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I just got over a health scare. I don’t mean a big splinter under my fingernail or a stuffed nose. To me a health scare means believing that some serious bodily problem might ruin or end your life.

Health Care Politics

The “might” is important. It’s scary to be unsure if this bad health moment might have disastrous consequences. So much of health care recommended by doctors and practiced for ourselves by all of us is about probability.

Some things are certain. The doctor was certain I had ruptured my spleen playing football when I was 17 and certain that the internal bleeding had to be stopped right away. That was a health scare I didn’t know about until afterwards, when the surgeon told me, “You could have died.” He was just trying to cheer me up.

Lots of medical issues are more speculative. Doctors consider the probabilities that particular symptoms mean this specific disorder and that certain medical and pharmaceutical steps will help this patient. We the patients weigh our options, based on what we know and don’t know, using our own set of intuitive needs, beliefs, and probabilities.

My doctor helped me recover from this current scare by telling me, “Something else will probably kill you.” He and I both understood the value of frank talk about the future.

My doctor helped me recover from this current scare by telling me, “Something else will probably kill you.” He and I both understood the value of frank talk about the future.

My scare was not at all about money. I knew I’d have to pay something for the visits and tests and more visits and tests. But I knew it would be affordable, because I have good health insurance. Like nearly everyone my age, Medicare is my primary insurer, the biggest health insurance organization in the US. Medicare is bureaucratic, but reliable. They will not go bankrupt, like my parents’ long-term care insurance provider did.

Medicare is incredibly cheap. In fact, coverage for hospital visits, so-called Part A, is free, with a deductible of about $1300 for each hospital stay. Not bad when the average hospital stay costs about $10,000. You only have to pay something per day if your hospital stay is longer than 60 days, meaning the total cost has probably gone well above $100,000. Medicare coverage for doctor visits, tests, and other services, so-called Part B, is not free – that costs about $1600 per year for anyone with an income under $85,000, that is, for most people. That’s cheap, too.

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All my probabilities would change if I didn’t have good health insurance that I could count on until something else kills me. That puts me in the minority of Americans. Health problems become health crises for most Americans when they worry, “How are we going to pay for this?”

My doctors’ recommendations were based on careful scientific studies of tens of thousands of cases over many years. My political representatives’ recommendations about health care are based on self-interest and dogmatic political ideology, designed to misinform me and everyone else. The discussion of health care and health insurance in this country is worse than useless, it is often deliberately misleading. How can average Americans judge health probabilities when our politicians constantly threaten to upend our health insurance system?

Democratic politicians created an imperfect system which drastically reduced the probability that an American family would be uninsured. I think that’s great. Democratic politicians have been arguing for a long time over whether some version of “Medicare for all” would be even better for most Americans. We need that debate.

The Republican contribution to our national health discussion has been, “We will destroy that system and tell you about a much better system later.” If they really had developed another system, we would know about it by now.

Conservatives hated Medicare when Democrats created it in 1965. They have never stopped complaining about it and have never done anything to make it better. House Speaker Paul Ryan announced in December that Republicans wanted to cut spending on Medicare. A few months ago, the White House budget proposed cutting $554 billion from Medicare over the next 10 years. In June, the trustees of Medicare, who are mostly Republicans, like Treasury Secretary Steven Mnuchin, reported that Republican policies have hurt Medicare’s financial prospects.

Nobody knows what our President, Cabinet, or Republican majority in Congress will do about American health care tomorrow, next year, or any time in the future. That makes all of our health care probabilities worse by increasing the financial uncertainties of all Americans. Nothing they have done so far has made anyone’s health better. That is a national health scare.

I hope that something else kills me before any Republican health care plan goes into effect.

steve hochstadt

Steve Hochstadt
Taking Back Our Lives