Friday, October 31, 2008

Health care and Centralia: An Analogy

Here is a diary that is cross-posted at Daily Kos.

One of yesterday’s heart wrenching diaries that was rescued last night inspired me to write just my third diary. As someone who lived three long years without health insurance, this has been gnawing at me for a while. My university recently forced me to purchase its student health care plan. It is not very good coverage, but at least I have something in case I get hit by a car trying to cross Nebraska Ave. Bonus: no health questions. Every student is approved.

I would prefer to have full socialized medicine, but that is not going to happen. As a viable alternative, I am supporting Senator Obama’s health care reforms. At the core, the proposal is to offer affordable health insurance to all Americans, regardless of preexisting conditions. This diary will make that argument by comparing health insurance to a town that died from short-sightedness.

We are all familiar with the dismal state of health care in the United States, but knowledge of Centralia is largely limited to Pennsylvania folks and coal company executives. As we are all well aware, 45 million Americans, including a lot of children, do not have any health care. have not seen numbers on under-insured people. Centralia, on the other hand, is a town that has been burning down for the last 46 years.

I know that we have a lot of Pa. people here at Daily Kos. Coal company executives? Probably not so much. As you read this, though, consider this question: Would you prefer to see your tax money pay for a few hundred dollars in early remediation or thousands and millions of dollars to fix a serious situation?

Centralia was once home to a thriving coal mining industry and about 1,200 residents. In fact, a major anthracite coal vein runs under the town. (Just a little plea here: please no flames regarding Global Warming. That’s not the point here.)

In the spring of 1962, the town decided that the old dump next to the cemetery could use a good cleaning up. Memorial Day was fast approaching and the dump was looking unsightly. In those days, dumps caught on fire all the time and extinguishing said fire was difficult.

Ironically it was also tradition to intentionally set dumps on fire. This had the dual benefit of clearing out some of the trash in the dump and giving the firefighters practice extinguishing dump fires. (Again, let’s not get into a discussion about the resulting air pollution. This was eight years before the first Earth Day.)

The problem was that somewhere deep inside the dump was an exposed coal vein. The fire in the dump spread to the coal seam. No one noticed that day. A few months later, someone asked the borough council whether the fire was out. No. The fire was still burning and it was burning right underneath the town.

The first bid to put out the fire was $175. Naturally, that was in 1962 dollars, but still not a huge amount. One of the local boys offered to bring in the backhoe and dig out the burning coal. Problem solved? Not so much. The bid was rejected as being too expensive. Besides, mine fires are not uncommon in coal country. This one should burn out, too, the people reasoned.

Well, the fire didn’t burn out. It got worse. Much worse. By the 1980s, people noticed dangerous levels of carbon monoxide in their homes and gasoline tank thermometers were recording temperatures of nearly 800 degrees as the fire raged underground.

The federal government has since paid $42 million into relocation efforts (there are still a few diehards who won’t leave). Additionally there have been some efforts to put the fire out that ran into the millions of dollars. Despite all of the (mostly half-hearted) efforts, the fire burns on and might burn for thousands of years. Hopefully, the fire does not reach the nearby towns of Ashland (two miles) and Mount Carmel (six miles).

So what does a dead coal mining town in Pennsylvania have to do with health care (aside from the mental and physical health questions surrounding the holdouts)?

Consider this:

Imagine you have a minor throat infection that could be cleared up by a prescription antibiotic. If you have no insurance, you are looking at about a $100 visit to the doctor. If you are lucky, the local Walmart will sell you the antibiotic for $4. (I have a lot of problems with Walmart, but their $4 drug program is not one of them.)

Unfortunately, if you don’t have health insurance, you probably don’t have the extra $100 to go to the doctor. Without the prescription, you can’t get the $4 antibiotics. You just lie in bed and hope to get better tomorrow.

You don’t get better; you get worse. Now you are heading to the emergency room before you die. Afterwards, you are looking at a bill of several thousand dollars. Add a few hundred more if you have to call an ambulance. Public assistance (via tax dollars) will cover some of the cost, but you will probably be stuck with a huge medical bill. You may have to declare bankruptcy and ruin your credit. This is all the result of a minor throat infection that would have cost $104 to cure.

I could make the utilitarian argument and say that we have the responsibility to help out our fellow humans. Instead, I am making the financial argument. It is more rational to pay a lower amount to solve a problem early than to may a lot of money to solve a problem later. That's second grade math and logic.

Using the same argument, I would rather that my taxes pay for a $175 plan to extinguish a mine fire instead of several million to relocate people and maybe extinguish the fire decades later.

That is why I am supporting Obama’s health care plan. He would like to open the health care plan that covers members of Congress to everyone who would like to join in. Additionally, Obama wants to take on the insurance companies and force them to stop denying insurance for preexisting conditions. It would also be nice if certain groups, (all women for example) were not charged higher rates than others.

These are the things that will encourage people to go to the doctor early and not run up huge bills at the emergency room. It might mean some up front costs, but the long-term benefits are obvious.

This proposal is not as good as being able to walk into a clinic in Britain and not pay a ha’ penny for treatment, but it’s a start. That’s more than anyone else has offered.

I owe my great friend, Jenn a major tip of the hat for her extensive research on the Centralia topic. (I hope she had fun protesting Palin and supporting Biden in Williamsport.



Rev. Irwin Addison said...

That's probably why Walmart has $4 prescriptions, Chris. They get great PR and they may not have to honor the deal very much because of the very scenario you describe.

Jenn said...

Well, considering I am from the Centralia area and I don't have health insurance, I guess I'm doubly screwed. Nice assessment/analogy, though knowledge of the fire is not only limited to locals and coal execs; you forgot to mention the shamed state and local politicians! Can't let them go without some of the clout.

While I'm not sure that socialized health care is the answer, the system we have now is ridiculous at best, debilitating (financially and physically)at worst.

Enjoy your new insurance plan! (oh, and not to sound too cynical, but try not to get sick, I had one of those basic institutional plans we'd say in anthracite country: it don't cover shit, yo.

American Girl said...

What a horrible story!

As an ex-pat who is experiencing a national healthcare system first hand, let me point out that in no way does the Canadian public system compare to the quality of the private US system. However, everyone gets access to healthcare and no one goes bankrupt because they had to have an appendectomy.

I would hope that if The States got on board with universal healthcare, a way could be found to integrate the quality of the US private system into a nationalized system.

Oh, the National Association of Graduate and Professional Students used to offer a health insurance plan.

Chris said...

Thanks for the comments, everyone.

Now, I need to review the paperwork to see what exactly my insurance covers. One thing I am sure of: everyone should have some health insurance.

It ain't socialism. I'd rather my tax money is spent intelligently.