Friday, November 13, 2009

The ABC’s of Medical Care

The Horror of “Obamacare.”

The Great Unwashed clog free clinics with their endless needs. Aunt Gabby, insured through her job, but who’s never been happy unless she has the latest ailment, burdens the system with imagined complaints. Richie Rich goes to a private cash-for-care facility, which, if necessary to avoid government interference, may be located offshore. “Death Panels” decide whether you or your loved one merits the expense of life-saving medical treatment.

The real horror is that such a system already exists, right here in Hometown, USA. There are three tiers of medical care, not to say there aren’t levels within each tier or that there isn’t a degree of overlap among them, but basically here’s how it appears:

Level C is where you end up if you don’t have insurance or money. You might have a low-paying job without insurance, or you were laid off and lost your insurance. You could be chronically unemployed or homeless. Maybe you’ve just arrived in this country, knowing that you can have your baby in one of our hospitals for free, or that if you need an operation or treatment, you’re much more likely to get it here, eventually, than you are back home in your Third World country. You’ll have to wait in long lines at free clinics and county health departments. You’ll be at the mercy of slow-moving, non-caring bureaucrats. If you’re really sick or hurt, you can go to a hospital emergency room. You’ll wait a long time there, too. But they eventually somebody will take a look at you. And with a little luck they may actually help you out.

At level B you’re a working stiff lucky enough to have some sort of insurance. If something serious happens to you, you won’t lose your shirt, and they’ll take reasonably good care of you. You’ll probably be in a shared room, if hospitalized, but you’ll move down the medical assembly line with relative ease. You may have to wait for elective surgery and for non-emergency tests and procedures, but in an emergency situation, they’ll take care of you before things get out of hand, and you’ll be OK. Still, it’s a good idea to have an intelligent advocate available to help make decisions in case you are incapacitated, or in case they start treating you like a number on a chart.

At A level, you’re likely to have a super-duper insurance policy (the kind they’re talking about taxing to pay for the Level C’s), or you’re extremely wealthy, or you’re relatively prominent in your community. It may help to be a doctor, or be related to a doctor, but it helps even more to be an attorney, or related to an attorney. (A doctor knows the limits of health care; an attorney does not.) At this level you’ll get a private hospital room. You won’t have to wait very long for anything; it’ll seem as if all the procedures are streamlined. You’ll wonder why anyone has any problem with American health care, and you’ll be sure that “we have the best health care in the world.”

“Death Panels”? At level C you may have something to worry about. At the higher levels, the problem is more likely to be that they’ll use extreme measures to keep your body alive past the point where your quality of life has disappeared, just because somebody, whether insurance or government, is paying for those measures.

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