August 18, 2009
Why I Cancelled My AARP MembershipBy Mary Anne Lonze
Imagine my surprise when, a few days after seeing AARP's CEO claim that organization had not decided whether to endorse Obama's health reform bill, an AARP commercial appeared on TV urging members to contact their representatives in support of it.
One could argue that this shouldn't be so shocking, considering AARP's sponsorship of the recent staged town hall meeting. Still, it's broadcast so soon after the demurral by the CEO, makes his purported equivocation suspect.
Surely, this advertisement was "in the can" long before the CEO's misleading statement was issued. It should not surprise anyone to realize that advertisements are not funded, dreamed up, scripted, taped and scheduled for broadcast overnight. My late husband was in the TV broadcast industry for over 30 years. I know how these things work.
More than just a concerned American, I'm also a registered nurse with a master's degree in public health. The bulk of my career has been spent in the field of managed care, working in the field of preauthorization of diagnostic imaging, on behalf of some of the largest health insurance companies. (Their names are easily recognized - most of them publicly traded.) I've approved many thousands of requests in my career and have sent my share of cases for further physician review if the request did not meet approval standards at my level. These people are not the evil, money-grubbers described by the biased press. The managed care industry hires thoughtful, caring physicians and nurses who make decisions in the best interest of the patient, based on well-crafted criteria and guidelines - which are continually under review by the health plans, independent panels of physician experts and regulatory agencies. There is no coin-toss involved in the decision making process. We are very aware of utilization rates and the effects that increased usage has on the cost of maintaining the viability of those health insurance companies who pay the lion's share of patient bills.
Regarding the elderly population (AARP's client base), there is no question that senior citizens' utilization of medical services is higher than that of a younger cohort. Their health is eroding over time and it takes more and more resources to maintain a status quo. Also, geriatric medicine is a relatively new discipline, simply because people are living longer now than ever before. There are new medications and ways of treating the elderly that didn't exist before. Indeed, the definition of elderly itself is changing. When I worked at a nursing home in the late 1960's, an "elderly" patient was likely to be in their late 60's.
We also need to be mindful of the fact that many seniors look to physician visits to ameliorate the loneliness in their lives. They are looking for attention and reassurances. In some cases, it's the only periodic personal attention and human contact they receive.
For any age group, many tests and procedures are ordered because they are available and in the patient's best interest. Yet how much utilization is caused by physicians practicing defensive medicine? They fear being sued over missing something that might be found in a diagnostic test. Ordering guidelines are inconsistent. Inconclusive tests lead to more tests, in the hopes of ruling out or confirming suspicions. We are a litigious society and some trial lawyers are all too eager to line their own coffers representing frivolous cases.
It's not a perfect system. There appear to be 3 tiers of coverage available to Americans today. Superb, for those who can afford treatment at any cost. Average to sub-optimal coverage for the vast majority of working class Americans, and poor-to-none for the uninsured. Yet, this should not be confused with access to health care.
Most people who walk into an ER are provided some level of health care, whether or not they can pay for services. In fact, a requirement of not-for-profit hospitals in order to maintain their favorable tax status, is that they must treat a number of patients for free, or at least far below their cost.
My neighbor, who posts a large sign in a front window that erroneously demands "Health Care Now" doesn't appreciate the significant difference between health care and health coverage -- like so many Americans currently caught up in the emotional fray. In fact, the health care providers currently provide access for everyone. It's not access that is in question.
I'm not necessarily advocating for continuance of the health care coverage status quo. Still accepting the ObamaCare program -- or any program, for that matter -- on blind faith isn't in anyone's best interest. Ginning up support of a program through scare tactics isn't an effective way to gather support, either.
Last week, determined to tackle the content of the bill, I began reading HR3200 line by line. The language was riddled with legalese, cross-references, and confusion. There were so many holes and unanswered issues; I took a break after reading for 2-1/2 hours. By then I'd filled several pages of a notebook with handwritten questions.
The most pressing question was how are we going to pay for all this largesse? Then I remembered the Democratic silver bullet yet to be fired -- the VAT.
Next question: Why isn't the real issue, tort reform, being addressed? One has only to look to some of the greatest contributors to Democratic campaigns: trial lawyers.
Why aren't those two issues getting press, instead of the hysteria and spectacle that so besots the media?
What's the rush? Why not take the time to do it right - to the benefit of all Americans.
AARP doesn't get it. So I sent them an email cancelling my membership. As a symbolic gesture, I pulled the AARP card out of my wallet, cut it into pieces and tossed it in the trash.
I'm feeling better already.