Pull the Plug on This Chronically Sickening Health-Care System

For the sake of my health, I’ve stopped opening mail from my health insurance company. I’d only get upset and my blood pressure would go into the red.

Now, I’m not particularly unhealthy, nor is anyone in my family. But all it takes is a few visits to the doctor and you’re in for months of paper pushing by the most inept health-care system on the planet.

An indecipherable “statement” from the insurance company is followed by an urgent notice of nonpayment from the doctor, and a war of escalation has begun -- all because of a sore ankle or new pair of glasses.

Am I covered? Am I not? If not, why not?

There are no answers, and the only solace is knowing you’re not alone.

Last week, I wrote about skyrocketing health-care premiums touching off the strikes by MTA and supermarket employees, and about my father having to pay $88 for a thimble-sized vile of glaucoma medicine despite having both Medicare and supplemental coverage.

Readers began mailing and calling in their tips, gripes and war stories, and I made a fatal mistake that I’ve made before: I dived head-first into the morass.

There is no getting out once you’re in. I interviewed policymakers, analysts and elected officials who agree on only two things -- we’ve got ourselves a real mess, and we’re nowhere near solving it.

My blood pressure started creeping up.

“We desperately need substantial reform, and approximately 90% of the population agrees,” said E. Richard Brown, director of the UCLA Center for Health Policy Research.

So why doesn’t it happen? You know why.

Because, as Brown said, “an enormous amount of political power is generated” by all the usual suspects, who lobby to keep the current system in place because their profits are in the billions.

HMOs, hospital conglomerates, pharmaceutical companies, lawyers, insurance executives, etc., etc., etc.

In other words, like a lot of problems in this country, the answer is campaign finance reform. But that’s a whole other morass.

According to an August report in the New England Journal of Medicine, the United States spends $1,059 per person on health administration costs, compared to $307 per person in Canada, which has a national health-care program.

So why don’t we take a cue from our friends up north?

USC’s Jeffrey S. McCombs said a government-run national health insurance system in the United States could be disastrous, in part because doctors would have little incentive to control costs. But UCLA’s Brown said there’s something to be learned by looking abroad.

“Frankly, every other industrialized country has done a better job of controlling costs than we have,” Brown said, “and every one of those countries has had the government in the driver’s seat. That doesn’t necessarily mean owning the system, or even running the system, but it means managing all the involved parties in a very firm way.”

What we have now, said state Sen. Sheila Kuehl, is insane.

“Where has the free market gotten us? The notion was that managed care would save money and everyone would do better because it would be so competitive. But frankly, it’s been the perfect storm of shrinking coverage, escalating premiums and this crisis in which people are desperate to find a different way.”

That different way, she said, is her bill. SB 921 would create a health-care insurance agency and provide coverage for every man, woman and child in California.

“You would have a card, just like your health card now, but you could walk into any hospital, any pharmacy, any doctor’s office, any dentist, any ophthalmologist, and they would know you’re covered,” said Kuehl, who added that all those services would remain private.

What, no more insurance statements in the mail?

Before you get too excited, be advised that Kuehl sees no chance of passage this year or next. The bill would be funded with a 4% payroll tax, which business leaders oppose, and a 2% income tax. It would require a two-thirds approval of the Legislature, and we just elected a governor who promised no new taxes and smaller government.

But Kuehl, urged on by thousands of Californians who support the cause (see www.healthcareforall.org), isn’t giving up. She argues that her plan would be simpler, more effective and less costly for everyone.

“More than 30% of the $150 billion now spent in California on health care goes for administrative costs. Why? Because there are more than 9,000 health plans in California. I’m not exaggerating,” she said.

Kuehl will be explaining all of this on Monday, Oct. 27, at St. John’s Health Center in Santa Monica at 2 p.m. and again at 6:30 p.m.

I plan to be there, and would like to suggest that we all bring our health insurance statements, toss them into a pile and light a match.

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Steve Lopez writes Sunday, Wednesday and Friday.