One advantage of social media like Facebook is the instant discussion it can spark and how open, and illuminating, that discussion can be.
For example, the other day I posted a link to a story I'd found in the New York Times about how the Affordable Care Act (Obamacare) depends on young healthy people signing up so the program's income matches its outgo.
I said with the link, "People don't think of insurance as a way to spread risk and share the cost of paying for illness. They see it as some sort of golden goose -- you wait until you might get sick, pay a little in and it pays your giant medical bills. Why buy it when you are healthy? This is why we need mandatory single payer."
It's nice when you don't have to pay that $40,000 hospital bill, but there is no golden goose. When I got a bill for $40,000 last March, lots of other folks paid it for me through their insurance premiums, and I thank them.
We all pay for the uninsured, whether they be young and healthy or poor and sick, through higher medical costs, bureaucratic abuses of the current system and the societal and fiscal disruption of medically-induced bankruptcy.
Everyone should be paying in because everyone is going to have to have a medical problem they need paid for. This needs to be a national system, paid for by all, paying for all, instead of the current for-profit system in which medical insurance companies decide who gets coverage and which procedures they will pay for, no matter what your doctor says.
The profit system is rife with abuse at our expense. The folks who chimed in on my Facebook post had a long list of examples.
Said one: "I had a dermatologist who refused to look at more than four moles per visit. And for someone like me -- whom my family physician humorously termed an 'Appaloosa' on account of the constellation of moles covering my body which number well into the thousands -- that would have been a full-time job just getting screened for skin cancer.
"I finally went to another dermatologist who looked me over head to toenail and dug out about a dozen moles, half of which had pre-cancerous abnormal cells. For a doctor to refuse to give life-saving treatment, or to ration it out to the patient under their care, well, they can go where insurance execs go."
Said another: "An acquaintance of mine who is vehemently against "Obamacare" was complaining recently because his teenage daughter, who is pregnant and on Medicaid, couldn't find a decent doctor.
"He was blaming Obamacare for that. I pointed out that if Obamacare were in full effect, his daughter would be on his insurance and her pregnancy would be covered, or if she were somehow on Medicaid, there would be more options for her because Obamacare compels more doctors to accept Medicaid and compensates those doctors better than the old way.
"But that just made him mad."
The problem of doctors working the system to increase billable office visits came up several times. I can sympathize. Both times I was in the hospital for major surgery I mentioned, on admission, that I have asthma. As a result a doctor from respiratory therapy would poke his or her head in the door every day and ask me how I was breathing.
"Fine" I'd say and they'd say "good," and go.
Each visit got billed for around $200. That's $1,000 for five days of saying "fine." Wouldn't it be cheaper to wait until I told the nurse "Hey, I can't breathe!"?
But I was a captive audience. Other doctors, apparently, are more blunt, like the doctor who'd only do four moles a visit, or this guy's doctor:
"My wife needed her blood pressure prescription refilled and instead of just having her go in and have them check it for free the doctor said that she had to schedule an office visit before she could get the refill.
"When she told them she didn't have any insurance and couldn't pay for an office visit they still said she had to schedule a visit. I called the clinic and asked why she couldn't just get her blood pressure checked to see if the prescription needed to be adjusted they said the doctor wouldn't give her a refill without a visit."
We are told capitalism can control these things, that government intervention is not necessary. Pure codswollop.
A New York Times study on medical costs found that hip implants cost $1,000 each to make but are sold for $13,000, just for the part. Why? Because that's what all five companies that make implant parts have agreed to charge. They control the market, we are stuck.
Decades ago I wrote a piece in this paper saying it was wrong that a Roy woman, who I'd just done some stories on, to have to beg for money to get her child a liver transplant while paid-for $20 million F-16s flew over her house. If we can afford one, I still believe, we can afford the other.
Is the Affordable Care Act the best answer? No. I'd much rather see Medicare extended to everyone, make everyone's insurance premiums into Medicare taxes, and be done with it.
But "Obamacare" is a start, and is a lot better than what we have now. If you disagree, you must be very healthy, or a Republican in Congress.
Charles Trentelman is a retired columnist for the Standard-Examiner living in Ogden. He writes a blog at http://charlestrentelman.blogspot.com