My Little Health Care Rant

Comment

Comment by Cissi Sherlock on July 31, 2009 at 1:20pm

Maureen,

I like your post and I know exactly what you are talking about. I do have a question, though.

With the new single-payer universal policy that is remniscent of HilaryCare and HMO's, how do you feel about the doctor having to submit requests for testing to an independesnt panel not wholly comprised of doctors, but who only represent the restrictions and limitations on cost and care that will be put on the doctors and patients?

Actually, is for everyone. It is food for thought for all those trying to come up with a solution to the health care crisis and all those who are considering backing it.

I had my own experience years back when I went to the emergency room for a bladder infection and as they were taking my information (while I sat there suffering), I aslo had to wait while they called an independent source for a referral. It turned out that my policy did not cover bladder infections and I was denied care - and I was at Wishard! The nurse got on the phone and explained to the representative what might happen if the condition went untreated and they could only apologize.

Of course, I was treated and billed for the entire visit! And, I was pissed! An independent panel can't feel my pain and they won't be there for me when my condition turns into something more serious. That's why HMO's went the way of the dinosaur and I don't want anyone being in charge of deciding whether or not I need care, especially if they are not a doctor.

Independent panel, my foot!

Ooops, I guesss that was my little health care rant!

Comment by Maureen on July 31, 2009 at 11:22am

In the past 4 weeks, I think I've experienced the extremes of what is possible in good and bad care. I would be in favor of something that helps us understand who we are seeing and anything that encourages doctors to work together to promote 'quality care' and give consumers a way to investigate who these strangers are that we get referred to.


I wasted time and money seeing a doctor that really should not have taken the appt.........not that it's going to stop him from billing me.


My faith in doctors as a whole is restored by the people at Methodist Sports Medicine....wow, what a difference.


Hey Doug, I like your post. I read somewhere that healthy people actually cost MORE because they live longer.......seriously.


Oh, re: preexisting conditions. Once I applied for health insurance and as a part of that, reported an er visit that I had had. Well, they took their sweet time following up on that and did not get the job done before their 'legally mandated time limit'............as a result.........I was denied.


Ultimately I was approved but now, whenever i fill out a form that asks "Have you ever been denied coverage for any reason?" I am legally required to say yes


Here is another trap........if a doctor 'recommends' a test..........it goes on your record and if you don't have the test..........and it turns out you should have..........you are not covered because YOU should have done what they said to do.


I got caught up in a 'test' test and more test thing last year that took me a year to pay off.


Consumers have got to have some protections from bad practicies! Something has got to give here.

Comment by Cissi Sherlock on July 29, 2009 at 10:13pm

This just in!

Comment by John R.(Dick) Troll on July 28, 2009 at 8:52pm

Uh OH! When Fortune, the financial magazine, sent a reporter to find the " Jack Welch" of healthcare guess what they found? When the Rand Corporation did a study using 294 measures of quality guess what they found? When Bill Kristol was cornered guess whom he admitted was delivering excellent health care services. And, if you still can't guess- guess whose costs per patient are declining while overall healh care costs spiral?
Our very own Veterans Administration. With the highest patient satisfaction survey levels anywhere to be found.
These are conclusions based on data. Not on someone's uncle from Italy or a friend of a friend of a friend of Sentator McConnell.
Changing health care for the better is not really about policy. It is often about changing our preconceived notions of how things work.
Mike, you pointed me to the superb New Yorker article. The author traveled the country far and wide. He interviewed scores and scores of doctors and administrators. He unearthed the amazing contrast between two cities in Texas. And from all his observations he noted that those organizations functioning efficienclty shared a certain characteristic= they were all non profit organizations.
As we absorb all this data and discuss how we should proceed we can either deny or diminish the evidence or we can reassess our point of view. Sadly, all to often, we choose to diminish rather than reassess.

Comment by Mike Seidle on July 28, 2009 at 3:28pm

@John R. Troll - I'm sure the doctors would say that's ok if the lawyers did the same thing. Seriously, though, I'm not sure that being for or not for profit is the key as many of the area's hosipitals are NFPs. As a Catholic I was and and will continue to be outraged by this gem about St. Vincent's Hospital ran (for the non-Catholics, here is who St. Vincent de Paul is) in the Indy Star. In short, St. Vincent's (with all apologies to the actual St. Vincent) is the least charitable hospital in central Indiana and writes the least business off because people cannot afford the bill. We actually just had our new son at Community North because I'd rather do business with a business than with a wolf in sheep's clothing like St. Vincent's (again, with many apologies to St. Vincent).

Comment by Douglas Karr on July 28, 2009 at 10:51am

My response on healthcare was a bit too long for a comment.

Comment by Steve Stuck on July 28, 2009 at 8:50am

@Dick Why don't take the profits out of your business?

Comment by Maureen on July 28, 2009 at 8:37am

Yes and it seems to me that although well-intentioned, current proposals will only exacerbate what has become a very frustrating and expensive issue for most families.

I am currently in the process of trying to get surgery and although everyone tells me that this is a 'no big deal' surgery...........what I have had to go through with Dr's and the insurance company could be the subject of a dissertation.


The only thing that the medical profession seems to want to do is maximize the number of office calls I have and require me to have more 'imaging'

It is very scary knowing that NO ONE is taking a wholistic look at me and what is best for me. No one (so far) has talked to me in a way that gives me confidence that they will make a good faith effort to do what is best for me.


Pray for me, I have my second consult this week. Insurance company only pays for two. I think this guy is going to be great (fingers crossed).

Finding a 'Good' doctor' these days is NOT easy...........getting in to see them is even harder. Making sure that insurance covers it is just ridiculous.

It's like doing a freakin tax return! didn't this used to be easy?

Comment by John R.(Dick) Troll on July 28, 2009 at 7:51am

Mike:
The answer to your question can be found smack dab in the middle of the New Yorker article. In discussing the Mayo Clinic and the other well run facilities the author notes:

All of them function on similar principles. All are not-for-profit institutions. And all have produced enviably higher quality and lower costs than the average American town enjoys.

We change the culture of medicine by taking profit out of medicine.

Comment by Mike Seidle on July 28, 2009 at 7:03am

Maureen - That article is great. It really exposes the battle that I've watched growing up (Dad is a doctor, Mom is a nurse): administrators and the gold stethoscope club versus people who care. Those in health care to make money, well, the emphasis is all on performing as many procedures as possible. Those in it because they care usually tried to perform as few procedures as was necessary to get someone better.

The question is, how do you change the culture of medicine and put the people who care back in charge?

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