Clearly, as per usual, the “fuck those of you without money to pay for it — the weak die young” attitude (which is really what’s being said) doesn’t go over well with those of us that know the facts — that minorities and women are always going to be hit harder by this bullshit than the whiney white men in power.

My husband works for a conservative company — a nearly notoriously conservative company — and my recent not-nearly-so-common procedure was fully covered because said company has its head on straight about what they want covered in a plan — preventative care. The answer here is NOT giving insurance companies the option of paying for cancer prevention now or actual cancer later — the answer is changing the health care culture in this country, so that people DO seek preventative care, even young maverick men who maybe, just maybe, are going to have an appendicitis tomorrow.

My concerns about ideology are more to do with what the classical Marxists called “false consciousness”, or with what some more contemporary ones might refer to as “interpellation”. My thought is that the idea of certain things becoming essential or necessary for human life should not be separated from any analysis of who benefits from the institutionalization or embedding of that need, whether it is a thing such as literature, technology, human rights, hospitals, or clean renewable energy. There are many things in life we regard, in our own ways, as unqualified goods. Yet, I think that the process through which we decide the good and set it apart without qualification is not always as virtuous or immediate as we confuse ourselves into believing.

So, provisions given from whom? Xon believes, as valeko pointed out, that by eliminating government controls over the marketplace of health care, people will be better off to afford a reasonably priced, reasonably effective treatment. However, valeko also pointed out that his personal experience has been (I take it) the opposite: under the managed system of the Soviet Union, he received better preventative care than in the managed system of the United States. I take it that one such reason why the care in the United States is less is precisely because of who manages the care in the US and how much they need to retain a percentage of their income as profit.

Mandating insurance companies pay for preventative care, or simply not permitting exemptions of preventative care, (these are very different things, and it seems we get more arguments for the former, even though such arguments supercede those for the latter) perhaps will not change the drive to profit in a more equitable or just direction so long as there is still the human incentive to turn any service or provision into a means of procuring wealth.

In other words, until we even stop treating our own preventative care, to ourselves, as a way of saving money. As I summarize Nikki’s concern:

It is cheaper in the long run if we all get it instead of, oh, I don’t know, FUCKING CANCER, because cancer is expensive to treat.

My concern is not for making the place free for the market to determine what things are essential or amenities for us, through our participation in the pricing and purchasing of these products. My concern is that in any struggle to achieve a just society, whenever economic justice triumphs as a way to measure the accomplishment of the distribution of good, we already have a market evaluation in progress, rather than an evaluation with respect to, say, dignity or virtue or charity.

I think Nikki is entirely right on the facts: preventative care and preventative maintenance are, on the whole and in the long term, far more cost effective than treating illnesses or disease once they become too debilitating. But, I also think Xon is right about one interpretation of the facts: we cannot want cheap and widely available quality health care all at the same time, unless we are willing to make a very gratuitous concession. Xon leans in the direction of that concession being the free market. Others lean towards that concession being control of health care by an elected, accountable body. But we know that cheap and widely available products that are advertised as such are intuitively regarded as pejorative commodities. Unless certain market forces are redeemed or reformed or revolutionized, we will not have good quality health care but McHospitals.

And some, poorer than we are, probably already know we are there.

I apologize for the length of this comment, in advance.

As to my overall point, y’all still aren’t addressing it. In fact, you’re just reconfirming it. The original complaint was about laws governing what insurance companies have to cover. My argument is that there should not be such laws because such laws drive up the price of health insurance. Now, in the process of this conversation thread, a number of you are complaining about…the high costs of insurance. You want all this stuff to be covered, and you want it to be cheap, but you get upset when the government gives insurance companies the kind of freedom necessary to make it cheaper. Your position seems to have, as the olde tyme philsophers would say, a coherence problem.

My point is not that everyone who doesn’t have health insurance is choosing to live dangerously, but rather that a significant number of people who don’t have it are choosing to live that way because they think their money could be better spent at this point of their lives. Any law that moves towards mandatory insurance for everyone (and laws dictating what insurance companies have to cover, all the time, are a move in this direction) is a move towards taking away the freedom of those valeko’s of the world who simply think their money could be better well spent. And is valeko in a horrible place? Hardly. But the politicians group him in with the “millions of uninsured Americans, how sad what a pity.” But certainly you are correct to note that there are also people in this country who really want health insurance but simply cannot afford it at its current rate. But then it is curious that you don’t support policies that would make those rates come down for those poor souls.

Try going for your yearly girl-oriented constitutional. It’s quite thorough. As was the physcial I had done about a year and a half ago. The stuff they don’t want the poor widdle insurance companies to pay for ARE ALL preventative care items.

Yeah, I’d have to go with what Nikki says. Going to the woman-doctor is about as thorough you’re going to get, short of an anal probe. No, wait, you get that, too. And that inspection DOES (to quote valeko) lead to the accidental discovery of things that are in the process of making you die, which is how one of my best friends found out she had cervical cancer at age 19. She didn’t go in there to the doctor saying, “hey, doc, something feels funny in my cervical-area, you think it might be cancer?” It was something that was discovered on a normal, routine, preventative PAP smear. Something that, had her insurance not covered it, she may not have thought to have it done (because she was supporting herself on a very limited income), and there’s no telling where her cancer would be today, 6 years later.

And THAT is why I think its ridiculous that anyone is even arguing this point.

Listen, I’ve got plenty of problems with the insurance industry and the state of our health care, but insurance (if you can get it) is worth every penny. Making it more accessible is another thing.

Yeah. Like, how about the fact that my dad hasn’t had health insurance for most of my life (because he couldn’t afford it, and being self-employed there was no employer to partially subsidize it); then when he finally got to where he could theoretically pay for it himself, he was denied due to “existing medical conditions.” What the fuck kind of bullshit is that?? And then, of course, as you know, he had a stroke (accompanied by a diagnosis of type 2 diabetes), the hospital stay for which my parents are having to pay for out of pocket.

Wonderful thing to happen in the wealthiest country in the world. Ever wonder why the wealthiest country isn’t also the healthiest country?

And, a preemptive “fuck you” to anyone who comes back and starts a comment with, “Amber, what happened to your dad is unfortunate, but…”

That diagnostic process is usually initiated by patient reports of symptoms.

From my own childhood experience, I can attest to the fact that Soviet (and even European, tendentially) preventative checkups were a lot more thorough, so they had a much higher probability of catching things. Those would probably be worth the $20. An average visit to an American GP isn’t worth the hair in my navel, and I’d only take it 1) if it were completely “free” (”covered”) 2) if I had lots of time on my hands 3) was feeling lonely.

That’s where I really get torn between supporting and opposing the Libertarian ethic on the subject as far as my personal finances are concerned. It’d be much more rational to make some successful investments and have the money to cover those kinds of expenses out of pocket than stay bound to these absurd HMOs. But my existence is privileged enough for me to able to have those kinds of considerations at my disposal. As Amber (and Nikki, and duane, and everyone else) rightly point out, that’s not the case for everyone, and it’s their welfare that’s at issue here.