Reading about health care
Reading about health care has been enlightening, distressing, and disgusting.
What Claire McCaskill said yesterday about how difficult it is going to be to pass a new health care bill made me pause. She basically said if it was easy, it would have been done years ago. She also noted that there is so much money in health care that it will be difficult to get Senators to make changes ( basically as I am not quoting her here ). What I got out of this was that lobbyists and money control each and every Senator in some way or another and that is why nothing gets done in Washington.
Enlightening…yes. Distressing….yes. Disgusting…absolutely. Surprising…not really.
Take a look at Albany right now. You can't make this stuff up. It is like a bad reality show. Obama is attempting to make serious changes in DC, I believe he should push even harder for each change, but how do you turn back hundreds of years of business as usual?
I remember a few years back when we had a party for someone running for the Senate. His assistant told me that after getting elected, a Senator has to spend about 75% of their time raising money for the next run. Makes me really wonder about everything the Senator hopeful had to say about what issues they believed in and what they wanted to accomplish. How can they accomplish anything when 75% of their time is spent raising more money?
I make donations to support politicians that believe in what I believe in and I hope they represent my vote in the Senate ( or other places of Government). It has nothing to do with access or slanting their votes. I don't believe in that. I am happy to discuss and give advice if they have any interest in listening to me but I really give to support people I believe in. Call me crazy.
After reading McCaskill's words yesterday, watching Albany implode and seeing a bit of the business as usual go on, it really makes me question the whole machine. And BTW, as bad as the Democrats seem to be these days, the Republicans are in bed with the lobbyists and big business more than their counterparts. Big business should not be controlling the voice of the people.
I agree that this process is laying bare the depravity of our elected officials. I’d prefer that the Congress not pass any healthcare legislation. Anything they pass will make the situation worse.Who’s influencing things?One big special interest influencing this debate so far is not corporate America but the unions. Some legislative drafts contemplate taxing health benefits (which I support if combined with an individual deduction, unforunately not contemplated), but would exclude people covered by a collective bargaining arrangement. Talk about repulsive.Second on the influence peddling hit parade is the tort bar. Talk to any physician, and the threat of punitive damages is a huge cost for them – in terms of insurance and more importantly running tests to cover their rears so they don’t get sued. Is there tort reform considered in any legislation on the Hill? No chance.Private health insurers? They would be wiped out in any legislation that includes a public option. So would indivduals’ ability to control their own healthcare choices. Naturally, Congress would exclude themselves from any such restrictions.
Naturally, Congress would exclude themselves from any such restrictions.But I do believe something needs to change.
In Massachusetts, usually a case for malpractice goes before a tribunal. Unless, there has been real damage a case does not go any futher. It is very expensive to persue a malpractice case so the idea that everyone is suing is incorrect. The hospitals and doctor organizations do not police themselves and when a doctor has been successfully sued he usually really screwed up. Malpractice suits seem to be the only way to get rid of really incompetent doctors because the hospitals just cover everything up.Lawsuits are Not the reason for high health care costs. Most of the doctors I know only prescribe tests because they can’t figure out what is wrong with the patient. Why would a doctor prescribe a test if he knew the cause of the problem? At that time there would be no actionable cause for a lawsuit. If a doctor does an extra test at the time of a patient’s complaint the doctor can sometimes save thousands of dollars for the system by early diagnoses. If a physician was a mind and body reader, he wouldn’t have to perform any x rays or tests. We could also save billions of dollars if we just shot everyone who had a medical complaint. To use medicare as a health care model would be horrible. Obama talks about too many hospital readmissions. What he doesn’t talk about is how there are so many readmissions, because the drg’s throw our elderly out of hospitals far too quickly.They are pushed out without proper diagnoses and many do die because hospitals are rewarded by early discharges.I could go on and on but this is the Gotham gal’s blog not mine.
As much as the European system isn’t perfect, I believe that is the way weneed to go as a country. If you have the means to pay for a doctor out ofyour pocket, which by the way many doctors in NYC do not take insurance asit is, then that is a layer of health care that will continue to exist.Anyone should be able to get an annual check up, walk into a hospital withan emergency and get treated. Preventative health care, such as annualappointments, would have an immediate impact on the costs. The layers ofreferrals etc is a huge cost in itself.Bottom line is that people who don’t have health care are costing people whodo have health care money because the insurance companies and hospitals justrecoup their losses through the people who are paying their premiums, etc.There must be a better way and now we are just funding big business.
Gotham Gal, years ago we paid over $30,000 a year for a two person master medical BC/BS policy. Blue Cross did everything they could to transfer us to a ppo policy. Blue Cross no longer offered the master medical policy in favor of a ppo. With master medical, a fee for service indeminity plan Blue Cross paid 80, we paid 20 per cent for office visits with a 5 million dollar lifetime limit.Now with our ppo we pay $28,800 a year. We have no lifetime limit and office co pays are $15. For some reason I feel Blue Cross will never ever let the limit get anywhere near a 5 million dollar limit with all their managed care policies and benefit management policies. I hardly ever use my health insurance. For one who never really sees the doctor I have not utilized my benefits. They were there for “future illnesses”, however I feel that my hundreds of thousands of dollars of paying into the system will have been wasted as now I will be rationed to death. I would have preferred to have had my own health savings account where I could have put my health care dollars into it and it would have been there for me when I needed it.All I would have wanted would have been the same discounts from doctors and hospitals that Blue Cross is offered.
Stories like these are heartbreaking and they happen many times over daily.It is unacceptable. So sorry it happened to you.I have looked into the insurance where you put money in to your own healthsavings account. It is an interesting concept and one many healthy peoplelike yourself are starting to do. What is awful is that when we werepitched on the idea, I didn’t trust the person who was pitching us. I don’ttrust any of these insurance companies…I always feel they are out to screwthe people who they are supposed to protect.I am sort of feeling that way about the Government these days too.
I found this link and I agree with it.http://online.wsj.com/artic…In 1995 I had a very tough time getting my mom into the hospital. She had been a healthy and active person. I chose a doctor because her blood cell count dropped from 45 to 18. He was a hematologist. He spent a month stonewalling me as she got sicker and sicker at home . He finally said “Once you get them into a hospital meaning the elderly you can never get them out.” finally she fell from such a low red blood cell count and I insisted. The minute she got into the hospital the doctor kept pushing to get her out. She was never diagnosed with a terrible gastric bleed and needed much more care when she finally was, than if the doctor initially treated her as a vital human being dispite her age and gave her the necessary test at the onset of her problem. I never want to relive that. Instead of worrying about he,r I had to beg for treatment for her.
Great article. It is so incredible, although not really, that the lawmakers who are voted in by us seem to have very little interest in makinglife easier for the common man.
Joanne and all your followers,Go to Dr.Stanley Feld’s blog: Repairing The Healthcare System, http://stan.feld.com.He's been writing regularly on how to fix the mess. He really gets to the heart of the matter with real solutions. Its no holds barred.There’s a lot there, so look for the summary articles.Cecelia Feld
First of all I do not believe in giving doctors money for denying a patient care or a hospital a bonus for not admitting a patient or kicking a patient out too early as in the drg system. The “incentives” for “good care” are to penalize doctors for prescribing lifesaving tests or granting too many hospital admissions. Where in the free market system do we reward people for NOT doing any work. This is crazy. What we will get is desperately sick people like my Mom who sits dying in her bed at home for lack of any really good care, in the name of cost savings to medicare and bonuses to doctors. As for Tom Daschle I read Critical and think he is totally insane. First he thinks Lipitor and other statins are 99.9 per cent useless and goes on to say that we should give a pcp a lump sum of money for each patient and if the doctor orders tests or sends a patient to a specialist it comes out of that lump sum. If the pcp does nothing he gets to keep the whole lump sum. This is not why I have spent a fortune in health care premium insurance my whole life.If this gets passed Blue Cross will go to this system for everyone, because as it is already has signed up a a number of hospitals and practices in Massachusetts. This was the old “carrot” that managed care gave doctors when managed care was offered to keep them happy. Give doctors, patient money to not treat their patients. If you gave your contractor $50,000 and told him to build your bathroom and pick out all the materials etc. do you think you would get any real quality? I don’t. And then make it illegal for you to sue the contractor if the plumbing didn’t work or the toilet overflowed.
I love your analogy at the bottom. Agreed.
If you want the answer to healthcare reform read my blog summary. President Obama is pushing the wrong things. They will not work. I have outlined how you can align everyone’s incentive, decrease costs, increase quality and create universal care. Healthcare is a complex issue. The solution is simple but politicians in reality represent vested interests and not the people, It will take the consumer to break the cycle.You can see my summary’s at http://stanleyfeldmdmace.ty…I would start with my letters to President Obama in the middle of the page and then work back and forward.Stanley Feld M.D.,FACP,MACE
You seem to be lamenting the ineffectiveness of government, while at the same time advocating more govt control of healthcare, energy, etc. “I’m for whatever Obama wants…he’s pure and not ‘controlled’ by special interests”Nuts!