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Posted by aaron at 11:01PM, Wednesday, December 08th, 2004

You know what some of us don't like about this country? Capitalism.

I don't object to the notion of an individual or a corporation making a reasonable profit for goods or services. I object to the notion that a megacorporation's profit is more important than providing health care to a society's people. And I get ripped when my insurance company (Harvard Pilgrim), time and again, in ever more vile ways, treats me like a criminal if I have the gall to use the services I pay for to get a prescription.

I'm leaving the country for a while. Naturally, I call up my pharmacy to get some prescriptions refilled before I leave. For a couple of these, I still have a few days left before the prescription is officially expired. Does insurance cut me any slack, and give me these a few days early? Does it try to maintain the average time between refills, rather than allowing me to get one a few days early, as long as next time I refill it on the normal date? Hell no.

Over the past couple of years, I've been dealing with their per-prescription co-pays increasing dramatically, while their flexibility has disappeared. Five years ago, there were far fewer problems. If I used a little much insulin -- that being a prescription where there's no set dosage, since your body doesn't absorb it the same way depending on time, activity, stress-levels, sleep, food, etc. -- that was no problem. They've all become stricter and stricter, and my Harvard Pilgrim plan is now intolerable. This behavior is appallling to people who need to take pharmaceuticals. It's also short-sighted. It encourages people to not take their medicine, rather than deal with getting on the phone and arguing with someone in India about why they should be able to get refills. And what happens when you don't take your medicine? Well, long-term chronic health problems are one result. Are you telling me it's cheaper to nickel and dime me on insulin and glucometer test strips than to pay for having my leg amputated if I don't control my blood sugars?

I suppose the numbers, overall, must pan out in their favor, because health insurance companies are making record profits. It's still bad karma for them, and bad health for society. Neocons would argue I have a choice in health care, but that's bullshit. We have an oligarchy of companies that extensively lobby congress for rules to benefit them. Their rates and "services" are all pretty similar. Health care in this country is not a free market, given the protectionist legislation and lack of competition. The industry had a whopping success in New Hampshire a couple of years ago, but when insurance became unaffordable for everyone self-employed, the legislators who enacted the whims of the insurers quickly found themselves out of work, and the law's been rescinded. Our only alternatives, as consumers, are to go uninsured, which is, perhaps, a reasonable short-term gamble if you're young and healthy as an ox, but isn't if you have children, or chronic diseases; or to leave the country, and go to somewhere with less stone-age public health policies.

When I was travelling in Canada, I ran out of glucometer test strips (naturally, my insurance company wouldn't give me extras for the trip, but I thought I could stretch them out. I was wrong.) These are about $25 a box over-the-counter, here at home, and the co-pay, I think, is $20. I walked into a pharmacy in Canada, and explained the situation to the pharmacist (who was far more helpful than any I've dealt with at home, lately. I suppose paying service industry people decent money makes for better service -- not that American-style capitalism gets that.) He found the strips I needed, and after making sure they would work with my glucometer, checked me out at the register. I paid $20 Canadian for two boxes.

Like I said, this isn't a free market. We still have some choices, though, and if I could wave my magic wand, I'd choose to create Canadian-style health care in this country, right now. The neocon talking point in response, of course, is that I'd have to wait for care. That talking point only works with anyone who hasn't tried to make a doctor's appointment in the United States in the last five years. I made one, in July, to see a new endocrinologist. The earliest appointment I could get is in October. God forbid we gave up this level of timely service in order to offer health care to those who aren't rich.
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