Back Atcha

After my letter to the editor on 2/1/14, Tom Newcomb, who I don't know, wrote a diatribe about my letter taking me to task.  He was obviously a right wing conservative who got his information about our health care problems in this country from Fox News.   He said that Obamacare was passed by "we the dems".  LOL  Bottom-line, he totally distrusted government as any solution to our problems.  Here is what I wrote back.

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Tom Newcomb

Anecdotes and disparate factoids do not refute the main point I made.  The legitimate profit objective of the private enterprise system is incompatible with the public’s interest in determining and executing an optimal societal health care policy.

Governmental programs and legislation are often less than perfect or down right misguided sometimes but at least the citizens get a vote as to whether those who made these calls get to stay in office.  It is messy, but changes ultimately get made.  There is no such balance of power when the private sector or your employer controls your health care coverage.  

One of the best explanations of the pricing abuses in our health care system is the highly acclaimed investigative report in Time Magazine, “The Bitter Pill” that came out last March.  Our system is killing us with excessive costs from virtual monopolies with no competition or constraints on pricing.  It makes our US businesses uncompetitive in the world economy and costs us jobs. 

Your comments about US health care spending in relation to GDP (18%) versus other first-world countries (next closest is about 12%) was funny in its logic. You don’t think that other first-world countries enjoy the same pricing advantages for food and energy?  Don’t forget that in the denominator of US GDP is spending supporting our military industrial complex, an enormous part of our economy and having no size comparison in other countries.  This makes our spending as a percent of GDP even more over the top.  By the way, our health care system is deemed middle of the pack not by the “measure of life expectancy” but by a comprehensive analysis of societal medical outcomes.  The fact that we are the only first-world country of about 38 without Universal Health Care (50 million uninsured) adds tremendous friction costs as we deal with our uninsured population.

I come to my conclusions after spending the better part of four decades in the private sector, more than half of it working for one of the largest US health insurance carriers. It was fine company that played by the rules but was handcuffed with wasteful 50 state regulation and monopolistic pricing of our medical industrial complex.

 It is my belief that certain societal needs are not appropriately met by market forces.  National defense, the safety of our food and water, managing our infrastructure, etc. are most appropriately handled by government.   Our present heath care system is broken and a reasonable solution is one central health care plan for all.  It is remarkable to me how much senior citizens universally love their government run single-payer insurance called Medicare. 

Fred Campau 2/2/14

Misdirecting the blame

This is a Letter to the Editor was published in the Wilmington Star News on February 1, 2014.  It is ironic that it was in the paper on the first day of my life that I became eligible for Medicare.

 

Misdirecting the blame

 

Sunday's "60 Minutes" had a gripping segment on the failure of our health care system in dealing with mental illness. A women's support group related the experiences of their loved ones being denied care, often with tragic consequences. Time and again, they blamed insurance companies for denying coverage.

The majority of Americans get their health insurance from their employers, who purchase plans in the for-profit private enterprise system we Americans hold sacred.

Employers buy coverage that aligns with their profit objectives or budgetary constraints. Some plans are rich in benefits, but most … not so much.

People are quick to blame the insurance company when coverage is denied. This is shooting the messenger.

 

Usually, people are getting what they or their employer paid for. The message is that whenever the profit motive of employers and insurance carriers drive the design and administration of health care benefits, patients often don't get what they really need.

 

The U.S. health care system is the most expensive in the world, delivering mediocre results.

Many parts are an unfettered monopoly with no competition or pricing constraints. Profit is king, not the patient.

 

We need a universal, single-payer system under which policy is determined by "we the people," and not by a private enterprise. When this happens, we will be the last first-world country to finally figure this out.

Fred Campau, Wilmington

Sorry Sam, Just Gotta Do It

My recent close call with death and the quiet times I have now have led me to many thoughts about what is really important in life and how little time I may have left to make a difference.  I have been bugged for some time now by the employee pay a benefit policies of Walmart and Sam's Club. Many of our friends have switched over to Costco in protest.  It is a little thing really but with Cathy's support, I sent this letter yesterday.  I sent a copy to the CEO of Walmart.

 

To Sam's Club,

My wife and I have been long term members of Sam’s Club originally joining in May of 1992.  I have calculated that we spent $5,778.18 at Sam’s in 2013 and estimate $80,000 to $90,000 spent over 21 years.

With the recent news of the huge profits made by the Walton family and their obscene accumulated wealth, we are troubled.  Also, the national debate on the Affordable Care Act has brought to light how much the tax payers have to subsidize workers that are paid below the poverty line as well as not provided health care insurance.

We have decided to vote with our feet and resign from Sam’s Club.  We have a lovely Costco store within a mile of Sam’s that we recently joined where we have enjoyed good prices, selection, and excellent customer service.  The fact that Costco employees are paid a living wage and many more than Sam’s are provided health insurance are the deciding factors to patronize Costco exclusively for our warehouse club needs.

We enclose our Sam’s Club cards and ask that you proceed to cancel our membership.  If we are due a refund of part our membership dues, we ask that that be done.

Sincerely,

Fred & Cathy Campau

Putting the Collar On Me and You

Wearing my Philadelphia Collar 24/7 for 8 weeks is a depressing proposition but is the price I have to pay to heal my broken neck.  I will do it with determination and with a smile.

My collar was provided by the hospital.  It came with two sets of pads.  I have been wearing the collar for three weeks now interchanging the three pads of each set every couple of days.  Even though Cathy has been washing the pads, they are retaining a smell in the foam rubber and are starting to wear out.

This week we traveled to a pharmacy to try to buy new pads.  A very nice lady told us they did not carry them but gave me three places to call.  I called the first place and the woman asked me for my name.  I gave it to her and after checking her records, she did not find my name.  She told me since they did not provide the original Philadelphia Collar, I would have to have a prescription to buy replacement pads from them.  I wanted to yell, YOU HAVE GOT TO BE F**KING SHITTING ME!

I called the second place, Floyd Brace and Limb, whose address was near the hospital.  I told the lady my situation and what I needed and after a few minutes, she said that they could provide me the pads for $50.00 a set.  YOU HAVE GOT TO BE F**KING SHITTING ME!  Since I thought I might need at least three more pad sets to make it the next 5 weeks, $150.00 was down right crazy.

The next day Cathy and I stopped at a fabric and upholstery store.  I found a roll of foam pad that was just the right thickness, softness, and texture.  We bought a 12 inch length off the 4’ wide roll and cut out three sets of pads.  This small piece of foam rubber pad cost $2.00 plus tax.

Thus the problem with our medical industrial complex in the US, a monopolistic system with virtually no competitive market or governmental forces to control cost and greed.  We spend 18% of our GDP on health care with mediocre outcomes, ranking us about 16^th compared to other first world countries.  The next closest country pays about 12% of GDP.  And we have 50 million people uninsured placing the US as the only first world country on the planet not having some form of Universal Health Care covering all citizens.  Now that is “American Exceptionalism” for you. 

Miraculous Things Do Happen

A friend suggested that I compose an update as a follow-up to the “grim” news in my Thanksgiving eve email.  Yes, it was grim I suppose and yes I owe everybody an update and this is a good time since I just saw my neurosurgeon Wednesday.

I really don’t believe in miracles anymore but hey, one just happened to me.  Three weeks out from my accident, I am up and about and pretty much pain free except for a low grade headache that sometimes flares up to be down-right annoying.  I do have to wear 24/7 a god-awful neck brace for the next six weeks at a minimum.  I can take it off briefly to shower and can loosen it to eat as long as my head is supported.  After January 20^th, hopefully, I will be able to take it off and drive, eat & drink normally, and sing, maybe all at the same time.

Dr. J. Alex Thomas, a Georgetown trained Board Certified Neurosurgeon, did my surgery that lasted about three hours.  Since my C1 vertebra was shattered and useless to hold up my head, he had to install a device called an Occipital Cervical Fusion System.  Mine is a rectangular titanium plate that is screwed into the base of my scull with rods that extend down and screwed to my C2 and C3 vertebrae.  I am attaching a photo I found on the internet that shows this very well.  The critical thing is to make sure my head and neck stay still enough not to jeopardize the integrity of the screws until the bone heals around and over the fusion system.  My doc told me that if the screws fail while I am healing, I will be in deep, deep doodoo or “DDDD”.

My prognosis is excellent.  It takes about four months for the bone to fully heal around the fusion system.  After that I can start to resume all my normal activities; golfing, biking, skiing, etc.  I will have to get used to a permanent limited range of motion of my neck and head.  My turning will emanate from my C4 vertebrae and below.  This should aid my golf game with the fusion device helping to keep my head still.

I have been humbled by the outpouring of concern and support.  I have received untold number of cards, calls, and emails that I realize now I truly needed for my physical and mental healing.  Life gives us so many wonderful things and also many not so wonderful things.  To make it we have to learn to embrace all of it and stay focused on the positives.  This I will do.  Thanks to each and every one you for rooting me on. 

I wish the season’s peace and goodwill to all.

Gratefully yours,  Fred







 

 

Happy Birthday Cathy

December 9, 1948, Catherine Ann Sczepanski was born into this world in Detroit, Michigan.  On July 10, 1971 we were married.  We have been together what seems to be most of our lives.  This is the poem I wrote in a card I made for her birthday today.

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Oh my God, Oh my Dear

Today starts your 66^th year 

We’ve been together for most of that time

Near 43 years since you agreed to be mine 

How time has flown as we moved here and there

Making a family with Chris and Sara bear 

We’ve had our ups and we have had our downs

Many more laughs and not too many frowns 

Could anyone be a more special mother

As I look at our kids, would not want any other 

As we walk together into our golden years

We’ll face the our mortality without any fears 

I thank you for holding my hand on the way

To Wilmington now where we’re going to stay  

All my own words to say I love you so much

No store bought card this year to use as a crutch 

HAPPY 65^TH BIRTHDAY CATHY

Medicaid in the Polarized World of ACA

John, a 60 year old good friend of mine who has a rare form of cancer was recently notified by Medicaid that he no longer qualified for coverage effective 1/1/2014.  He is on total disability and has no income other than Social Security.  He was told that he had to apply for coverage under Obamacare.

In total frustration and fear, he posted on his Facebook page that he had gotten screwed out of Medicaid by Obamacare.  Of course, many of this friends posted comments and condolences and seemed to agree.

It is so discouraging to me the level of misinformation and ignorance around the health care debate in our country.  I decided to write to John to give him my thoughts and I share what I wrote here.

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John,  

I have been doing a little study and research into what is happening to Medicaid in NC after the passage of the Affordable Care Act and your losing your coverage.  Also, my son Chris, who is active in the Social Services field and is a student at North Carolina State, has given me some interesting insight into the problems facing Medicaid in our State.  He was asked recently to serve on a government committee to suggest improvements to NC’s Medicaid system.  Chris started the Collegiate Recovery Program at North Carolina State and he was ask by the Governor’s Office to participate to represent the perspective of those recovering from Alcohol and Drug abuse.  They have met twice so far.  By the way, I am really proud of him for this.

 What I didn’t fully realize is the big differences between Medicare and Medicaid.  We all kind of know that Medicare is for people 65 or older and is a “single-payer” system administered and financed totally by the federal government.  Medicare rules and eligibility are the same in all 50 states.  Here is Wikipedia’s words describing Medicaid: 

“Medicaid is the largest source of funding for medical and health-related services for people with low income in the United States. It is a means-tested program that is jointly funded by the state and federal governments and managed by the states,^[1] with each state currently having broad leeway to determine who is eligible for its implementation of the program.” 

The most important difference is that Medicaid is State run with States footing a good chunk of the bill.  States are not even required to participate in the program, but at present they all do.  Yes, the Feds require some basics but States set the rules.  Therefore, there are major differences from State to State.  Texas, for example, has the largest percentage of uninsured of any state in the nation.  As is the case whenever big money is involved, Medicare rules and eligibility gets very political.  From what I have been reading, in general, Red states have the most restrictive Medicaid programs vs. Blue states.  When budgets get tight, guess where the politicians look to save money.  It is pretty clear that the changing of the guard in NC has been making things progressively harder on the poor, minorities, the disadvantaged, and sick. 

Chris tells me that the biggest problem that his constituents complain about are the constantly changing eligibility rules and what is covered and what is not. It is a constant state of flux with so much uncertainly.   Medicaid was set up to be a temporary solution for the poor.  You know, as soon as the poor finally get off their lazy asses and get a job, they can get employer provide HC or buy their own insurance like all upstanding god-fearing citizens do.   

Along comes Obama-care which I prefer to call by its proper name, The Patient Protection and Affordable Care Act (ACA)……less racist.   Obama wanted to pass a single-payer system but had to settle for what he could get passed……Romney-care, a Republican idea in its genesis.  Wikipedia says, 

“The ACA aims to increase the quality and affordability of health insurance, lower the uninsured rate by expanding public and private insurance coverage, and reduce the costs of healthcare for individuals and the government.”  
 

The ACA expands Medicaid eligibility and Federal funding to up to 133% of the poverty line.  Again, quoting from Wikipedia,  
 

“The federal government would pay 100% of the cost of Medicaid eligibility expansion in 2014, 2015 and 2016; 95% in 2017, 94% in 2018, 93% in 2019, and 90% in 2020 and all subsequent years.” 

NC and SC and 18 other States (almost all Red States) declined to accept this expansion.  To me it is unconscionable to decline this expansion.  This recent article in the Raleigh News and Observer is a good one to read:  http://www.newsobserver.com/2013/08/28/3144617/medicaid-coverage-gap-looming.html 
 

John, I was a registered Republican all my life, the party of Lincoln.  I am sure ole Abe is rolling over in his grave with what has happened to the GOP in the past 10 to 15 years.  The far right, the Tea Party, and their ilk steeped in ideology and no-compromise, has driven me out of the party.  I am a proud Independent now.  I am socially Liberal and fiscally Conservative.   

My liberal side believes that health care for all is a basic human right.  Of the roughly 38 first world countries, the US is the only one without universal health care.  Sure, many of the health care systems around first world countries run the gamut in effectiveness but they cover all.  My fiscally conservative side looks at exorbitant cost of our country’s health care system (we pay something like 60 to 70% more than other first world countries).  We rank about 18^th in the world in outcomes.  We also have 50 million uninsured.  With the focus access for all, on preventative care, and on education, the bi-partisan Congressional Budget office forecasts that health care costs will be driven down under ACA.  
 

So, my take on your situation is that the target of your frustration should be on Governor McCrory and the Republican majority in the NC Legislature.  ACA tries to expand coverage for all.  The Republicans seem want just the opposite.   

I hope things work out for you with John Schmidt and BCBS.  I am rooting for you.   

Your friend,  Fred