Saturday, July 11, 2009

Living the not-so-good life in Sedona

Our little city of Sedona, nestled amid the red rocks of Northern Arizona, is a resort community and tourist destination. A lot of people retire here to live the good life, or choose to live and work here for the same reason.

It's reasonably affordable, as such places go -- unless you come down with a catastrophic illness and are subject to the whims and foibles of our health care system. I am not talking about myself here. I am talking about a couple in town who lost pretty much everything in a futile attempt to battle the wife's colon cancer. This was reported recently in our local newspaper, the Sedona Red Rock News. Here's a link to the story, entitled "Health system fails Sedona couple." Here are some excerpts:

It wasn’t long before all of the DiMarcos’ days were consumed with medical appointments, arguing with insurance companies and pleading for help from state agencies.

By 2007, their lifelong savings had
dwindled to nothing, exhausted by treatments and drugs deemed ineligible for coverage by their insurance company. With no money left, Joseph turned to credit cards to pay for hotel rooms near hospitals, for co-pays and for pain medication.

. . . In spite of hundreds of thousands of dollars of tests and treatment, painful procedures and mind-numbing drugs, by 2008 Andrea’s doctors held little hope for her recovery and she was referred to RTA Hospice and Palliative Care in Sedona. She passed away two months later.

Joseph is left with the memories of a woman he describes as his soulmate, a twin flame with whom he wanted to grow old. He is also left with a mountain of bills, having to choose which one to pay each month.

In the latest print edition is another story
(not online), this time about a patient with heart problems who faced the unfairness of the system first-hand. This involves the "churning" of insurance applications, in which private insurers look for an old condition or treatment you may have forgotten to mention and use it as an excuse to cancel your plan rather than pay for the care you desperately need.

My point here is that in any community -
- even one of 15,000 people -- there is story after story like this. Health care reform is needed not only for the 50 million uninsured, but also for the many millions more who are insured, only to find that the system fails them when they need it most.

Here's a letter I just wrote to the editor of the News:

I’d like to commend the Red Rock News for its recent series of articles on how failures in our health care system have caused heartache and pain for local residents who are the victims of cancer and other serious diseases.

I am one of those stories. In 2003, I was diagnosed with chronic lymphocytic leukemia. Mine is a fairly aggressive form of the disease and I have required several rounds of chemotherapy. Fortunately, this has been covered by my health insurance, a state-sponsored program for small businesses. But the plan has its limits. It specifically excludes adult stem cell (bone marrow) transplants. I am 52 years old and the exper
t doctors I have traveled to see out of state (at my own expense, since my plan only covers a limited in-state network), have told me that I am unlikely to see 60 unless I get a transplant. These can run upwards of a million dollars out of pocket, well beyond my capacity to pay.

As you might imagine, private plans that cover transplants want nothing to do with me. Unless there is health care reform in Washington that requires all insurers to take patients with preexisting conditions, I face a bleak future.

I am all for keeping private insurers, but I also strongly favor a public option. Some mechanism has to be put in place to keep private provid
ers honest, as your most recent article about the “churning” of health care applications demonstrates. If people cannot rely on their private insurance in a pinch, then they deserve an option where care is truly guaranteed.

To those who were recently seen protesting here against “Obamacare” and who argue that they don’t want the government managing their health care, I have this to say: What is so offensive about creating a system that preserves your sacred private insurance but also gives people like me a chance to receive life-saving care? Is it really preferable to have penny-pinching private insurance bureaucrats finding excuses not to give you the procedures and drugs you need? I’d take a government bureaucrat any day -- I’ve
been dealing with them at the state level for years -- since they don’t have that vested interest in finding ways to deny me, or my doctor. Finally, if you really hate “socialized medicine,” then give up your Medicare coverage on principle. I’d gladly take it.

David Arenson


Counties in blue have some sort of universal health care system. Countries in green are trying to institute one. Countries in orange -- Iraq and Afghanistan -- have universal systems instituted by the United States after they were invaded. Perhaps we have to declare war on ourselves to get universal care?


Anonymous said...

I urge all of you to read the book "Our Daily Meds." Few people are as cynical as I am about corporate America, but this book shocked me. Even the minority of doctors who are not bought-and-paid-for by the drug companies are often ignorant about the true risks/benefits of the drugs and procedures they prescribe, because the information they get even in the leading medical journals is often biased propaganda, or worse.

Moreover, any illusions one might have about armies of researchers looking for helpful drugs against minority diseases like CLL are pretty well dashed by this book. The drug companies, which fund most research now, are only really interested in blockbuster drugs that they can convince millions of people that they need.


Anonymous said...

Please don't fall for the cheap tricks David pulls here!

As we ALL KNOW, anecdotal stories are the trade of the snake oil salesman. Evidence-based medicine is the only scientific way to make decisions about tough questions.

It's very easy to come up with an example here or there to make a point. That's the lazy way out, the indefensible way out.

David's predilection for socialized medicine will destroy the health care system in the US. Drugs now covered by legitimate health care plans (not the ones cited by unscrupulous crooks cited here) will disappear under the weight of the need to pay for health care for CLL patients.

The first to go? In my opinion IVIg will go quickly. It's expensive, and hasn't been shown to lengthen life. Next, Rituxan. It still isn't available in many socialized medicine countries.

We will be back to chlorambucil, fludarabine as a single agent, and lots of prayers.

Instead of reading the isolated tale David lazily cites, I challenge you to search on NICE, the bureaucratic lazy folks in the UK who love to deny coverage. Read about the debate before you fall into David's trap.

Folks, these are life and death issues. Please be informed, and realized how wonderful our system is here, in comparison with elsewhere.

Or you could follow David to Cuba, where fatso Michael Moore thinks health conditions are better than the US.

The only REAL problem facing this country is how to pay for the uninsured. Most everyone else is happy with their own health care plan.

Let's not destroy the best, and end up with the worst, to solve an easy-to-solve problem.

Anonymous said...

Thanks David for your article. As one who lives in a so called 'socialised medicine' country (Australia) I am eternally grateful that all of my health care needs are paid for through the public purse. And as a percentage of GNP Australia spends roughly 8% on health which is way less than the US. If and when I need a transplant I will not have to pay, nor will I have to pay for FCR when I need it. No stress, no worries!!


Anonymous said...

In a civilized country, health care should not be a consumer good as it is here.


Anonymous said...


Thanks again for your post... and re Michael's posting - I was thinking exactly what you wrote - I too live in Australia and thank god that I do as far as the medical system is concerned. David, only wish you were here in Australia to reap the benefits.