Valley View vs. Greenville
Cars and Parts Springfield Swap Meet
Carroll Commencement
Ellen Belcher is the Dayton Daily News opinion pages editor. She writes about state government, education, the environment, higher education and all things Dayton.
Martin Gottlieb is an editorial writer and columnist for the Dayton Daily News opinion pages. He focuses on the political process itself and does such national issues as war, the economy, taxes and Social Security, as well as a hodge-podge of local and state issues.Home > Blogs > A Matter of Opinion > Archives > 2009 > September > 10 > Entry
Guest column: How can we let anyone be treated this way?
This column was written by Lawrence E. Mieczkowski, of Kettering, an internist who specializes in cardiovascular disease prevention.
“So, doc, what do you think about this health care debate?”
I am usually in the midst of writing a prescription or filling out paperwork when a patient asks. The younger patients don’t usually bring up the subject. They usually are employed and have coverage and generally don’t need a lot of medications.
A few of my wealthy patients ask, assuming I oppose President Barack Obama’s call for universal coverage. They are usually put off by my response that I support a single-payer system.
Sometimes I win over these patients, but, for many of them, this is simply an intellectual debate. They have health care insurance and can’t imagine a scenario under which they wouldn’t.
The most earnest questioning comes from the over-60 crowd; the retirees who took a buyout some years ago and were promised they’d have coverage and now are losing it; and the 30- to 40-year-old guy who is in-between jobs — yet again — and has no coverage.
I see the fear in their eyes, the worry about how they’ll afford the medicine they need, the relief when I tell them that I can give them samples. Their looks are the same when I offer to switch them to a less effective, but cheaper, generic drug, and when I waive their co-pay.
I also tell these patients about Ed, a 70-year-old retired truck driver living on Social Security and a small pension. He pays for the Medicare Part D drug coverage, but his monthly insulin costs alone are more than $300, and he falls into the prescription coverage donut hole within four months of the start of every year.
He calls us every two to three weeks, pleading for a couple of insulin vials. Sometimes he shows up at the check-in window unannounced. How can we refuse his request? I know that he doesn’t take the dose that I prescribe, in order to space out the insulin. We have a first-come-first-served approach to giving out insulin samples. People call to reserve them; we limit the give-aways to a bottle or two. That’s all we have.
Pharmaceutical companies have significantly cut back on samples. Sometime my office only gets five to six vials a week. Most of the time, that’s not enough to meet all of our requests. Ed usually requires five or six bottles monthly.
Then I share Tom’s story. At age 31, he was way too young to have suffered a heart attack, but he did. He wasn’t overweight, and he didn’t smoke. Now 38, Tom inherited a genetic cholesterol problem and then developed diabetes. Because of the diabetes, he then hemorrhaged into the back of his eye and almost went blind.
Still, he kept trying to work. He probably could’ve applied for Social Security disability since he has a bad heart and only one good eye. He’s one of the guys I call the working wounded.
He has had insurance coverage, but he couldn’t afford the co-pays for his diabetes medications, the insulin, the prescription blood thinner, the cholesterol medications, the heart and blood pressure medications, the co-pays for the family doctor, my fees as a specialist, his cardiologist and the two eye specialists. Meanwhile, there are medical expenses for his wife and two children.
There have been times when I have walked Tom out the door with more than $1,000 in medication samples. I’ve told him to send his $15 co-pay when he gets his paycheck at the end of the month. More recently, things have gotten worse since his employer fired him unfairly.
I ask the inquiring patient, not expecting a reply, “Where is Tom to go for help? Is this fair? How can we let this happen?”
These conversations happen sometimes six to seven times a day, week after week. So, yes, I say, repeatedly, forcefully, but respectfully, I favor health care reform.
Permalink | Comments (33) | Post your comment | Categories: Guest Columns, Health Care
Comments
By Bill in Brookville
September 10, 2009 8:22 AM | Link to this
This is a comment that will never be heard on fox news. hey will however support the company that fired Tom, and the drug companies, insurance, and any others that feed on a system in dire need of repair. We need to hear more from those in the front lines like this Dr.By jt
September 10, 2009 9:13 AM | Link to this
It amazes me how when Liberals don’t have anything real to say, they blame Fox New and conservative radio for their inability to say anything coherent and reasoned. If people were interested in what Liberals have to say the New York Times, MSNBC and CNN would be the gold standard. Instead, they are background noise in an already noisy environment of bs. Obama has become so desperate to get some kind of reform; he has resorted to scare tactics and misinformation. The doctor is right, those patients should be helped but Obama’s and Congress’s plans will not do it, they will only make things worse. And until there is a better choice, the American people will not support it. Give me an example of an efficient government supported company and I’ll pinch you to wake up from your dreams. The Post Office? HA! Try again!By joe_mamma
September 10, 2009 9:15 AM | Link to this
Those are all tragic stories. What I don’t understand is why stories like this mean we should have a single-payer government run health care system? The first step should not be a government takeover, but common sense reforms like tort reform, tax reform, allowing consumers to purchase insurance out of state, move away from employer insurance to individual etc…. There are lots of good ideas out there. Doc, you might have thought of this already, but I think it would be a good idea to ask your patients that can afford your services if they would be willing to contribute a few bucks each visit to help your patients that are in need. I know I would contribute and you might be surprised how much you collect.By Bill from Brookville
September 10, 2009 11:03 AM | Link to this
Neither the President or any one in Gov’t has suggested a single payer system( like Canada’s) if you would listen to anything but fox you would know this. The President has specifically rejected this. Per AARP BulletinBy scooby do
September 10, 2009 11:42 AM | Link to this
“would be willing to contribute a few bucks each visit”. Good luck with that. So our healthcare is reliant on a tip jar outside the Doctors office, right beside the homeless pets jar. When my wife needs more test for breast cancer I can tell them to get the payments from the tip jar, I am real sure that will work out. If you like, the tips jars idea so much and think it will collect so much money, let’s pay for the 2 Bush wars. Take the money out of the budget for the wars and move it over to healthcare that way healthcare will be paid in full so that ends the rightwing, and Medicare and SS will be rolling in the money. If that isn’t enough money, let us do the same with the 1.3 billion-tax cut for the wealthy from Mr. Bush too.By Don Juan
September 10, 2009 1:28 PM | Link to this
I was a McCain supporter until he chose Palin. I don’t understand people’s fears about a Government-Run, Public Option. We already have 5 Gov’t Plans: Medicare, Medicaid, VA, Congressional, and Federal Employee. Now, if the GOP Congressmen and Senators are so against it, why are they on the Gov’t Run Public Option??? Once they all drop their coverage, and come up with their own plan, I’ll start listening to them. Until now, they are nothing but a bunch of blowhardsBy joe_mamma
September 10, 2009 2:09 PM | Link to this
Bill, Please explain how a private company is supposed to compete with a government backed plan. Is the public plan going to pay the same income taxes that private insurers do? Is the public plan going to pay the same gross receipt taxes in Ohio that private companies do? Will the public plan be susceptible to no-limit malpractice or class action law suits? Is there going to be a guarantee that the public plan will not take advantage of other government privileges such as property tax exemptions, sales tax exemptions or absorption of administrative costs? Is the public plan going to be held to the same accounting audit and financial reporting compliance as the private insurers? I think these are pretty reasonable questions. If the answer to any of these questions is “no”, then the playing field is not level and is in fact designed to drive private companies out of the industry and to leave us with only the public option.By null
September 10, 2009 2:19 PM | Link to this
I really don’t have a dog in this fight. I am a retired federal employee and I have the same coverage as congress does. Federal health care won’t be affected. Most will never see this kind of coverage. BHO will see to that that.By joe_mamma
September 10, 2009 2:31 PM | Link to this
Scooby, Really man. You aren’t adding anything to the debate. Someone offers an idea that might help this doctor RIGHT NOW take care of some of his needy patients and you start talking about the Iraq War? I might disagree with the doctor but at least his putting forth a coherent argument instead of repeating Keith Olberman. You can make fun of charity all you want but Americans contributed over 300 billion last year. Charity won’t solve the health care cost problem, but it might be able to help this doctor and his patients out right now.By Howard Ford
September 10, 2009 5:56 PM | Link to this
thank you you. this is a great article. very thoughtful, i’m glad you shared your perspective with usBy drunken orangetree
September 10, 2009 8:04 PM | Link to this
Scooby treated the “tip jar” idea with the ridicule that it deserved. And while jo_mamma’s concern for the poor little insurance companies is touching, I would like to see some sympathy directed towards the people Dr. Mieczkowski talked about.By richardo
September 10, 2009 11:55 PM | Link to this
The solution to healthcare is simple: I’ll take the same coverage, for the same price, that the Congress & Federal employees/retirees have. Let Congress figure out the details - that’s what they’re paid to do!By joe_mamma
September 11, 2009 7:58 AM | Link to this
Ha. As usual Drunk can’t add anything to the discussion. He has no ideas other than to abdicate his responsibility to himself and others to the federal government. In typical statist form he has a dim view of humanity and ridicules the power of charity because he can’t stand the idea of people actually choosing how much they give and to whom they give.By joe_mamma
September 11, 2009 8:12 AM | Link to this
Richardo, No offense, but did you ever take a civics class? To have a functioning democratic republic the public needs be informed and an active participant. The parties you are entrusting to work out the details, Republican and Democrat, have run up a 12 Trillion dollar debt, bankrupted Social Security and Medicare, took over two car companies, selectively bailed out Wall Street firms and could not even run a simple rebate program called Cash for Clunkers. How on earth can you think they are capable of managing your families healthcare?By Bill in Brookville
September 11, 2009 8:57 AM | Link to this
The Public Option,if it makes it out of Committee, which is in doubt, would only be available to those not in an employee provided program. No thinking person can say the current system is not broken. Something has to be done.By Bill in Brookville
September 11, 2009 9:09 AM | Link to this
joe, if you followed anything but fox you would know the bail out of wall street is already starting to show a profit as the money is being repaid. you buddys cheney/bush allowed the insurance companies to control medicare payments to those with supplemental policies causing a 14% increase in costs to the plan. Oh yeah, the Gov’t won’t be managing your healthcare only regulating it as they have for years. Only fox claims they want to run it.By joe_mamma
September 11, 2009 9:25 AM | Link to this
Nice try there Billy-boy. It is true that according the house bill that the public option would be only offered to those not in an employer plan. However, the penalty to a company not offering an employer plan is 8% of their payroll. Guess what…it’s actually cheaper for a company to not offer an employer plan and to pay the 8% penalty. So a lot of companies will just drop the employer plan and make their employees take the public option. Gosh!!! That sounds like it just might be an unfair advantage and advance the goal of driving private insurance companies out of the market.By joe_mamma
September 11, 2009 10:11 AM | Link to this
Wow Bill. The government earned 4 Billion on the bailout so far. Let’s see all they need to do is earn another 45 Billion for Citigroup, 45 Billion for Bank of America, 182 Billion for AIG, 65 Billion for Chrysler and GM, and 96 Billion for Fannie and Freddie. Then they need to come up with another 12 Trillion to cover the national debt. Then they’ll break even. But hold on there is also 37 Trillion in unfunded medicare liability and another 70+ Trillion in unfunded social security liability. Guess what Bill? If the government is paying your medical bills they will be running it not you. You will have little to no control. You are so partisan that you can’t even see that both parties are screwing you. Take off the blinders man.By davidss2
September 11, 2009 10:34 AM | Link to this
I notice the doctor wants health care reform, not a government takeover. Big difference. The problem is Obama is trying to quelch discussion of his imaginary bill where he gives out imaginary facts to ridicule anyone against him. But the bills in existence aren’t the ones he has been drawing facts from: they will service illegals and will mandate moving you to the government plan with any change in your plan or employment. A big question for narcissistic Obama is “H” “O” “W”? Three little questions he never wants to discuss. How to do (ain’t no bill specifics, never has been, never will be, because that’s what allowed people to realize clinton care wouldn’t work. Obama also can’t pay for it. If there were efforts to reduce fraud in Medicaide instead of not wanting to swing the bucket of cash flowing there, if there were efforts to reduce fraud in Medicare instead of just cutting payments and services (doctors will refuse medicare even more along with hospitals because of small payments). ———————Cut legal suits against hospitals and doctors and you can lower medical costs. But that would hurt democrat leaning attorneys just like UAW kept the US auto mess from being cleaning up properly to maintain UAW voter’s and contributor’s jobs.—————Remember when Obama said he’d keep lobbyists out of DC after the election. What a laugh.—————A problem is Dr. Majestic is talking about patients who expect medicare and social security to be full retirement programs instead of extra to the retirement they worked and earned and saved for. ——-Right.By DAVE
September 11, 2009 11:15 AM | Link to this
I just find it hard to trust the government that has mismanaged medicaid, social security and welfare to get it right. Suppose this plan passes congress, who holds the government accountable? They have already shown through numerous failed policies that they won’t get it right.By keithfromxenia
September 11, 2009 1:51 PM | Link to this
you should pay more attention billy boy. obama, in his pre president days, supported the idiotic single payer system. i heard congressman wehner on…..holy cow, fox, calling for it. they just know the american people are too smart to fall for it. at least most of us. medicare works because it under reimburses docs and hospitals who then tack money on to the charges to private payers, cost shifting it is called, to make up for the losses. obvious question, if there were no private payers, who would they cost shift to?? by the way, the current single payer system we have, medicare, has 500 billion or so in unfunded liabilities. sounds like just what we need for everyone else doesn’t it. some of you need to wake up and smell the coffee.By fed up
September 11, 2009 1:57 PM | Link to this
jt the post office has been ran well for years. They are in some trouble now because people are choosing to pay their bills online, and send emails. This is hardly the fault of the government. The future of libraries will also be changed because of the internet. But I consider them both to be good examples of wonderful government ran programs.By fed up
September 11, 2009 2:04 PM | Link to this
jt the post office has been ran well for years. It’s in a little trouble now because people are choosing to email and pay their bills online. That is not the governments fault The future of libraries will also change because of the internet, but both are wonderful government ran programs.By drunken orangetree
September 11, 2009 5:35 PM | Link to this
Medicare has been around since 1964, and Social Security has been around since 1934. While medicare is potentially in trouble, because health care expense inflation is outstripping the rest of economy, Social Security is NOT going bankrupt. In 2037, income will not meet outgo, and benefits will be cut to 70% of current levels, unless we raise the income cutoff. So, one program has done pretty well for 40 years and another will do well for a hundred years. All this despite goopers trying to run both programs into the ground just so the capitalists can buy ivory back scratchers and tools like joe can pay to wield those devices. So tell me again how government can’t do anything right. You must mean gooper government can’t do anything right.By quentin
September 11, 2009 11:03 PM | Link to this
I wonder if he was actually involved in socialized if he woudl feel the same. It took 9 months after I was discharged for a serious medical issue requiring pain medication to get started in the VA system. It then took a lot of fighting to get back on the pain control medication and narcotics I rely to function. Now if you think a 9 month wait in extreme pain before they would even TALK to you and then several more months in that pain being told they do not have or want to give you the medication you need is a better system, give it a try. After all, expecting you to work and support your family while in enough pain that it causes you to have cold sweats, nausia, sleep problems and etc is easy enough isn’t it?By Bill in Brookville
September 12, 2009 8:26 AM | Link to this
The bailout is only months old and IS getting a quick return on the investment. it took cheny/bush 8 years to put us in this mess. Just think how social security would stand if they had gotten to privatize it like they tried. health care is regulated by our Gov’t not run by it. billy boy IS paying close attention that’s why he says the health care system is broken and needs repairBy joe_mamma
September 14, 2009 8:20 AM | Link to this
Drunk and Bill, You realize how foolish you guys sound right? Drunk is defending social security which is supposed to be in a “trust fund” for everyone, but is pillaged every year and used in the general fund. Drunk…here is an accounting lesson…an unfunded liability means that there is not currently a way to pay for it!!!! You are defending that?????? They either have to raise taxes or cut social security by lowering payments or raising eligibility requirements. And Bill I hate to break it to you but the government is RUNNING Medicare and Medicaid and they are going bankrupt. Politicians love guys like you. They tell you they are going to turn a profit on the bank bailout…meanwhile you ignore all the other bailouts and the trillions in debt they are running up. Nice try guys. Your undying belief in having the government provide for you does not fly with me.By DetailsMatter
September 14, 2009 6:10 PM | Link to this
Bill from Brookville. You said nobody is suggesting a single payer system, I thought you might be interested in what our President has to say about the matter. http://www.youtube.com/watch?v=p-bY92mcOdkBy Rick
September 14, 2009 10:30 PM | Link to this
According to the New England Journal of Medicine, 73 percent of doctors surveyed support a public option, with 10 percent of them supporting a single-payer system. The 10 percent who favor single-payer say it’s less of a headache dealing with the government than private insurers.By drunken orangetree
September 15, 2009 7:44 PM | Link to this
joe, the reality is that social security is a pay as you go system. That is, everyone who pays FICA taxes now is paying the current SS recipients. Right now, income from FICA taxes are exceeding payments to SS, so the excess goes into the trust fund. Starting in 2017 or thereabouts, income may exceed outgo and we will have to resort to the trust fund. By 2037, or so, the trust fund will run out, and benefits will be cut to 70% of their current level. Unless we raise the income cutoff. All of this information is available at ss.gov. Now, you should know that this is info from bush’s social security admin.By joe_mamma
September 16, 2009 1:23 PM | Link to this
Drunk, There is no “trust fund”. There aren’t any assets there that can be redeemed or drawn upon. It’s nothing more than an I.O.U. accounting entry. THE GOVERNMENT IS RUNNING A DEFICIT. ALL THE MONEY THAT COMES INTO THE GOVERNMENT REGARDLESS OF WHETHER IT IS AN INCOME TAX OR FICA IS SPENT AND THEN THEY SPEND EVEN MORE. I’m not sure how you touting that social security will payout more in benefits than it receives in taxes in the near future helps your case for government run healthcare.By drunken orangetree
September 16, 2009 3:44 PM | Link to this
Right, joe. the government is going to default on its obligations. And send the world into a depression that will make 1929 look like a luau. You need to tell that to all the people who have bought government securities, everybody from China to geo. bush.By joe_mamma
September 17, 2009 7:28 AM | Link to this
Let’s see…off the top of my head I can only think of Argentina, Russia, Germany (twice) and Iceland (last year) that have gone bankrupt. Countries can’t totally default on their debt per se, but they do miss payments. That totally destroys the value of their currency and is catastrophic. Again…I don’t see how supporting the government’s mismanagement of social security and medicare supports your claim for government run healthcare.