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Dear Senator McCain, about health care in the hands of bureaucrats

Monday, 8 Sep 2008

Dear Senator McCain,

I watched your acceptance speech, start to finish, and it’s raised certain questions in my mind.  First and foremost due to a coincidence of timing, I’d like you to explain more about your comment that Obama wants to put health care decisions in the hands of bureaucrats, please.  Here’s why:

Trust a nurseI have a close friend who’s struggling with her current insurance provider’s decision makers.  I thought they were bureaucrats making decisions about her health care – without evidently consulting medical practitioners – so I’d like to tell you her story.  I hope together we can figure out who the problematic bureaucrats are, my friend.

She’s divorced, so technically a single mom of two children.  The youngest is away at college, but she’s part of the story, too.  You see, during an unplanned VBAC delivery resulting in the delightful arrival of her now college-age daughter she suffered irreversible nerve damage that left her with an incontinence issue.  After struggling with many courses of treatment over the years, her Urologist has settled on a particularly effective medicine.  But her insurance provider, Health Partners, decided that was too expensive, and since she was a woman of a certain age they determined that she could just as effectively be treated with another class of less-expensive drug.

They didn’t consult with her Urologist, mind you, they just decided she was obviously one of those middle-aged women who has bladder/incontinence issues, and that she’d have to change to another medical treatment.  After all, they’d paid for 5 years of an effective course of therapy already, so it was time to try something cheaper.  It didn’t work.  So they proposed another drug. It didn’t work.  They proposed a third alternative.  You guessed it: no success.

She got assertive and asked had any urologist – or any medical professional at all – reviewed her case? Well, no, Health Partners admitted, they had just decided that women her age on the one drug should be moved to the other class – a class she had tried previously, but when she pointed that out the bureaucrat — oh sorry, the curiously powerful non-medical person she was allowed to talk to who was obviously looking only at the bottom line, not the health and/or well-being of the actual person — they said that she absolutely had to try the drugs that had previously proven ineffective, because they had neither interest in nor any appreciation of the particulars of her diagnosis and prescription by a specialist.

So, Senator, tell me again about how we will lose control of our health care choices in the U.S.A. if Obama starts moving away from the current oh-so-capitalism-friendly system of health care decisions – and how well it’s working now?  This isn’t the story of somebody on medical assistance who lost her coverage, this is actually a practicing, experienced, board-certified, hospital-based R.N. who knows full well how to deal with the clerks and other non-bureaucrats at insurance companies – she does it daily on behalf of her patients.  Yet she suffered the inconvenience and indignity of having a clerk tell her that her prescription was no longer covered; without consulting any medical records or professionals familiar with her case, Health Partners enforced a MEDICAL decision based on saving money. They determined and mandated a course of treatment that wasn’t indicated for her condition.

nicer than doctorsThat may be the sort of health care you think is working for Americans, my friend, but I don’t get it.  We can talk about taxes or bridges some other time if you like. When a veteran RN can’t get proper treatment because Health Partners makes an administrative decision, what’s going to happen to non-medical folks?  Should our health choices be controlled by clerks? I’d rather trust an R.N.

What would you advise, Senator?  You say you’re in favor of changing everything that’s wrong in Washington, you’re trying to reclaim your former label as a maverick who does what’s right – but leaving health care the way it is isn’t being a maverick, it’s toadying up to the lobbyists from big insurance companies, and that’s not going to win her vote – or mine.


Thomas Hayes

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