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Dean's Real Healthcare Reform

Dean's Real Healthcare Reform

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Published by sherry hardy
Chapter One of Gov. Howard Dean's Prescription for Real Healthcare reform
Chapter One of Gov. Howard Dean's Prescription for Real Healthcare reform

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Published by: sherry hardy on Jun 21, 2009
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06/20/2009

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HOWARD DEAN’S
PRESCRIPTION FORREAL HEALTHCARE REFORM
HOWARD DEAN, MD
with
Igor Volsky and Faiz Shakir
 
SPECIAL PREVIEWCHAPTER ONE
Chelsea Green Publishing CompanyWhite River Junction, Vermont
How We Can Achieve Affordable Medical Carefor Every American and Make Our Jobs Safer
 
HOWARD DEAN, MD
 with
Igor Volsky and Faiz Shakir
 
Downloaded from Progressive Book Club,http://www.progressivebookclub.com/healthcare/
 
In 1988, a thirty-two-year-old woman whom we’ll call Clairecame to my medical office in Shelburne, Vermont. She was oneof the first employees in an early start-up company inBurlingtonand had had no previous unusual medical problems. This time, however, she was worried. She felt restless andunusually thirsty much of the time, and experienced frequenturination and weight loss. A series of tests ultimatelyconcludedthat she had become diabetic. Her disease was severe enoughtorequire daily insulin injections.She consulted routinely with an endocrinologist, who beganthearduous task of teaching Claire all the things a diabetic neededtoknow. We agreed that I would remain her primary care doctorbutthat she would continue to see the endocrinologist on afrequentbasis initially, and then less so as her condition stabilized.Fortunately, Claire had less difficulty than most keeping herblood sugar under control, and, with adequate monitoring,goodexercise, and terrific teaching from the nurse-practitioners anddoctors at the endocrine clinic, she adapted well to her newdisease. She was bright, willing to work, and well past theoftentumultuous teenage years, which are so difficult for insulin-dependent diabetics.Four months later, Claire was back in my office in tears, feelingthe same restlessness that had first brought her in for aconsul-
 
tation. But this time, the anxiety was not medically induced. Ihad initially assumed her tears were a delayed reaction to alife-changing illness. Although diabetes can be managed relativelyeasily, it’s nonetheless complicated, especially for someonewhofor thirty-two years had lived disease-free with the exception of the usual childhood illnesses.I could not have been more wrong. Claire was in tears becauseher health insurance company had refused to renew her policy. The start-up company Claire worked for was unable to affordhealth insurance, so its employees bought individual policiesfrom a well-known firm in the Midwest. The company claimedthat it provided individual health policies at a reasonably lowpremium, especially for younger people, and promised toprovideadequate care, good benefits, and health security. Shouldsome-thing untoward to happen, Claire would be well taken care of.Or so she thought. The fine print in her contract revealed otherwise.Letters to the Vermont banking and insurance commissionerrevealed that this was a frequent problem, not just with thiscompany, but with many others that worked in the individualinsurance market. In fact, this is not a Vermont problem;compa-nies elsewhere have continued to refuse to insure people afterthey became ill, claiming that the conditions were preexisting,that they resulted from negligence, that the insurance wasnevermeant to cover particular conditions.While employers are guaranteed the right to purchase healthinsurance, the great majority of states—which govern the indi-vidual insurance marketplace—do not extend the same protec-tions to Americans who buy individual insurance policies. In

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