Sunday, March 19, 2006

Q: What might be the most important Open Source project around?

A: Universal Health Care

Let's face it, there are 46 million people in this country who do not have or cannot purchase health insurance. They are on their own. Either they can pay a doctor, clinic or hospital for health care, or they can depend on th kindness of strangers. Most times the stranger is the Emergency Room at a local hospital. This means that if you are uninsured and cut the palm of your hand slicing a bagel on a Sunday morning, you get to go to the emergency room, get stitched up and pay up by cash or plastic. If you don't have the cash or plastic, you work out some sort of payment plan. And, if you don't have the cash or can't work out a payment plan, don't worry. That's the way it works. The Emergency Room has to treat you. After all, that's what an Emergency Room is for—fixing up sliced hands on a Sunday morning. But, what if you are a single or divorced, 45 year old, $75 an hour independent software developer on the way to meeting a client about a new project. In the elevator on your way up to the client's office you start loosing feeling in you legs. The next thing you know you are sitting in chair in the client's conference room. Seems you passed out in the elevator.

You go home.

You haven't seen a doctor for the last 5 years. You have been frightfully healthy for as long as you can remember. You don't smoke. You go to the gym regularly. You run a a mile a few times a week. You don't eat a lot of red meat. You are more of a Chinese food and Sushi guy.

At one time you worked for a company that provided health insurance, so you took it. But when you lost that gig due to all the stuff that went on with the dot com bubble burst and the end of Y2K, you were lucky enough to get a 6 month contract for 50 bucks an hour. The tax advantage that you gained by all those “business expenses” put more money in your pocket than when you had a full time job. Yeah, you lost the medical coverage. But, you had enough money on hand to pay your dentist out of pocket and for a year or two you bought catastrophic health insurance: if you got in a car accident or got appendicitis, you'd be covered, sort of.

You like working on contract. You don't have to put up with the office politics that come with any full time gig, you get to do a lot of interesting work and get a breadth of knowledge that you would have missed if you stayed in one place for all those years.

And, the money was good when you could get it. Working contract has it's ebb and flow. Your rate is reasonable, not too cheap to have prospective clients think you are incompetent, not too expensive to have to work the hardcore, suit and tie corporate consulting thing. Most often you got a new contract within three weeks of the termination of the old one. But, one time you had a two month layover. During that time you let the catastrophic coverage go. But what the hell, all your teeth are healthy and you can bench press your body weight.

Everything was fine until this morning.

Luckily a friend of a friend is a doctor. You call the friend and he calls the friend and you get an appointment three days hence. You go to the friend doctor. You fill out the forms on the clipboard that the receptionist gives you. She asks for your insurance card. You tell her that you don't have one.

A nurse comes and takes you to an examination room. Just as the nurse is about to put the gizmo on you that's used for taking blood pressure, your legs start to loose feeling again. You let the nurse know that something is going on. The next thing one know you are looking up at the doctor. He says that there is no time to waste, you need to get to the hospital. Something is seriously wrong. The receptionist comes in and tells you that you cannot drive yourself, against doctor's orders. She says that she has called a cab. If were insured, she would have summoned an ambulance. Oh yeah, since you don't have insurance, you will be taken to a public county hospital....

And this is only the beginning. You don't even know what's wrong. There is a real possibility that you might die very, very soon. However, you can forget about getting insured at the moment. After all, you can't insure a burning house.

Far fetched you say dear reader?

Well, do the numbers. The general US population is around 240 million and there are 46 million uninsured. That means that 1 out of 5.3 people in this country are on their own. Actually, the 240 million includes kids. So, if you take the adult population, a ratio like 1 in 4 is more likely.

So, think of all your friends who are contract workers and freelancers and tick off every fourth name, because that name my friend is in serious trouble if his or her body decides to stop working according to spec or the bagel cut severs an artery.

It's time to make a change.


Blogger papa said...

Bob, I'm sorry if the uninsured "independent software developer" is you. I'll pray for your health.

10:34 PM  
Blogger Bob Reselman said...

I am insured and still in quite good health. The important thing is that the current state of health coverage in this nation affects us all.

10:57 PM  
Blogger papa said...

I'm glad to hear that. I also hope your example is just hypothetical and not anyone you know, either.

However, as an argument in favor of universal health care, I don't think the example is very effective. Do we need a system to protect independent professionals from the consequences of their own choices?

11:23 PM  
Blogger Bob Reselman said...

It's an aggregation of a lot of stories I know. I left out the one in which I met a woman who had a daughter the was chronically ill, in need of full time care and a kidney. The woman had no insurance. She was watching her dautghter die.

Yeah, the illustration does not lend itself well to the plight of people that don't buy insurance when they can. But the reality is that, in this case we still get to pay via the emergency room, which may be why here in LA a lot of emergency rooms in low income neighbhorhoods are closing.

The sad part is the the quality of "health care for all" affects us all. There comes a point, I think, when the notion of American Self-Reliance doesn't work for a Commonwealth.

8:41 AM  
Anonymous Anonymous said...

I'll give you a real world one Bob...
First post -

Second post -

Punch line -
I have apost that I have yet to figure out how to write. It's called "Tribute." Bottom line is this, I don't have a Mom today... I have a grave site I can visit. She passed away at 57 years old (in about 2 months from now she would have been 58). The point is she was way too young to die.

If you want to email you can (you should have my email somewhere)

11:51 AM  

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