by Jeff Costello, May 4, 2016
Obamacare? I know nothing about it, but it seems those who hate it are the same ones who hate Obama for the usual reason. I've never had commercial medical insurance of any kind. This is where a chronic lack of money pays off, how the US differs from places with real socialized medicine. Anyone can be seen regardless of income and social status, but here you must be seriously broke and able to prove it. Reagan's mythical welfare queen is a fairy tale concocted for reasons of racism and resentment of anyone "getting something for nothing." Going through the hoops to get medicaid coverage is not "nothing." It requires time, social skills and willingness to suspend all traces of vanity.
In the early 70s I found out about Medi-Cal, as Medicaid is called in California. This came in handy although I didn't use it much. Coming down with double pneumonia in 1976 I was admitted to Marin General, told I was at death's door and prescribed heavy-duty antibiotics. Once you're into the Medicaid program it's easy to stay in. My health was relatively good until I went to stay in Wisconsin in 2004, where I needed prostate surgery and entered the university hospital system. Not long after the prostate issue was resolved, it was cancer, something I wouldn't have afforded treatment for if not for Medicaid.
Middle class - that's who's getting the shaft and it's getting worse If you want decent medical care, you're better off being rich or poor - in between is where it's dicey. If being middle class is the American Dream, you can have it. A lot of people who qualify will not sign up for reasons somewhere between fear and pride. Wait till they find out what an MRI costs, or even a basic doctor appointment.
The university hospital system, to be sure, is not your friendly home town doctor with the black bag. I first heard the term "HMO" in the 90s, the Clinton years. Health Management Organization. The university system appears to be a giant HMO, or a chain of HMOs. The experience is a bit Orwellian but the hospitals are highly rated, and once you get in, the doctors generally behave like human beings. The staff does not know or care if you're on Medicaid (or Medicare these days, since I achieved age 65). Since then I've had follow-ups and any peripheral medical business at three more university facilities - UW in Seattle, UC in San Francisco, and University of Colorado. One's medical records move easily through the cyber world. These places are usually crowded, parking is a nightmare.
Do I have a choice? No, it's the only option there is. Your doctor is called a "primary care provider." He or she mostly manages information and writes prescriptions, gives minimal exams and shuffles you off to a specialist (a department) if anything specific needs attention. I've gotten used to it and am glad to have it. Fortunately I don't need to be coddled. It's business, not personal.