Thursday, July 05, 2007

Our 'Sicko' Story: Reality of the Absurd

Last Friday, Kevin and I went to see "Sicko." We highly recommend it to all. This health care professional learned a thing or two. Like Michael Moore, I too believe that the US for-profit insurance industry should be abolished.

We left Plaza Frontenac about 4:30 pm that Friday, and as we sat at the stoplight at Lindbergh and Clayton, we chatted about the movie. Then it happened: BLAMMO! We were rear-ended by a minivan. Wow. Neither of us saw it coming so we were not able to anticipate the blow. Luckily, we were far enough behind the stopped car ahead of us, so we did not hit them. I have never experienced a force of that magnitude; I immediately thought of some of my nightmare auto accident patients. My thoracic and cervical spine were not happy. Kevin began having flashbacks of being rear-ended in Chicago and the hassle he went through with that. What of our nice Subaru Forester?

Well, the person that hit us pulled over with us and we exchanged info. She was very apologetic. Her minivan appeared to have no damage. Shelia Subaru appeared to have handled the blow magnificently! She was not crumpled; there were a few scratches and the outline of the minivan license plate embedded in her bumper. We immediately drove to our Subaru dealer and got an estimate on the bumper. No other damage. But we were still sick at the thought of it all. And our necks, and my t-spine, really did hurt. I wonder how much force the car absorbed? Did it keep us from being hurt worse?

Now the sicko, absurd part. We have been contacted by the other driver's insurance company. They will send someone out to check out our car. That's the normal stuff. But then we also got this second call about the medical aspect of our claim. We have reported to them that we have pain, and are getting better, but are dealing with the treatment ourselves (me being a PT and all). We have not and will not seek outside medical consultation. Without a piece of medical documentation, nary one bit of proof of my license, this company has offered to pay us a lump sum to compensate us for the injuries; as long as we sign off and agree to never pursue further treatment for this against them.

Now, it is clear, that in this process, we could go for bigger bucks if we wanted to. I could claim to treat and treat myself and argue for a higher claim amount if I really wanted to. I even have a former client who is a pit bull personal injury attorney and could have him handle things or at least advise me on how to get more out of these people. But isn't that the whole problem with the system? Too many people taking advantage of a system and an industry that continually (and by mandate) sucks money out of US citizens because of the fear litigious medical claims?

I cannot do it. Call me naive or stupid. I will not lower myself to manipulate the system for my personal financial gain. My guess is that we would not be faced with this type of ethical dilemma if we were in Canada or France. We would simply get our injuries treated if we liked; there would be no bill for ANYONE to worry about paying. There would be no one writing checks to anyone just to make sure they go away and don't sue. It is sicko.

One particular question lingers in my mind, and that is whether or not this situation would have been different had Kevin and I been on bicycles rather than in our car. Would the insurance company be treating us and our injuries with the same urgency and importance?


Anonymous said...

You absolutely are doing the right thing in not pursuing legal action. I don't think you'd want to be treated in either France or Canada or Cuba for that matter unless you weren't interested in timely access to medical care. And there is a BIG cost to medical treatment in those countries...don't fool yourself. In France and Canada it's confiscatory taxes and in Cuba it's life without freedom. Cheers.

The Iron Maven said...

Thanks for you comments.

I don't believe the cost of care and the quality of care in nationalized health care systems is as high or as slow as most Americans are led to believe, especially for basic everyday general medical and emergency care.

I would much rather pay the exhorbitant premiums we currently pay for-profit Aetna (despite a $2500 deductible, no current health problems) as a tax to a nationalized system, like that in Canada.

After all, we have "socialized" postal service, police and fire protection, etc. It is not perfect, but much about tax-supported infrastructure works just fine.

Of what freedom do you speak? The freedom of Aetna or BCBS to deny care to people so their shareholders and CEOs can make a profit? As a practicing therapist, I've had to fight to get these companies to pay for people to get legitimate physical therapy treatment. That is not freedom for either the patient or the provider. Our current system is backward, unethical and wasteful. There is an inherent conflict of interest with for-profit health insurance.

Anonymous said...

You're right, Iron Maven

In almost every measured category, US health care underperforms other industrialized countries -- sometimes dramatically so. And it costs 150-200% as much. Further, within the US, over the past 50 or 60 years, overall healthcare costs have been cheaper the more the govt spends on it. That is, it isn't just the health care costs that individuals pay that is lower the more the govt. shells out, but the actual cost of health care declines, too.

There's almost a blind faith in the US that anything the government touches must be less efficient than the market, but the market's primary aim is to make a profit, not to provide services. The latter is a happy afterthought. Of course the government is large and inefficient and often corrupt. But so are many corporations, and their motivations are different.

I have a few personal stories of friends or family suffering health problems abroad (Italy, France) and being utterly surprised to undergo major emergency procedures without paying a dime. Often getting better medical attention on top of everything.

Something is definitely amiss.

Hope you're well.

-- a different anon

Casually Me said...

You have my vote. I could not agree more.

Anonymous said...

I agree our system is broken, but please remember one thing: Without profit there will be no reason for the medical community to pioneer new techniques and drugs. Why would anyone work harder if there wasn't some type of reward attached. Plus without profit our best and brightest may decide to become engineers and CEOs instead of MDs. Check out where most medical technology has been created... right here in the USA where medicine equals huge profit.