My Log 504 February 20 2016: A Guest Article: My son Ben, now a permanent resident in the United States, tells the truth about the improbable cost and trouble in dealing with health care in our southern neighbour, and it ain’t pretty!

English: Barack Obama signing the Patient Protection and Affordable Care Act at the White House (Photo credit: Wikipedia)

Supporter of a single-payer health care plan demonstrates at an April 4, 2009 "March on Wall Street" in New York City's Financial District (Photo credit: Wikipedia)

A CANADIAN TAKE ON HEALTH CARE

by Ben Richardson

of Austin, Texas

I am getting really sick of people telling us that single payer healthcare is a pipe dream.  It has worked so well for so many countries.  The people who are against it really want to maintain the status quo.  I’m not shitting on Obamacare because it is so much better than what came before it, but it is basically flawed without the single payer option.

After ten years of living in the US as a non resident alien on assorted work visas, I met my wife Natalie we were married in 2014.  Natalie, while generally healthy has a number of health problems that need attention from time to time.  

I got my Permanent Resident status in 2015 in time to sign up for Obamacare.  As I am a self-employed musician/touring soundman and she is in the service industry we average  between $20,000 to $40,000 a year taxable income (depending on how much work I can drum up).  So when we signed up, we picked a Silver Plan from Humana, which seemed like a good deal.  $6900 a year is the cost of the plan, but with the subsidy we only had to pay $1440 a year.  For this we got Primary Care doctor and urgent care visits for a  $35 co-pay, Specialists $50 co-pay.  For anything extra we had to pay 100% till we reached a $1400 deductible and once over that, we had to pay a coinsurance of 20%.  Once we reached $4500 in additional spending the insurance would cover 100% from then on.  Drugs were also cheaper through the plan

It worked fairly well for the first few months until I got an unanticipated job for quite a bit more money.  Once I had corrected my projected income through the Obamacare website our subsidy dropped and our yearly payment rose to a total of $3840.

The coverage was good. Humana had lots of urgent care clinics in their network.  While we never got around to using the policy to its full potential (finding a primary care doctor, having a physical etc..), whenever Natalie had a problem, we would go to the appropriate provider and for $35 she could see a doctor.  A couple of times, I got small bills in the mail for tests and such for around $100-$150 which I paid with no problem.  

This year when I went to renew, I found that the Humana plan I was on had raised its rates by about $150  a month.  So I went on the healthcare.gov website and tried to find a similar Silver Plan.  I found one from Ambetter that was about the same cost as the Humana plan had been in 2015.  It seemed similar, although i had to admit the whole process is quite confusing and not set up well for comparisons between plans.

A few days ago Natalie got sick at work, and the next day I went on the Ambetter website to find a doctor to take her to.  The first couple of clinics that came up were both less than a mile away from our house.  That seemed like a good sign, but it was not to be.  The first of the two clinics turned out to be inside the Del Valle Jail, the second was the children's clinic inside the Delle Valle Primary School.  The next two places I called, only took appointments and didn’t have anything available till next week.  On the third call a woman registered us, then had a consultation over the phone with Natalie.  After spending a good thirty minutes on the phone, she told us that no one was available and to go to the emergency room.  She was extremely insistent that she should go right away.  I asked her if she could recommend any urgent care clinics and she kept insisting that we go to emergency.  I finally searched urgent care on the Ambetter website and was directed to the only one in Austin. It turned out to be inside a CVS drugstore.  When we got there, the nurse said they didn’t have any doctors there and that Natalie should go to emergency.  I finally got a guy from Ambetter on the phone and as it was getting late, he said  he would find us a doctor early the next morning, and he did phone back

The next morning he called back with the primary school and prison phone numbers. At that point I lost my cool and asked him sarcastically if the $6900 the Plan was costing me, really entitled us to a doctor.  I then posted my story on the Ambetter Facebook page, telling them that they sucked.  I soon received a call from an Ambetter lady who, after I took her to task on the lack of walk-in clinics in their network, promised me that she would get me an appointment in the next hour.  She called back and gave me the number of a doctor who could fit us in at 2:30PM.  Talk to Betty, she said.  So I called Betty right away, only to be told in a most unpleasant manner that the doctor had NO openings that day.  By this time, Natalie was starting to feel a little better and we both basically gave up exhausted and frustrated.  

The only silver lining in this whole mess, is that a couple of weeks before the end of the enrollment period, the Health Alliance for Austin Musicians had called me to tell me about a Silver Plan they were pushing that turned out to be a bit cheaper, so they signed me up with The Sendero Silver Plan that is slated to take effect March 1.  They apparently have a lot more urgent care and walk-in clinics so we have our fingers crossed that it will be more like the Humana plan from the first year.

“So why didn’t you just take her to the emergency?” I hear someone ask.  Well I am pretty suspicious of hospital emergency rooms in the US, based on my experience, and also that of Natalie, who always went to emergency rooms before she met me.  I was on travel insurance for the first ten years here, when I went to the hospital one night with a sore abdomen.  Four hours later I walked out with a diagnosis of a strained abdomen.  They presented me with a bill for moe than $12,000, and tried to get me to pay for it and get reimbursed by the insurance company, even though the insurance rep had told me that that hospital could direct bill them. I didn’t pay them, and when I later followed up with the insurance company to make sure that the bill had been paid, they told me that they had asked the hospital for a detailed accounting of all charges.  The hospital had responded by sending a bill for $900 which the insurance paid and that was the end of it.  Can you believe they tried to rip me off for $11,100?

One time, on the road, Natalie had terrible stomach pains and I took her to the hospital for a three-hour visit.  I later received a bill for over $4,000.  

On another occasion she was rear-ended by another driver and had to go to the hospital that night, returning the next day feeling worse, requiring a second visit.  I had decent car insurance, the other driver had none. My Insurance company covered the repairs to the car, and assured me that they had taken care of all the medical bills to the tune of almost $3000 (the maximum they were legally obligated to pay).  Imagine my shock six months later to get a bill from a collection agency for more than $14,000 for the second hospital visit.  I think this is because the doctors just cavalierly order the tests and not once in my experience have they ever mentioned that these tests are costing you thousands of dollars.  Even when I would question the need for so many tests, the nurses would just cheerily brush off your concerns by saying “the doctor has ordered them”.

After we had signed up for coverage, and Natalie feared during a Caribbean holiday she had caught some kind of infection from a biting insect. We were driving from Dallas Airport back to Austin late in the evening and she called a hospital in Waco and asked them if they took our Humana Insurance, which they assured us they did.  We were there for two hours but after an examination they gave her a clean bill of health.  I specifically asked them if there were any charges as we left, and they said no the insurance has got it.  A month later I received two bills, one from the hospital and one from the doctor totalling more than $900.  The Humana contribution was $96.  But nobody tells you any of that. They usually tell you as little as possible till they’ve done every possible test they can think of, and then present you with a massive bill.   To add insult to injury, in not one of these cases I’ve talked about did we turn out to have anything  seriously wrong with us, certainly nothing that should cost $12,000, or $14,000, or $4,000, or even $900.  This is highway robbery by the whole medical insurance industry.  

So this is Obamacare.  Much much better than the previous system where the insurance companies could deny coverage at anytime and if you had a pre-existing condition you either didn’t get insurance or had to pay a small fortune for it.  The only reason that I became a permanent resident was because it looked like Obamacare would cover us for not too much money.  But the whole system is so skewed towards making a profit that it really is obscene to a Canadian like me.  

The whole day I was looking for a doctor for Natalie, none of the people I talked to gave me the impression they were  really concerned about her welfare.  All they cared about was whether they took our insurance.

I lived in Canada from the age of seven, till I left for Austin at the age of 43.  I confess for that whole period I never gave a single thought to healthcare because it was just there. Though each province has a slightly different way of doing things, the bottom line is that all essential healthcare is covered.  

You just give the doctor or hospital your health card and almost all the charges are covered by the government.  No co-pays and no deductibles and almost no paperwork.

When I was 20 I grew a cyst the size of a tennis ball on my forehead, and had to spend a week in the hospital as they drained it to make sure the infection didn’t spread to my brain.  The cost to me… $0.  When I was 24, my lung collapsed.  That was another week in the hospital.  Then it collapsed again.  One more week in hospital.  Then I had to go in for chest surgery to fix it.  That was a MONTH in the hospital.  Again… the cost to me.. $0.

Five years ago, my Dad almost lost his left eye.  Only a specialist in optic surgery was able to save it.  Cost to him… $0. In 2007 my mother died after two years of daily at home nursing and doctor visits plus two longish spells in the hospital.  Her care was uniformly excellent.  Again cost to my Dad… $0.

“Oh but you’re paying way more in taxes,” I hear someone saying.  Well as someone who has paid taxes in both the US and Canada, I think I can say with authority, that I wasn’t paying any more in income taxes in Canada than I have in the US.  Alcohol, cigarettes and gas are definitely more expensive, and the cost of living can be higher, but that is really because Canada and most other first world countries have higher standards of living, and access to excellent healthcare.  And I have spent roughly the same amount of time waiting in emergency rooms in both the US and Canada.  

The US spends twice (that is double) what most other countries pay for healthcare per capita, and I can see why.  So much time, energy and money is spent trying to eke a profit out of the consumer that its no wonder Americans are so unhealthy.

There’s certain dignity that comes with being confident that when you get sick, you will be taken care of.  That dignity is sorely lacking here in the US and that is why the citizens need to elect Bernie Sanders to put the idea of single payer healthcare squarely on the table.

It will save us a ton of money and lower costs in the process.  The other aspect that no one seems to be talking about is that it will be amazing for business.  I saw somewhere that the average cost to the employer for healthcare is now in the neighborhood of $12,000 per employee.  So even if the taxes were $3,000 per person for the government to pay all the costs, businesses would still be saving a ton.  Hell, if I had to pay $3,000 in extra taxes I would still come out ahead of Obamacare.

I can’t vote, but you know Natalie will be voting for Bernie Sanders…  Feel the Bern!!!!!

My Log 503 Feb 18 2016: NDP a party that would run a mile rather than admit it is “Socialist”: time for a re-evaluation, with a new team in charge

Federal CCF Caucus, in 1942 with new leader M.J. Coldwell(Photo credit: Wikipedia)

Clement Attlee, British Prime Minister 1945-51 (Photo credit: Wikipedia)

Plaque recording the location of the formation of the British Labour Party in 1900. (Photo credit: Wikipedia)

M.J.Coldwell (Photo credit: Wikipedia)

Thomas Mulcair, present leader of NDP(Photo credit: Wikipedia)

President Ronald Reagan, who began the downslide of the common man (Photo credit: Wikipedia)

U.S. Senator Bernie Sanders of Vermont, who is putting the cat among the pigeons in the present US primary elections (Photo credit: Wikipedia)

Tommy Douglas, leader of the NDP, of whom CBC viewers said he was the greatest Canadian who ever lived (Photo credit: Wikipedia)

When I arrived in Canada in 1954, having been raised under a Labour government in social democratic New Zealand, and having, on joining the workforce, automatically become a union member, I suppose I could have been described as a raving socialist, and a red-hot union member.

Naturally, joining the work force in Canada was a bit of a shock, especially since my first job was with the notoriously anti-union Thomson Newspapers, where I first came across the automated linotype machine to which a role of copy cold be affixed and printed out mechanically, especially to obviate the need to hire a linotype operator who might be unionized. In those days as a reporter, I would never have thought of taking a picture, because that was judged, in the union contracts I had always followed, to be the work of a photographer, and I would never have thought of stealing his job.

Of course from the beginning I supported politically the CCF, later the New Democratic Party, and later, when I was working in Western Canada, I even got to interview both M.J. Coldwell  and Tommy Douglas, CCF leaders, and my impression of both was that they would have died rather than allow the word
“socialism” past their lips.  Both, of course, were quite admirable. I was accustomed to such leaders who, while dreaming of a revolution, nevertheless trimmed what they fought for to the winds of popular acceptance. I was more or less driven out of New Zealand in 1950 by my disgust at the apostasy of Prime Minister Peter Fraser, a self-educated working class leader, who entered Parliament when in jail in the First World War for opposing conscription, and who, in 1949, returned from an Imperial Defence Conference in England where he was persuaded that New Zealand needed conscription to confront the so-called Soviet menace. Thus he split the Labour party and ensured its defeat after 14 years of good government. But not only that: he became the all-time symbol, for me, of the well-known affliction for radical leaders of the “embrace of the duchesses.” I arrived in England in 1951 just in time to join the Labour Party and lick stamps for them during the election, and then to quit in dismay after hearing my new leader Clement Attlee speak, an establishmentarian if ever I heard one.

So, on arrival in Canada, I never had wild expectations of any party, but I did realize that the NDP had performed a useful service to the country in differentiating it from the elephant in the south, through having espoused and seen through into legislation such measures as unemployment insurance, family allowances and universal old age pensions. Of course, such policies were stolen by the Liberals, which sidelined the CCF and later the NDP. The party had, to me, an unfortunate habit of being led by Protestant ministers, but of these Tommy Douglas at least appeared to be a man of conviction, ready to stand alone in face of reactionary legislation as he did in opposing Trudeau’s War Measures Act imposition in 1970.

I spent the 1960s in England, but on my return witnessed the election of a number of more or less lack-lustre NDP leaders --- I recall my astonishment when watching the entirely admirable labour leader Bob White dance a gig in celebration of Audrey McLaughlin’s election as leader --- and it is no surprise that none of these leaders has ever taken the party anywhere.

These reflections have been stimulated by an excellent article by Michal Rozworski  and Derrick O'Keefe published in Ricochet.media, reflecting on whether the success of Bernie Sanders in the US might presage the end for Tom Mulcair in Canada. They contrast Sanders’s wholehearted approach to change with the drift to the right engineered by the former Liberal Mulcair during the recent election, and by the fact that to all intents and purposes, Justin Trudeau’s Liberals went to the electorate with a more radical programme than that offered by the NDP.

Nor is anything likely to change so long as Mulcair remains the leader. He is, at heart, a Liberal, and a wholehearted believer in the status quo, as we can see now that the mist has cleared away from he election campaign.  He has been, it is true, an effective Parliamentary debater, and in that role played his part in exposing the former Prime Minister Harper in such a way as to hasten his downfall. But that the Liberals should have been willing to tax the rich, while the NDP was not, surely tells us enough about the direction in which Mulcair is leading the party.

That Sanders has, as the Ricochet authors write, managed to put “socialism” back on the political agenda of the United States, where it had been for decades almost equivalent to poison, suggests to them that Canadians of the Left must take heed, if they are to have any chance of playing a role in the future.

Another interesting article on Sanders and the Left has appeared in The Guardian by Thomas Piketty, who claims that the rise of Sanders signals the end of the era ushered in by Ronald Reagan. Until Reagan, writes Piketty, that is to say, in the years from the 1930s to the 1970s, “the US were at the forefront of an ambitious set of policies aiming to reduce social inequalities.”  He recalls thatthe tax rate for the people of highest income ($1 million or more) was for half a century an average of 82 per cent, with peaks of 91 per cent from the 1940s to the 1960s, and were still as high as 70 per cent when Reagan was elected. This was accompanied by very high rates on estates, up to 80 per cent (twice as much as in France or Germany), and these were measures which greatly reduced the concentration of capital in the United States, and did not adversely affect its economy.

In the context of the Canadian Left, which has been shuffling to reduce its recognition of “socialism”, it is extremely important to be reminded of these facts. If the United States could do it in those days, then surely Canada could do it in these days. And by “it” I mean introduce a coherent set of policies to reduce inequalities and redistribute money from the wealth-owners to the people who do the actual work, the middle and working classes, primarily through social measures such as transfers, child care, early education, free University tuitions (which, someone has reminded us this week would amount to no more than $10 billion a year, no more than four per cent of the federal budget).

It is ludicrous for the right to argue that we cannot afford measures which we could afford in 1970, even though today we have far more wealth to distribute. This is, or should be, the essential difference between Left and Right in politics. For the Right, with their untrammelled market system, it is every man for himself, and the devil take the hindmost. For the Left, all politics should be underborn by a recognition that we are our brothers’ keepers.

Although the NDP has a good record of having stimulated progressive measures implemented by other parties, they are showing no evidence at the moment that they are thinking about what is going to be needed in our new age of technology and accumulation of wealth, if life is to remain liveable for every one of us.

My Log 502 Feb 4 2016: Big celebration in praise of the illiterate bricklayer, Sweaty Valho --- oh, how I wish it were so simple!

Flag of the Republic of Dubrovnik.Guess who at the centre? (Photo credit: Wikipedia)

There are more statues of Sveti in Dubrovnik than you can shake a stick at (Photo credit: Wikipedia)

Statue of Saint Blaise, Dubrovnik (Photo credit: Wikipedia)

One of the animals Sveti saved?
Dubrovnik,  (Photo credit: Wikipedia)

Dubrovnik: Before this church all the festivities took place (Photo credit: Wikipedia)

I feel myself constrained today --- I wish it were not so, but, as we used to say, needs must, in the service of truth and actuality --- to recount an event part of which I witnessed yesterday, in praise of St Blaise, the patron saint of Dubrovnik. Indeed, this saint is honoured in many places in Christendom, and is known by different names, according to the local languages. When he was first mentioned to me in Dubrovnik, he was called Sveti Vlaho I thought they said Sweaty Vlaho, and I immediately had the fantasy that this saint had been a simple man, possibly an illiterate bricklayer or something of the sort, who attained his sainthood and millennial following from being kind to the birds that would perch on his shoulders as he laid his bricks, or on the wall he was building, twittering away merrily as  the construction mounted towards what they no doubt call, in these parts, the heavens.

Perhaps I should pause here by way of disclosure, to make clear that my attitude towards religions --- all religions --- is unsympathetic. I know we are always enjoined to respect everybody’s religion, and I go along with that to the extent that I would not wish to interfere with anyone’s following of his or her chosen religion. But I find it more difficult to honestly admit that I can respect the choice a religious person has made. For, to take the most obvious examples, that would be to say I respect the opinion of someone who, shall we say, has benefited from the highest available education, who yet asks me to believe that their patron came into the world by virgin birth, an event so incredible that it has never yet been recorded in human history. Or that, their Master having been executed by Roman soldiers, and placed in his grave in some sort of cave, the entrance to which was  blocked by a huge stone, nevertheless the corpse found the strength to rise from his grave, roll aside the huge stone, and then, as they say, “ascend to heaven.”

I find it quite impossible to say that I respect the actions of believers who propagate such nonsense around the world as if it were the actual truth. Similarly, to take the case of another religion, we have seen in recent years the spectacle of hundreds of young people offering themselves up as suicide bombers, on the promise that their martyrdom for their cause would earn them when once they have, in their turn, ascended to heaven, a future in which they will be free to amuse themselves with 72 vestal virgins. Such people live right in our present day, and are wreaking havoc around the world with  insensate acts of killing people who are totally innocent of whatever actions they might have been killed for.

And indeed, to return to the case of Dubrovnik, the protection of their patron Sveta Vlaho may have pulled them through their recent war against their Serbian, Montenegrin, and Bosnian neighbours, but it seems not to have guided their thoughts in a particularly noble direction when their soldiers, engaged in fighting on the ground in defence of their Bosnian neighbours, suddenly decided to switch sides in mid-battle, and on the spot undertook a  brutal and treacherous attack on them.

Okay, just to say, I am not a religious person. Nevertheless It was suggested to me yesterday that I should have a look at the spectacle laid on by this city and the villagers who ---- everybody told me this as if to suggest these obeisances were the resort of simple villagers, not of urban sophisticates --- would come flocking in, wearing their traditional garb, and waving their parish flags as they paraded before the Bishop, or whoever was the lead character in this drama.

I do not myself enjoy dressing up, and have a limited taste for it when others do it; I have always hated flags, the main purpose of which in my experience has been to gather the faithful into a group ready to attack the bearers of other flags; and the spectacle of hundreds of priests in their black gowns, colourful robes, fancy hats and the like, is such as to turn my stomach.  So I cannot claim to have greatly enjoyed the proceedings, although I did wonder why the whole procession was brought to an end by a solid column of men dressed as Roman soldiers.

The only thing I enjoyed were the two brass bands. I grew up with brass bands in the far south of New Zealand, and I have always thrilled to the memory of 26 bands marching towards the Rugby Park on the occasion of our annual epic struggle against the neighbouring province to the north. This was before the Second World War, before I reached my teens.  The Dubrovnik band yesterday did play one of the essential British marches, Colonel Bogey, with which our proceedings in those far off days were enlivened, but I did feel they had a musical  arrangement which, towards the end of a phrase, seemed slightly out of tune, at least to my ears.

I have made an effort to discover the origin of Sveti’s sainthood. He was apparently a physician, elevated to bishop,  lived in historical Armenia (modern-day Turkey), and died by beheading by a Roman legionnaire in 316 AD. At a certain point in his life he retired to a cavern, to which his good works attracted many people, hoping to be cured, and also, so it was said, “Even wild animals came in herds to receive his blessing.”  Just like Tarzan, summoning the wild animals from the jungles.

The most significant miracle he performed appeared to have been to have somehow helped a boy who was being choked by a fishbone caught in his throat, by which act he has become, according to Wikipedia, the favourite saint for curing throat illnesses, specially for  bones stuck in the throat.

Although he died in the fourth century, the legendary Acts Of Saint Blaise were not written until 400 years later, and were then used to make him one of the most popular saints of the medieval centuries. The Dubrovnik celebrations, of which I saw the first half hour or so, apparently ended (again I am indebted to Wikipedia) “when relics of the saint, his head, a bit of bone from his throat, his right hand and his left, are paraded in reliquaries.” 

A part I must have missed, again described in Wikipedia, was when “two candles are consecrated, generally by a prayer, these are then held in a crossed position by a priest over the heads of the faithful or the people are touched on the throat with them. At the same time the following blessing is given: ‘May Almighty God at the intercession of St. Blaise, Bishop and Martyr, preserve you from infections of the throat and from all other afflictions’. Then the priest makes the sign of the cross over the faithful.”

I guess, in this modern world, surrounded by its overload of information, you decide what you are going to pay obeisance to, and then do your stuff. Or not.