The third and final… thank goodness

I must admit, I am getting to the point where I am just tired of seeing these debates. I am really tired of seeing Kerry and Bush go back and forth shouting numbers and “facts”. But last night’s debate, while entrenched in fact slinging, was great. It is really one of the times when Kerry looked and acted most presidential. Bush, on the other hand, looked like someone fumbling around, chasing a ball that is obviously out of his control. But aside from the way that the candidates looked or acted, there is one thing that really disturbs me. I read all of the analysis of the debates on all kinds of different news websites, watch CNN, listen to talk radio, but what I am really peeved about is how most reporters and analysts merely point out in happenstance that Bush flat out lies all of the time. Usually, their stance on Kerry is that he may have exaggerated a true fact by increasing numbers or leaving out one particular caveat of the fact, but Kerry doesn’t just flat out lie.

And let me explain what I mean by lie here people. Because I know that if you are a republican, you are probably really annoyed that I would say that Bush lies. I look at a lie as when you don’t tell the truth. When you say something that, regardless if you believe it to be truth or not, is simply not true. With that said…

Lies, lies, lies! I just don’t get it. Last night’s debate was chock full of ’em. I winced when Bush started talking about No child left behind. That program was SEVERELY under funded. I winced when Bush started saying a myriad of things that “Kerry Said”, which simply were not true, or were taken completely out of context, or where just simply made up! Such as: Kerry didn’t say that he would let the other nations of the world make decisions about our national security. Didn’t say that! But seriously, if you really want to get down to the issues, I really believe that many people in this country just A: don’t know what they are, or B: they are faking it.

Case and point. Bush’s version of “relieving” the increasing medical coverage costs and the rising premiums is to change medical litigation. This essentially means that he would reduce the costs of medical coverage and care by preventing so many lawsuits against insurance companies and doctors, and speed up the process of litigation by having the system work together to determine what works best. I am not totally sure what this means 100% for every person, but when I read,

“Ensure that recoveries for non-economic damages do not exceed a reasonable amount ($250,000).
Reserve punitive damages for cases where they are justified, and limit punitive damages to reasonable amounts.
Provide for payments of judgments over time rather than in a single lump sum, to ensure that appropriate payments are there when patients need them.
Ensure that old cases cannot be brought years after an event.
Reduce the amount that doctors must pay if a plaintiff has received other payments from an insurer to compensate for their losses.
Provide that defendants pay judgments in proportion to their fault.”
(which by the way, is from the white house),
that sounds a lot like the patient would bare the brunt of most of that, doesn’t it? I may not be a lawyer, but I know that if something happens to one of your loved ones, and they are worsened or killed by a medical procedure or care, the loss of that loved one is complicated, and getting punitive damages can make things easier. Limiting the amount of punitive damages prevents you from getting what might be necessary to cover medical bills or previous expenses, but it doesn’t sound like this plan really cares about that. Sure, medical bills would come down when physicians don’t practice “defensive medicine”, but that is over the long term. In the beginning, and even in the middle, those that get screwed with these policies will be without. Simple as that. And I would like to know how someone who is making less than 35k a year is supposed to pay for more than $250k in medical expenses (since $250k is mentioned in the policy). I know that I make more than that, and I couldn’t pay it back in 50 years. And that is without doing the math. (there is policy also means that you couldn’t sue your HMO folks… so if they screw up, and determine that your claim is “your fault”, you get stuck with it).

Anther “bright” idea, is the proposal of medical spending accounts or HSA’s. Well, I know this, I am not an economist. I am not a person who does money calculations, or follows the stock market. I don’t know what the average rate of insurance in this country is. But I do know this. This is a horrible idea. Putting money in an account to pay for medical bills would NEVER pay back the bills amassed in a medical emergency. IT is true that some insurance is better than none. TRUE. It is also true that insurance is way too high, and most people that don’t have it, can’t afford it (that’s why they don’t have it). True. But if you cannot afford health care, how can you afford to set aside, albeit tax-free money, every month or year to pay for your routine medical bills? Most people can’t, that is why they don’t have health insurance. Here is what the white house says, “Americans who set up HSAs along with the purchase of a low-cost, high-deductible health care plan can use tax-free money to pay for routine medical expenses, while gaining protection against major medical expenses.” Well, I am fully insured, and I read my insurance bills. Without insurance, a ROUTINE trip to the doctor, you know for that nagging cough, would cost around $250. Well, let’s say that I am a sickly person, and I need to go a lot. That is $250 a pop, even though it is my tax-free dollars working, it is still a lot. Here’s hoping that I can pay for my “routine bills”. The fact is that, and being a public health worker, I have a little experience in public health, and I can say this pretty definitively… Health care for everyone works. It just does. Preventative medicine is the best way to go. Hands down. It works. It costs MUCH less to prevent than it does to treat, especially when people wait until it is so bad that the treatments must be the most invasive and potentially harmful to the patient. Also, if you don’t believe me, look at where we fall on the life expectancy list, worldwide. You will see that we aren’t near the top. That is also saying something. So it is safe to say that, while this idea would potentially provide health care to some people who don’t have it (making it “affordable”) it would still be way out of reach for others, probably those who need it most. Because let’s face it, those that live in poverty are unfortunately stricken with the most diseases, and that is just wrong. Especially when we have the power to do something about it.

Long story short: don’t limit our litigation abilities. It won’t be pretty. People will be going home with $250k mistakes that they must figure out how to pay for. Also, HSA’s are stupid. If you don’t have enough money to set aside for a $250K bill in the first place, how are you going to pay for “routine expenses” out of your own, tax-free pocket. Chances are, you probably won’t. See what happens when the insurance company sends you a bill for $1000 and you say that you only have $500… it will go on your credit report, if you don’t pay, and it will affect you in many other ways. Also, those in poverty are just barely making it as it is, so how are they going to come up with the money to cover “high deductibles”. I don’t even like to see those two words together, and I am not in poverty, and I have full coverage. So there.

If you don’t agree, I don’t care. This is pretty much the way I feel about it. And like I said, many people don’t know what any of this means. But it still effects you. And if you are just faking it, and think that I am off my rocker, then that is fine too. But I work in public health, and I understand how disease works. And to all the naysayers, did you know that disease has actually been used as a measure of poverty in different parts of the world, including the US? Well, then, there you go. Health care in this country sucks, but I don’t think that this is the way to “fix it”. Simple as that.

So in closing, let me say, that if you don’t like what I write, don’t read it. I don’t care. But if you do, cool. You all know I am NOT (let me repeat NOT EVER NEVER EVER) voting for Bush anyway, so what is the big deal. Oh yeah, and Kerry kicked his ass in 3 debates. So the choice should be clear. =o)

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