I have spent some time in the past year as a patient in the world of healthcare. It is not a fun place to be. Every time I step my toe into that world of appointments, insurance, new doctors, old doctors, and costs, I come away thinking about how the hell do we fix this mess?

I am not espousing anything that we all know. We depend on the system because we have to. I spent the last year trying to figure out something. Four doctors in I finally found one that actually peeked under the hood. She set me on the right path. I was so grateful which she appreciated but she stressed that she was just doing her job. Nobody else did their job. Why? Time is money, they didn’t know or didn’t care, they weren’t honest enough to say this is not an area I am expert in but this person is? Who knows the answer but between Dr. Google and a good doctor, I figured it out. Why should it be like that?

Why aren’t insurance companies proactive instead of defensive? What is everyone had to have an annual physical, and a battery of different tests as they got older, different pokes and prods based on your age and gender.

Data is pointing to more people dying of diabetes, heart disease and opiates. Wouldn’t it make sense that insurance companies would look at an individual and make a recommendation such as twice a year physical, needs to see a social worker or therapist for mental health issues, needs to see a dietician or nutritionist and in this case one that can help with the entire family, needs to exercise and should connect with the local gym and the right trainer to start on the correct path. Each person needs different guidance and health administration. This might seem expensive but not as expensive as getting a massive heart attack at 56 or 63 and staying in the hospital for weeks on end, paying for constant care and meds, and that doesn’t even count the cost to the long tail of not being able to work or care that is left for the family.

Is any insurance company looking into this? The good news is we are seeing more start-ups addressing each of these situations from the ground up with telecare through states that are trying to address these overwhelming issues in communities of need. The cost hits all of us and everyone deserves pro-active healthcare.

We should all be able to choose our own healthcare but we all must have healthcare that is thinking in new directions.

Comments (Archived):

  1. Erin

    You guys have all my sympathy. Your medical system is so stressful. I just finished another uni class where I wrote about Tommy Douglas, the father of Canadian Medicare. He was a small-town preacher from just a couple hours drive from me. Got his master’s of divinity in the US, then came back and settled here. He got involved in politics in the 30’s because Ottawa wasn’t doing anything to help the average working man during the depression besides just sending them off to work camps. He eventually went on to form Canada’s first (and only) socialist government. He was also premier of my province and set up so many public services and utilities, set up a ton of infrastructure. Then of course conservative governments come in and sell everrything off, and privatize everything. It was a good reminder that you always have to be an activist. You can’t really sit on your laurels. Anyway, it was good to learn about a local hero. About a decade ago, he was voted as the greatest Canadian. Oh and he’s Kiefer Sutherland’s grandpa!

  2. LE

    Why aren’t insurance companies proactive instead of defensive? What is everyone had to have an annual physical, and a battery of different tests as they got older, different pokes and prods based on your age and gender.There are many reasons for this but one thing you have to keep in mind (and check with any of your doctors) is the concept of ‘AMA’ that is patients who do things against medical advice or don’t follow what doctors tell them to do.Also poking and prodding does not lead to overall better outcomes in many cases. It can just lead to more tests, more stress and unintended consequences. All which cost money. You are not a typical patient. Ask any doctor who works in a hospital.This is not to say that a better system can’t be developed and implemented of course that is always the case.What is everyone had to have an annual physical, and a battery of different testsThis assumes that the current healthcare system can support the increase in activity. If you want ‘quality’ results it can’t currently. Over time could it develop under a massive plan? Sure it could. How is this paid for? Won’t just be by saving money in other areas.One thing that also needs to be discussed is the amount of disease caused by our current culture of food, dining and food marketing. And people eating and overeating for pleasure. It’s an addiction. And no the answer is not ‘organic’ or ‘eat healthy’. Drinking as well. Not small social drinking but drinking in excess. Liquor and the results of drinking to much (where the opinion on ‘to much’ changes over time). And no it’s not education people obviously have a greater pull to eat things that give them pleasure than to not eat to avoid some future problems as a result of that behavior.

  3. JLM

    .Surely you have a white glove medical concierge service?For $3-5K per year (some are as high as $10K) — which is likely less than what you are paying for insurance right now — you get your own doctor who makes house calls. He typically has 300 – 500 patients and may employ a nurse.He gives you 2X physicals, prescribes for you, refers to specialists, and is usually an internist.This is quite the norm these days.Cheaper than insurance.JLMwww.themusingsofthebigredca…

    1. LE

      I ‘sort of’ have that concierge thing.

  4. awaldstein

    Yes, been there and its a deep pit of anxiety.The one truth of the Wellness World was that no one but yourself can be in control of your health. I live by that one.It doesn’t make it easier but it puts the responsibility where it is actionable.

    1. Anne Libby

      Actionable and yet incomplete — plenty of random things, completely out of our control, are vectors for injury or illness.

      1. awaldstein

        You can only do what you can.With healthcare I am not part of the process of finding a solution. Too many battles to fight.I take care of my own the best I can on this one.

        1. Gotham Gal

          It’s the only way. It should be a better way

          1. awaldstein

            Your right.Went through a protractive painful poorly ending summer of this with a close family member so this is still very raw to me.The reality where great doctors are the saviors and the system is so painful and the cost barriers so broken that you simply do what you can in the midst of it all.

          2. Anne Libby

            I’m so sorry.And I’m pretty sure we agree on this. And I also resist the magical thinking that Wellness (being vegan/meditating/taking vitamins/whatever) is, in and of itself a kind of insurance. You can use nutrition to help heal a broken bone, but…

          3. Anne Libby

            And also, as the owner of a one person business with lousy access to insurance options that add up to “health care,” I also resist the notion out there that there’s a “market.”And this is not directed to you, Arnold, but a more general statement. I defy anyone to successfully negotiate with a hospital, or get an estimate of what a protracted entanglement with the medical establishment might cost before you get treatment.

          4. awaldstein

            hmmthere is genetics–can’t do anything.there is insurance–must make certain you can get the best care you need.there is nutrition and mental wellness that is a huge step in added odds for health and longevity.there is exercise that while less important than nutrition is an add on to least this is my way,

          5. Anne Libby

            I’m pretty sure we’re aligned here?

          6. awaldstein

            yes we are.have a great holiday season my friend!

          7. Anne Libby

            You too. And I wish peace and healing for your family member.

  5. LE

    Four doctors in I finally found one that actually peeked under the hood.About 10 years ago I was in negotiations to buy a medical practice for a Physician. (Yes I do that type of thing). So after going through and having an offer accepted, dealing with the accountant for the Doctor and their attorney, I ended up with a tour of the office (5 exam rooms, 1500sf). The Doctor who was older and was retiring was going to work (after he sold) for the VA hospital. He had already interviewed and had a job lined up.So as I am walking down the hallway there is this picture or certificate on the wall and the Dr. says to me ‘did I tell you I was in the Navy!’. I didn’t know so I said ‘no hey that’s great’. We keep walking down the hallway and there is another memorabilia on the wall and the Dr. repeats the same thing. ‘Did I tell you I was in the Navy!’. Well a few minutes later it was apparent from other things he said to me that he had (for lack of a better way to put it) ‘lost his marbles’. And yes he did have a job lined up at the VA. The deal was killed (he was supposed to consult for the physician buying the practice but that part would never happen). His son even worked in the office (doing billing I think). And yes he was seeing patients. True story! I ended up buying the real estate and rent it to this day to another Dr. The Physician I was helping now works for a hospital.

  6. Sierra Choi

    In Japan, when people turn 30 yo they have everyone take a comprehensive series of tests from everything to MRIs to brain scans to total bloodwork and assign everyone a grade on how healthy they are relative to the population. This sort of preventative care ensures that they catch any problem areas at the onset before it becomes advanced and I think this model could also be used in the US and the UK as it is quite effective. In the US, often the problem is treated when it is already at an advanced stage, leading to higher costs in patient care.

    1. Gotham Gal

      I know nothing about the Japan healthcare system. This is so smart!


    It isn’t just the insurance aspect of it. You said it, it took four doctors to figure it out until one went under the hood. What has happened is the insurance companies are forcing doctors to check off “us the patients” quickly so no doctor has time to look under the hood. It shouldn’t be this complicated and insurance companies and doctors have to remember their are humans in the room who need a human connection.

  8. pointsnfigures

    The economic incentives designed into public policy do not favor the patient. We have price floors and ceilings which screw up markets. Trump’s move to make price more transparent is a small step in the right direction. Obamacare was a major step in the wrong direction. As an independent worker who has an HSA and a $10k deductible, it’s really hard to get some things done. For example, when my kids had wisdom teeth pulled it took a few days to even find a price. There is a lot to work on here, but in this environment I don’t see how it gets done.

    1. LE

      Well all else equal if the quality is taken into account here is a quick tip.Find a practitioner that is not located in an upscale area. I don’t mean they need to be in ‘the ghetto’. Just not in an upscale type community.You would typically find a much lower market price for the same service.Here is an example.You live in NYC metro (I know you are in Chicago but I don’t know that neighborhood wise).So if in NYC check prices in Eastern PA. Or in Southern New Jersey (but not the upscale parts).The price difference may surprise you.For a certain dental procedure the dentist next to my office charges $1400; The dentist located across the river (who I started to use when growing up; practice was sold) charges under $900. Different client base (the neighborhood changed over the river mainly immigrant so what can be charged is capped somewhat).Will state the obvious that I would not shop medicine based on price because I don’t have to.