Broken System

Before your eyes glaze over at the idea of a discussion of healthcare let me say this is a little different. This is a few thoughts about the national debate from the perspective of a guy who is (a ) a business lawyer and (b) in the middle of cancer treatment. But: policy wonk alert. Go back to cruising hulu if you're just lookin' for fun.

One think that bugs me is the constant reference to the unanimous consensus that the system is broken. Hey... with a typical company medical plan I am using the best medical establishments in the whole damn world, on my way to survival of a serious cancer case, and not having to take on another mortgage to do it. Is this system broken for everyone but me?

This Broken System has placed an internationally recognized cancer treatment center 20 minutes from my house. The people I see in there for treatment are all colors and ages and walks of life. The Broken System treats them all, so far as I can see, with respect and courtesy. I know of no one who has abandoned this Broken System to get care in, say, Spain.

The insurance companies in the Broken System have been who they are: administrators of written policies of insurance. I'm going to have some issues; who wouldn't, with tens of thousands of dollars at stake at every turn. But they are not being evil, and it really offends me to hear the pols try to turn the populace into a lynch mob for evil insurance companies. Medical insurance companies sell coverage (or just administration) to companies based on written plans. If a company were to say - cover all my employees' medical claims, period; if it's a bona fide bill from a medical service provider, pay it -insurance companies could sell that plan, they'd be happy to. It would cost a fortune, however, and no company would buy it. So there are limitations based on pre-existing conditions, levels of care, types of illness that are not covered, location of the providers, etc.

In close cases the insurance companies have the job, as administrators, of making the call. But if something isn't covered, it's because the plan doesn't cover it. Not because insurance company executives are diabolical.

I know that this all is irrelevant to the person who is unemployed, or whose employer doesn't have a plan. They don't have care as good as mine, and it is probably costing society way too much to provide them the care they get. For this I'm sorry. But they don't have food or shelter or education as good as mine either; and I'm sorry for this, too. There is as yet no system that has figured out how to make all these things equal in a multi-cultural, multi-racial nation of more than 300 million people. (Please, forget Denmark. It has 6 million people, 80 percent of whom are fitness-oriented Lutherans. It's not comparable.)

What we do have, for now, is an American system of health care - organic, grown up in markets, complicated, private for those under 65, and with plenty of flaws. Driven in part by a long-standing tax break, where pre-tax dollars are used to pay premiums. It isn't broken. It has flaws that can be identified and addressed, one by one. It will never be perfect and will never, unless we want to become Cuba, provide exactly equal levels of medical care to everyone.

Waking Up

This must happen all the time. After surgery, or radiation, or one of the other dramatic things the medical profession does to us (often for very good reason) there is a period of recovery that includes a lot of discomfort, sleeplessness, disorientation and, well, drugs. It all becomes a muddle, until at some point - a point I reached last weekend - you say, enough. And you quit all the meds.

What happens next probably varies all over the place. In my case it didn't go too well at first and I grabbed for the anti-anxiety pills one of the many docs I have come to know had prescribed. But now I'm past that, and remarkably enough, tonight, on the heels of a really disastrous loss by the Cardinals to the Dodgers, I think I'm waking up.

Doesn't mean I feel like running a marathon or eating a cheeseburger. Still tired. But I'm getting to a level of clarity - and recognition that it's once again an interesting thing to be a man, husband, father, partner in a law firm, with a lot of people and things and events I'm responsible for.