A Tale of Two Health Care Systems

by Karoli on January 1, 2010 · 21 comments

: Image by Getty Images via Daylife

“It was the best of times, it was the worst of times…” For those who have health insurance, the best health care is as close as a 911 call. For those without health insurance, health care is rationed and expensive. When the “haves” think they’re having a heart attack, costs skyrocket for the rest of us, including those who are uninsured.

Conservative hypocrisy, thy name is Rush Limbaugh. His press conference today using his own health situation to politicize health care reform forces me to break my vow never to mention or draw attention to him, because there is no clearer example of our broken system than Rush Limbaugh’s brush with the heart attack that never happened.

Scene I, Act 1: Honolulu, Hawaii

After a round of golf on one of Hawaii’s lovely golf courses, Limbaugh has ‘pain like nothing [he]‘d ever experienced before.‘ Without so much as a second thought, Rush dials up the hotel security staff, is hauled off to the hospital via ambulance.

Upon arrival at the hospital, he ‘underwent extensive tests. Pain gone in half hour. Had angiogram, they found nothing.’

Narrator, offstage: “Extensive tests were required, not only for diagnosis but also to cover any possibility of misdiagnosis, large lawsuit from the champion of tort reform…”

Scene I, Act 2: Press conference, 2 days later

(Cue chorus humming in the background) Rush holds press conference to reassure his adoring public that he’s just fine, fine, and he’s been the beneficiary of the ‘best health care system in the world.’ No questions, please, but he wants to remind us all of this important public service message:

Don’t know what caused the pain. I’m almost 59. Don’t mess with it, any time you have chest pain, turn it over to professionals.

I don’t think there’s one thing wrong with the health care system. I got nothing special, no special treatment. The care was confidence inspiring… extensive, comfortable. The treatment I received here was the best. The nurses, aides have made this stay almost like a hotel.

Narrator, offstage: The union nurses, orderlies and staff in that hospital are some of the best and most highly-trained professionals in America. The hospital system in Hawaii provides excellent care, partly because Hawaii passed significant health care reforms 35 years ago.

Scene I, Act 3: Riding into the sunset

Turning on his heel, having pronounced the system to be the ‘best’, Rush ignores this simple fact: It’s only the best for the people who have insurance or are wealthy enough to pay for it.

Scene II, in one Act

In another state, far, far away, a friend’s mother visiting for the holidays doubles over in abdominal pain so severe as to be an emergency. After 4 hours waiting in the emergency room and multiple calls to the mother’s insurer to obtain pre-authorization for a CT scan to determine the cause of the pain and rule out any obstruction, a diagnosis is made without imaging equipment. Elderly mother is sent home with instructions to postpone any airplane travel for a week, to stay on a clear liquid diet, and finish the prescribed round of antibiotics she will take home with her.

Friends are given instructions for her home care, and also left with the task of sorting out billing issues since this woman was receiving out-of-network care.

One week later, she is recovering slowly, almost ready to travel after a painful, debilitating bout of diverticulitis.

Unfortunately, she is expected to pay extra because she had the misfortune of traveling out of network at the time of her illness, and her insurer will only cover a small percentage of the charges. Someone will have to make up the difference, and it will not be an insurance company.

Those that have, get. Those who do not, make do.

Had Rush Limbaugh’s chest pains happened to my husband, I’d have given him a baby aspirin and asked him to wait 30 minutes before I drove him to the emergency room. There would be no ambulance, no private room, and hopefully we would manage somehow to get through such an emergency without an admission to the hospital and the bills that would wipe us out.

The ‘best health care systems in the world’ do not exist on a two-tier basis. They do not lavish extensive diagnostic testing, immediate attention, and a private room that was ‘almost like a hotel’ on those who do not have the money, assets, or insurance to pay for it.

Those who cannot pay get the ‘other health care system’. The one that delays treatment and diagnosis while the insurance company works as hard as they can not to cover it. The one that allows insureds to assume more of the cost because they had the misfortune of getting sick while traveling to visit family. The one that has people consulting online health websites for ideas because they are simply afraid to go to an emergency room in an emergency for fear of losing everything because they have no insurance.

Even more insulting is this: Mr. Limbaugh’s little “hotel-like” hospital stay costs ALL OF US more. All those tests, all that star treatment that his insurer will pay for? It drives up the cost curve for everyone with insurance. For those of us without insurance, it’s high enough already.

If ever there was a living, breathing example of the case for health care reform, it is Rush Limbaugh’s Brush With Death in Honolulu.

Tagged as: cadillac insurance, have, have-not, health care reform, Politics, Rush Limbaugh

majorbedhead

This was awesomeness, plain and simple. You nailed it and I have no idea why others can't see what you so clearly laid out here.
http://www.drumsnwhistles.com/ Karoli

thank you! I hope others do see it…clearly. I can't recall the last time I saw such shining hypocrisy on display.
http://www.coffeefiltertv.com Kyle Sellers

Wait, I'm a little confused. When Rush Limbaugh's insurance covers his hospital tests it raises the costs for everyone else, but somehow when everyone's tests are covered by insurance it will lower costs? If Rush's tests cost us money, surely everyone's tests will cost us more money as well.

Oh, except for one thing. According to Limbaugh, he does not use his insurance and pays for all of his health care expenses out of pocket. So, not one other person is picking up a single dime for his visit.

—
On a side note, Limbaugh is actually a member of a broadcaster's union which he is unable to legally opt out of. This means that he has union provided insurance that he chooses not to use, even though he pays for it. So, in reality he is actually lowering the costs to ALL ONE OF US with insurance. Would you please write a corrected follow up post thanking Rush for lowering our health care costs?
http://www.drumsnwhistles.com/ Karoli

Kyle, you're mixing up costs and insurance. What I am saying is that it is entirely likely that Mr. I-have-it-and-you-don't probably didn't need any of the tests he received, but because he had them, along with the labs and the rest of it, the costs now rise as a total number combined for provision of health care reform.

If you have any friends who are cardiologists, it's likely you know they can tell from listening whether or not there's been a heart attack. An angiogram is generally warranted if they hear something thru the good ole fashioned stethoscope.

If I had gone to the hospital with chest pains and they heard nothing, the most I would get is a stress test…in a couple of weeks. And you know? That's really ok, because I don't need radioactive dye injected into my arteries to know I didn't have a heart attack that they already know I didn't have.

All that stuff about unnecessary tests? Right there, personified in the person of Rush.

As to the union insurance, he can certainly opt out of coverage, but his union dues will continue to pay for it. This is the only way they can actually get a rate that isn't outrageous for everyone, especially when the universe is limited to…broadcasters and their support staff, traditionally a high-stress, high stakes profession.

So no, I will not write a corrected post thanking Rush for lowering costs, because the fact is that he did not lower costs. Anyone else would have had a wait, and then the doctor would have listened and said nope, not a heart attack, possibly gall bladder, possibly indigestion, but not a heart attack. There would have been no 2-day hospital stay, no angiogram, no “extensive testing”.

Take 2 aspirin and get some rest. That would've been the suggestion. No corrections forthcoming, sorry.
http://www.coffeefiltertv.com Kyle Sellers

The call for a correction was tongue in cheek. And yes, price and cost are different. Every time I buy an ear of corn, I put a minute amount of upward pressure on the price of corn.

So, in your opinion, Rush Limbaugh should not have been allowed to purchase additional tests? I think he has every right to buy all the tests he wants for his peace of mind. What he doesn't have the right to do is to demand that someone else pay for all of his extra tests.

Which brings up an interesting point dilemma. If Rush should not have been permitted additional tests that he and his doctor agreed were necessary (unless you have evidence that the doctor thought they were unneeded), than you are calling for rationing. If instead, everyone should be allowed the same tests, then you must admit (given your own premises) that the cost of care must skyrocket.

Both of which the GOP has been saying and the Democrats have been denying.
majorbedhead

This was awesomeness, plain and simple. You nailed it and I have no idea why others can't see what you so clearly laid out here.
http://www.drumsnwhistles.com/ Karoli

thank you! I hope others do see it…clearly. I can't recall the last time I saw such shining hypocrisy on display.
http://www.coffeefiltertv.com Kyle Sellers

Wait, I'm a little confused. When Rush Limbaugh's insurance covers his hospital tests it raises the costs for everyone else, but somehow when everyone's tests are covered by insurance it will lower costs? If Rush's tests cost us money, surely everyone's tests will cost us more money as well.

Oh, except for one thing. According to Limbaugh, he does not use his insurance and pays for all of his health care expenses out of pocket. So, not one other person is picking up a single dime for his visit.

—
On a side note, Limbaugh is actually a member of a broadcaster's union which he is unable to legally opt out of. This means that he has union provided insurance that he chooses not to use, even though he pays for it. So, in reality he is actually lowering the costs to ALL ONE OF US with insurance. Would you please write a corrected follow up post thanking Rush for lowering our health care costs?
http://www.drumsnwhistles.com/ Karoli

Kyle, you're mixing up costs and insurance. What I am saying is that it is entirely likely that Mr. I-have-it-and-you-don't probably didn't need any of the tests he received, but because he had them, along with the labs and the rest of it, the costs now rise as a total number combined for provision of health care reform.

If you have any friends who are cardiologists, it's likely you know they can tell from listening whether or not there's been a heart attack. An angiogram is generally warranted if they hear something thru the good ole fashioned stethoscope.

If I had gone to the hospital with chest pains and they heard nothing, the most I would get is a stress test…in a couple of weeks. And you know? That's really ok, because I don't need radioactive dye injected into my arteries to know I didn't have a heart attack that they already know I didn't have.

All that stuff about unnecessary tests? Right there, personified in the person of Rush.

As to the union insurance, he can certainly opt out of coverage, but his union dues will continue to pay for it. This is the only way they can actually get a rate that isn't outrageous for everyone, especially when the universe is limited to…broadcasters and their support staff, traditionally a high-stress, high stakes profession.

So no, I will not write a corrected post thanking Rush for lowering costs, because the fact is that he did not lower costs. Anyone else would have had a wait, and then the doctor would have listened and said nope, not a heart attack, possibly gall bladder, possibly indigestion, but not a heart attack. There would have been no 2-day hospital stay, no angiogram, no “extensive testing”.

Take 2 aspirin and get some rest. That would've been the suggestion. No corrections forthcoming, sorry.
http://www.coffeefiltertv.com Kyle Sellers

The call for a correction was tongue in cheek. And yes, price and cost are different. Every time I buy an ear of corn, I put a minute amount of upward pressure on the price of corn.

So, in your opinion, Rush Limbaugh should not have been allowed to purchase additional tests? I think he has every right to buy all the tests he wants for his peace of mind. What he doesn't have the right to do is to demand that someone else pay for all of his extra tests.

Which brings up an interesting point dilemma. If Rush should not have been permitted additional tests that he and his doctor agreed were necessary (unless you have evidence that the doctor thought they were unneeded), than you are calling for rationing. If instead, everyone should be allowed the same tests, then you must admit (given your own premises) that the cost of care must skyrocket.

Both of which the GOP has been saying and the Democrats have been denying.
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http://www.drumsnwhistles.com/ Karoli

I'm not saying he shouldn't have been allowed to pay for them. I just don't think his insurer should pay for them when they were likely not really indicated. The battery of 'extensive tests' he received was for him to heave a sigh of relief, not medical confirmation. If he wants to pay, let him pay. But adding that charge to the insurance pool and forcing everyone else to pay is something else entirely.

Now we come to the guts of 'outcomes-based' medicine, and why it will be so hard to shift paradigms (and mindsets). Via medical dramas, pharma ads, and a plethora of contradictory 'studies', people have been convinced they “need” health care in the form of tests, medications and procedures that it's likely they really don't need.

Heart disease is a great example. Weight loss, giving up the cigars, learning to live a less bombastic life would all be better preventive measures for Rush to avoid heart disease than 2 days in the hospital and a plethora of tests. Dollars to donuts, he's gone off thinking he can live just the way he is now with no modifications since all those expensive tests prove he's got 'no blockage'. It was obvious to me that he's concerned about heart disease, yet seems unwilling to take hold of his own health and manage it. As long as the machines tell him he's fine, he'll keep thinking he's fine.
http://www.coffeefiltertv.com Kyle Sellers

His insurer didn't pay for them, that's the point.

And for a guy who has recently begun eating healthy and working out, who only smokes cigars and won't even take a Tylenol because he battled a prescription drug addiction, I think he has taken steps that many Americans only wish they would take. And it's none of the government's business anyways.
http://www.drumsnwhistles.com/ Karoli

I'm not saying he shouldn't have been allowed to pay for them. I just don't think his insurer should pay for them when they were likely not really indicated. The battery of 'extensive tests' he received was for him to heave a sigh of relief, not medical confirmation. If he wants to pay, let him pay. But adding that charge to the insurance pool and forcing everyone else to pay is something else entirely.

Now we come to the guts of 'outcomes-based' medicine, and why it will be so hard to shift paradigms (and mindsets). Via medical dramas, pharma ads, and a plethora of contradictory 'studies', people have been convinced they “need” health care in the form of tests, medications and procedures that it's likely they really don't need.

Heart disease is a great example. Weight loss, giving up the cigars, learning to live a less bombastic life would all be better preventive measures for Rush to avoid heart disease than 2 days in the hospital and a plethora of tests. Dollars to donuts, he's gone off thinking he can live just the way he is now with no modifications since all those expensive tests prove he's got 'no blockage'.
http://www.coffeefiltertv.com Kyle Sellers

His insurer didn't pay for them, that's the point.

And for a guy who has recently begun eating healthy and working out, who only smokes cigars and won't even take a Tylenol because he battled a prescription drug addiction, I think he has taken steps that many Americans only wish they would take. And it's none of the government's business anyways.
http://www.drumsnwhistles.com/ Karoli

Kyle, you can show me where the insurer will not pay for this most recent stay? Also…it appears that he is taking prednisone (or has), which is nasty, badass stuff. Not in a mind-altering way, but it is an steroidal anti-inflammatory medication that causes a ton of nasty side effects. (Prednisone is what exacerbated and exposed Sticks' diabetes). By his own admission, he was also taking some sort of medication for his back — maybe only the prednisone, possibly other meds. The point is simply this: The treatment he received is not accessible or available to many others, who actually might find themselves needing it.
http://wiredfornoise.com Summerm

When mine had a real, honest, fucking heart attack he made do without a trip to the hospital because time off work was too much and insurance hadn't kicked in yet. Rush as a chest pain and gets a private room and a billion tests.

Oh wait, I forget. We're poor so it's not like we're human beings worth anything as far as Rush and his cronies are concerned. Blah.
http://www.drumsnwhistles.com/ Karoli

Kyle, you can show me where the insurer will not pay for this most recent stay? Also…it appears that he is taking prednisone (or has), which is nasty, badass stuff. Not in a mind-altering way, but it is an steroidal anti-inflammatory medication that causes a ton of nasty side effects. (Prednisone is what exacerbated and exposed Sticks' diabetes). By his own admission, he was also taking some sort of medication for his back — maybe only the prednisone, possibly other meds. The point is simply this: The treatment he received is not accessible or available to many others, who actually might find themselves needing it.
http://wiredfornoise.com Summerm

When mine had a real, honest, fucking heart attack he made do without a trip to the hospital because time off work was too much and insurance hadn't kicked in yet. Rush as a chest pain and gets a private room and a billion tests.

Oh wait, I forget. We're poor so it's not like we're human beings worth anything as far as Rush and his cronies are concerned. Blah.
http://www.drumsnwhistles.com/ Karoli

Kyle, you can show me where the insurer will not pay for this most recent stay? Also…it appears that he is taking prednisone (or has), which is nasty, badass stuff. Not in a mind-altering way, but it is an steroidal anti-inflammatory medication that causes a ton of nasty side effects. (Prednisone is what exacerbated and exposed Sticks' diabetes). By his own admission, he was also taking some sort of medication for his back — maybe only the prednisone, possibly other meds. The point is simply this: The treatment he received is not accessible or available to many others, who actually might find themselves needing it.