Falling Sick

Elizabeth at Half-Changed World, in a post about how parenthood surprised her with its constant illnesses, wrote

The Republican argument that the problem with our health care system is overuse drives me crazy. ... It's nuts to make it more expensive to bring a kid in for a doctor or nurse to take a look, just in case.  Because the one night that D spent in the hospital with asthma two years ago cost our insurance company more than all the medical treatment everyone in the family has received put together since.

I can't say it better myself.

Honestly, as a parent, the biggest single cost of making a doctor's appointment (with or without a copay: we've had both kinds of insurance) is the sheer logistical hassle of the whole thing.  Schlepping the kid to the office, waiting through the appointment without the kid going crazy -- a $15 copay makes no difference either way in the face of that.  And for the folks for whom the money does matter?  Hello, they're often the ones with the greatest health risks, who would benefit most from seeing the damn doctor already.

Gemma was diagnosed with walking pneumonia yesterday.  Same nighttime cough, goopy eyes, and constant drippy nose as the other two kids, they were the ones hospitalized last year for pneumonia, but it's Gemma on the antibiotics this time -- and me thanking God we dodged a bullet, because if it had been Wilder whose virus went wonky in his lungs, we'd be in the hospital with him for sure.

But why is Wilder not in the hospital?  Almost certainly because he's on daily inhaled steroids and Singulair, which costs us $70 a month combined even with our pretty darn generous prescription drug benefit (and that's before we pay for the albutorol, which he only uses when sick, and the Zyrtec for his other allergies).  What about all the parents who can't afford the preventive medications?  How much money "saved" gets spent right back again in ER visits and hospital admissions?

I can't speak to the question of abuse of adult healthcare, because I rarely bother seeing the doctor and we do have access to a decent urgent-care facility when I need to make an appointment.  I know that my copay is $35 and the kids' copay is $15 when we see our primary healthcare provider, so either insurance thinks adults need more of a disincentive to "abuse" the system, or insurance thinks it would look worse (not to mention be worse) for the system to force a truly sick child to forego care than a truly sick adult.  Who knows.

Since school started, I've been worried about Wilder in March.  He needs not to get pneumonia this spring.  Three years in a row is enough.  And if that means I take him to the doctor's office more than I would otherwise like to do (because let me repeat myself: going to the doctor's is a pain in the ass), so be it.  Bring on the co-pays.

I'm just going to be applying them to our shiny new Health Savings Account anyway.

[The HSA: single stupidest addition to the tax code.  Why not eliminate the 2 percent minimum on the health-care deduction, let everyone save their receipts until 1040 time, tax businesses for the lost revenue (which probably would't be that much anyway), and let businesses make back their new tax losses via the administrative savings realized when they're not paying for or managing HSAs anymore?

Our "health care system" is insane.]

Comments

[parodie]

What I think is most interesting is the doublethink involved in "health care" in the US - on the one hand, everyone seems to agree that health care is not a regular commodity and can't be subjected to normal market forces; on the other, there is a strong reticence to move towards single-payer healthcare precisely because that would disturb the "market forces". So strange.

[maggie]

Our health care system is indeed insane. It should be a single payer system.

[tallulah]

Because three of my children were adopted through the state, they are on Medicaid until they are 18. They are also under our private insurance as well. Even though many times their healthcare could be free, there are so many logistical hoops to jump through as well as what I feel as comprised care, we process it through our private insurance.
The whole system is insane!

[SheilaC]

I'm so sorry to hear that Gemma is so sick. Best wishes for a smooth recovery. And I hope and pray that Wilder remains healthy. Elba and you parents too!

[susoz]

Your system *is* insane. I'm not bragging, just saying this so that it's clear there is another way - we pay a health levy via taxes. I don't pay any private health insurance (some Australians do, for some reason that escapes me.) Every childhood visit to the doctor, one month in NICU and surgery as a baby for my son has been completely "free". My own visits to the GP are free as would be any hospital care I needed. (Visits to see specialists are not.)This was the case in Britain when I lived there too, so it's possible even in a country with a much larger population than Australia.