Everyone, including the people who run it, knows our health-care system is broken. Among those being rightly blamed are medical professionals, insurance companies, drug companies, politicians. But perhaps the biggest culprits of all are never implicated.
I'm talking about ordinary health care consumers.
These are the folks who let the current rotten system continue. How? By putting up with it.
And no wonder. People can't complain about the health-care system without admitting they need it, and medical matters are often intensely private. Certain conditions - mental illness, depression, obesity, even diabetes - entail an element of shame.
The health-care establishment has achieved a masterstroke of self-preservation in its embrace of medical privacy. I can't even get an appointment without giving my date of birth. To protect my privacy.
It's a fraud.
The truth is, the people who are most likely to use medical information to hurt you - your insurance company, for instance - have unfettered access. Even the billing departments of care providers can rifle through your medical records, seeking ammunition against you, should you dare question a charge.
If you sue somebody or get sued, your medical privacy can be obliterated. In one case I know about, the mental-health records of a rape victim were turned over to her rapist's lawyer, to help tear her down.
The illusion of medical privacy is maintained because it serves to shield the medical establishment from accountability. Recently, when I complained to the state Bureau of Consumer Protection about an excessive charge, the provider smugly replied that it was not allowed to give the state any information. Medical privacy.
The false hope of protecting privacy is the main impediment to people's willingness to complain about the shabby ways they're treated by medical professionals and, especially, insurance companies. But their silence is allowing others to be victimized.
It's time for the people of this country to get publicly angry about the inadequacy of their health care. Speak up, fight back, don't take it anymore.
I'm actually optimistic that this can happen, in part because health-care coverage has gotten so lousy. For most of my life, I never thought twice about the nominal amount of health care I needed. It was covered by insurance.
But now, with the dizzying array of co-pays and deductibles and limits and exclusions - and the obvious zeal on the part of insurers to find some reason, any reason, to deny a claim - many folks, myself included, are paying for much of our care. For me, that's meant two things:
1) I avoid medical care whenever possible, to prevent getting screwed. (I for one can't wait to have government-run health coverage, and just hope it happens before I'm eligible for Medicare. I'm sure it will be a vast improvement over the private coverage I have now.)
2) I'm now paying attention to the money end of health care, developing a better grasp of the rotten things that have probably always gone on.
Recently, I found an obvious double charge on one of my bills. It took four letters of complaint and three and a half months before the provider removed the charge. ("This was a coding error made by medical coders," it claimed.) If insurance had covered this bill, it may have just been paid, no questions asked.
What can we do about this messed-up system? Perhaps the best tool we have is the ability to speak out. And the time to do it is now, when the promise of reform hangs in the air.
A group of Madison journalists has just launched a citywide collaborative reporting project focused, in its inaugural run, on the issue of health-care access. The group, known as All Together Now, plans to publish or broadcast an array of coverage during a two-week period this October. All local media are invited to take part.
The project is spearheaded by Brennan Nardi, editor of Madison Magazine, with others assisting, including myself, Andy Hall of the Wisconsin Center for Investigative Journalism, and Deborah Blum of the UW School of Journalism. The goal, the group has said, is to "put one community issue under a microscope and break the story - and new ground - together."
A number of topics were suggested, and health care was picked. The project aims to tell the stories of "ordinary people experiencing problems either obtaining health insurance or accessing health care with their current coverage." This coverage will, of course, be subject to the normal process of journalistic inquiry and include the perspectives of health professionals, many of whom also support reform.
Media outlets all over town - radio, TV, community papers, the dailies - may be looking for stories to tell. There are other avenues of expression, like letters to the editor and radio talk shows.
Over the next few months the medical establishment is going to have plenty of input into how our health-care system does or doesn't change. The rest of us should too.
