Central Machine Works
The Problems With For-Profits and Health Care
RECEIVED Tue., Dec. 29, 2009
Dear Editor,
Whatever the philosophical or ideological ramifications of using for-profit companies to deliver a social good, I have some experience on how this actually works. My close friend is disabled with Reflex Sympathetic Dystrophy/Complex Regional Pain Syndrome. Imagine having molten lead injected into your body. Seriously. Neuropathic pain can be worse than cancer pain. This condition was caused by refusal to properly treat. Contrary to Republican propaganda, it is not easy to file a malpractice suit, impossible under tort reform. Under the previous system, she was eligible for "dual enrollment in Medicare/Medicaid" with Medicaid paying for her meds. Our problem then was finding proper treatment. We found a doctor who is successfully treating her condition, allowing her to get out of bed and not need a wheelchair. Our problem now is that the for-profit insurance companies have a financial incentive to deny her care. Medical decisions are made by underpaid, uneducated phone workers who (as we know from recent testimony) are tasked with denying care. The prescribing decisions of a world-renowned specialist is overruled by phone workers who (at least pretend) to not understand the word "ingredient,” to name but one example. Under the new health bill this situation is not addressed. Using for-profit companies to provide a social good is unworkable because the incentive for the company is to make money. This is contrary to the goal of providing health care. My experience proves this. This is not an ideological position; it has been my friend's life since the passage of Medicare Part D. Every company acts identically, so it cannot be the fault of individual companies; it is a bad system.
Whatever the philosophical or ideological ramifications of using for-profit companies to deliver a social good, I have some experience on how this actually works. My close friend is disabled with Reflex Sympathetic Dystrophy/Complex Regional Pain Syndrome. Imagine having molten lead injected into your body. Seriously. Neuropathic pain can be worse than cancer pain. This condition was caused by refusal to properly treat. Contrary to Republican propaganda, it is not easy to file a malpractice suit, impossible under tort reform. Under the previous system, she was eligible for "dual enrollment in Medicare/Medicaid" with Medicaid paying for her meds. Our problem then was finding proper treatment. We found a doctor who is successfully treating her condition, allowing her to get out of bed and not need a wheelchair. Our problem now is that the for-profit insurance companies have a financial incentive to deny her care. Medical decisions are made by underpaid, uneducated phone workers who (as we know from recent testimony) are tasked with denying care. The prescribing decisions of a world-renowned specialist is overruled by phone workers who (at least pretend) to not understand the word "ingredient,” to name but one example. Under the new health bill this situation is not addressed. Using for-profit companies to provide a social good is unworkable because the incentive for the company is to make money. This is contrary to the goal of providing health care. My experience proves this. This is not an ideological position; it has been my friend's life since the passage of Medicare Part D. Every company acts identically, so it cannot be the fault of individual companies; it is a bad system.
Tom Cuddy