Les Faux Amis

Anyone who speaks English and has tried to learn the irrational complexity of the French language knows the phrase "les faux amis". Literally, it translates as "the false friends". It refers to words that look the same or are similar in both languages, but that have totally different meanings. On the scholastic level, they are also called "false cognates".

They look like one thing, but mean something totally different

One of my favorites is "formidable". In French, it's pronounced "for-mi-dah'-bluh". In English, it's "for-mid'-a-bull". The former means really, really good; the latter means really, really difficult. Not that difficulty doesn't ever lead to good, but the words are worlds apart.

Health insurance companies are, as a rule, faux amis. They gladly charge as much as they can for coverage, but then will try anything to keep from spending money to treat a life-threatening illness that will lead most probably to expensive care.

I've seen it first hand.

My best friend was diagnosed with a serious tumor that extended from the top of his throat around the top of his brain. His doctor wanted to send him to M.D. Anderson in Houston, one of the premier cancer centers in the world. His health insurance company decided, against his doctor's judgment, that he could live with a local, less advanced treatment center.

His doctor protested, and the peer-review panel of doctors who reviewed his case upheld his doctor's original decision.

However, it took too long for all that bureaucracy to act. He died a month or so later.

I don't know if getting into the hospital he needed to be in when he did made any difference, but the simple fact that his insurance company stonewalled and tried to deny treatment that his doctor thought was his only chance to survive dumbfounds me.

The myth is that if you have private health insurance your provider will take care of you. The truth is that, if you’re seriously ill, your insurance company will fight tooth and nail to keep you from getting treatment they deem unprofitable.

And if he had access to health care earlier, he might have survived.

Everyone is up in arms these days about government-sponsored health insurance. They say it will lead to sub-standard care. That rationing will mean they have to wait six weeks to see a doctor about a cold. That emergencies won't be dealt with in a timely manner.

That's all smoke and mirrors thrown up by the health insurance industry lobbyists.

While this is anecdotal and I have no hard numbers to give you, I can say that my partner's coverage through the VA is easily equitable to, if not better than, the insurance I pay $150/month for. My employer pays the other $450 that it costs.

The VA is one of the best-run health care systems in the world. And, yes, they do ration care. But so does my health insurance company. Faced with enormous budget cuts a decade or so ago, the VA reorganized and invested heavily in technology. They now treat more patients who receive better care because of the efficiencies they've achieved. And they do it for less than they used to.

A few years ago, my doctor wanted me to see a neurologist because of chronic shoulder pain. I had to wait 2 months to see her. In the mean time, I had an MRI, which cost at least two grand. Between the neurologist that I had to wait 2 months to see and the MRI, my insurance company dropped about $4,000.

Turns out all I needed was a new mouse. I bought a trackball mouse for $20 and it solved my problems. I haven't seen a doctor about that problem since I got it.

The experience enlightened me as to how the health care system works: people with insurance get endless referrals to specialists who charge way too much and keep referring them to other specialists when a $20 solution should be obvious.

I told them all that I did a lot of mouse work, but they either didn't understand the relationship between using a mouse all day and shoulder pain, or they just didn't care and wanted to take my insurance company's money.

It costs about $7,200 a year for my health insurance, and for that I get a network of doctors who want to refer me to someone else that I can see in two months.

By contrast, my partner with government-provided VA coverage gets as good or better treatment. He doesn't wait any longer than me to see a specialist.

The VA focuses on preventative care. It also has digitized records to the point that we can got to any VA facility in the country and they can pull up his full record. Their investment in technology has lowered the cost of his care.

These days, I'd trust the government to provide adequate and essential health care more than I would my private health insurance company that costs $7,200/year.

I don't have all the answers, nor will I pretend to. I'm not sure anyone does. As a nation, we've ignored this problem for way too long, and now we're left trying to figure out how to pick up the pieces and mold them into something coherent that provides health care to all the people in what is usually the greatest nation in the world.

We've dropped the ball on this issue too many times; the number of uninsured people in this slice of the world is disgraceful and cannot go on for much longer.

Providing universal coverage isn't an easy problem when times are good. And, to be blunt, things suck right now.

But it is a necessity. One of the reasons (beside the endless referrals to specialists) that my health insurance costs so much is that I'm subsidizing people that aren't lucky enough to have coverage.

And lucky isn't the wrong word. Working as an independent contractor, I went a decade or so without any insurance. I couldn't afford it.

I have it now and feel very lucky to have the benefits that I do.

There could be worse things than a government-administered health insurance program. The VA has proven that the government can run an efficient and responsive health system.

They do as good if not better than Aetna and cost a damned lot less.

Some paint grim pictures of socialism (waiting months or years for a critical operation) into any proposal for universal coverage, but I suspect that they have either never not had coverage or have never been sick. Those artists work pretty much at the behest of a health insurance industry that wants to keep a monopoly that allows them to make life and death decisions arbitrarily, ignoring or contesting doctors’ recommendations.

The people that have and pay for health insurance don’t have the standing that stock holders do.

Whatever the stock holder wants, the stock holder gets.

In any case other than healthcare, I'd agree with the stock holder principal. But when it comes to profit and loss, I have to raise the question of what loss they're worried about. Certainly not the loss of their customers' lives.

Trying to fix healthcare is very much like trying to understand how (and why) cats purr. No one knows what makes cats purr or how they do it exactly. We only know what it means: a purring cat is a happy cat.

Universal health care in the US remains much like Sir Winston Churchill's observations about the Soviet Union: "It is a riddle, wrapped in a mystery, inside an enigma."

He understood that Russia was a false friend, much like the health insurance industry is to American consumers. They gladly take money, but deny claims when it matters the most.

It pains me to say that, as the most powerful and prosperous country in the world, we can't find the wherewithal to take care of our own. Until this disparity is rectified, we are all, as a nation, faux amis.

False friends throw the word "socialism" like candy at a small town parade without even thinking about what it means to have to choose between going to a doctor and buying food. They seek to demonize anyone that would change that equation without acknowledging the crisis of care in their own back yards.

I come from a tradition where people take care of each other. If there's a death in the family, clean out the fridge, cause you're gonna need the room. If you get married, remember to take the checks and cash that got slipped to you out of the tuxedo before you take it back to the store. If your neighbor's sick and the yard is getting a little unruly, mow it for them, but don't accept anything more than a glass of lemonade or iced tea in return.

It's a small-town mentality, I know. But there's nothing wrong with that. We need more of it, not less.

And it's high time that a bank balance didn't determine access to competent medical care.

Any one who says otherwise is false. And definitely not a friend.

To paraphrase Jesus, "What you do to the least of these, you do to me." It's a simple statement about social responsibility. It means that, to one degree or another, I am my brother's keeper.

We need more keeping of our brothers. Being grateful for what we have and helping those who aren’t so lucky. We have to ditch partisan rhetoric and deal with the reality that we’ve created. One where healthcare is not available except on an emergency basis for too, too many people. One where children and old folks are not guaranteed basic healthcare services.

Even providing for the kids and the oldsters, we would leave out a few generations in between.

There is no easy answer, and anyone who says there is lies or is the victim of propaganda, whether from the right or the left. Either that, or they’re just plain stupid.

I don’t have an answer, either, easy or otherwise. I just know it’s a mess. One where the Judeo-Christian ethic might be of use: we need to be the true friends of people we don’t even know.

The task is formidable in both the English and French senses: it's an incredibly difficult task to take on, but facing it head on is an excellent thing.

I'm purring already.