ ​of​ ​what​ ​I​ ​know​ ​some​ ​will​ ​say,​ ​it​ ​would​ ​be​ ​illegal​ ​for​ ​Congress​ ​to​ ​set​ ​limits​ ​on​ ​business’ profit​ ​margin,​ ​they​ ​actually do​ ​it​ ​all​ ​the​ ​time.​ ​And​ ​besides​, ​this​ ​is​ ​truly​ ​a​ ​national​ ​emergency​ ​and​ ​it​ ​should​ ​be treated​ ​as​ ​such.

Carson City resident Donna​ ​Inversin is a retired registered nurse.