Commentary: Thinking about health care

Commentary: Thinking about health care

August 23, 2009
Written by Gregg Brekke

Along with many other Americans I've been thinking about health care this summer. Frankly, it's not something I do very often. On the downhill slope of middle age, I'm blessed with good health that doesn't require a lot of active maintenance and, more to the point, I and all of my extended family have good health insurance through a combination of private and public options. But this month's dueling television commercials, outraged talk show hosts, and town meeting shout-outs have prompted a bit more reflection about the benefits I tend to take for granted.

Early in August I scheduled my annual physical. My family physician is pretty low-tech, relying on touch, sight, and sound as much as elaborate tests, so it's not a terribly expensive visit. Operating on the "most things get better" principle, we tend to wait and see before embarking on expensive treatments. The EKG will cost a bit, but my $25 copay and a modest deductible will hardly be noticeable. The blood work bill was initially a few hundred dollars, but after the insurance paid its share, and the provider made the mysterious "adjustment," I only had to write out a check for $6.65!

My doctor and I decided I should have some growths on my shoulder and back looked at. So off I went to a surgeon last week. (It's nice not to have to wait months for a clinic appointment.) Filling out the insurance forms and paying my $25 copay took longer than the consultation. We agreed that some minor surgery is advisable, so I have an appointment in early September. That will be expensive, as will the pathology work, but my insurance will cover most of it. Should we be surprised with an unpleasant finding there may be things to worry about, but money won't be among them.

I renewed my blood pressure medicine on-line yesterday. A couple of months of the generic will cost me $35. I really have no idea what I'd have to pay without a prescription drug plan. And the company that provides a breathing machine to help me with my sleep apnea called to tell me my insurance will probably cover the cost of a new mask. "Just call when you want a replacement."

Pretty boring, unremarkable stuff! The primary obstacle to health care for me is not cost, but making appointments in the midst of a busy schedule of work and travel. Forty-seven million Americans don't share my experience, many of whom are dealing with health issues that far eclipse mine. It's not that I'm smarter than they are, have made better decisions, am morally superior, or even that I work harder. My life is easy compared to single mothers working two jobs without health care. I'm just plain lucky that I have a job that pays well and that offers a health plan emphasizing wellness and prevention. And if I would ride my bike more, or walk more, and avoid the pre-dinner drink or the in between meal snack more often, I'd be even luckier!

At age 59 I'll probably make it to Medicare with my health insurance coverage intact. If for some reason I don't, I'll have to do some rationing. I'd probably stop taking the blood pressure pills. My hypertension isn't bad enough that I'd risk an immediate stroke, but over time the impact on my heart could be significant. I would hand in the breathing machine, but the cumulative effect of restless, sleepless nights over time would take its toll. And those growths on my back? They're probably not skin cancer. Probably. So I could put that off. And I could easily skip next year's annual physical. In other words, I could do what 47 million Americans do every day. I could put my future well-being at risk. And the financial cost to everyone of my "deferred maintenance" could be huge.

Amid all the rage and noise of the health care reform debate there are millions of mundane stories like my own. Except they're not mundane for me. The fact that over 47 million of our neighbors can't tell stories like mine is wrong. It's just wrong. Many of us, for now, can literally "afford" to sit out this debate out and let the politicians and the medical industry battle it out. Many cannot afford to be indifferent now, and our own ability to afford indifference to the plight of the uninsured may not last very long either. Isn't it time for all of us to think long and hard about health care?

John H. Thomas
General Minister and President
United Church of Christ

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