DrMyers’s Blog

June 5, 2009

An Apple A Day Keeps The Doctor Away

apple
apple

 

Today, there is much more separating a doctor and his patient than a red delicious or granny smith apple. The high cost of health care can be the determining factor in your decision to seek out necessary help from the medical profession for yourself or a family member. Even with insurance coverage (forget including pre-existing conditions), the high cost of premiums, deductibles and co-pays along with prescriptions and any follow-up treatment or testing, have relegated health care to a “luxury item.” Many that have enjoyed employer provided coverage in the past are having it reduced or, in the case of job loss, completely extinguished..

 

Why an I concerned about this? Call it selfishness. I have no health care insurance and suffered a major stroke a few years ago. The residual effects of the stroke are minimal – to me, more annoying than debilitating since I’ve had to make time-consuming adjustments to the routines of daily life. I find climbing stairs difficult but suffer vertigo on escalators so elevators are the mode of choice. I lose my balance easily when the ground isn’t level and still have some difficulty finding the “right” word when I speak. My stroke affected the right side and, being right-handed, I have had to train my left hand to take up the slack. I was not eligible for government assistance because I was not deemed to be disabled. I was told to get a job in Walmarts.

 

I already have a full-time job. I’m the primary caregiver for my 90 year old home-bound father, who has suffered TIA’s and cancer, and my son, who has been diagnosed with bi-polar schizo effective disorder.  The monthly health care costs, even with insurance coverage, are astronomical and I’m worried about what will happen when the money runs out.

 

I tell you all of this not to get sympathy but to give you an understanding why the subject is so imporatnt to me.

 

I have spent many hours researching the subject of healthcare reform and have talked with numerous friends and healthcare professionals about what they perceive their needs to be. I have heard phrases like “choice”, “cost-cutting measures”, “deluge of administation and billing requirements” and “emergency room crowding”. One physician I spoke with talked about his current financial situation. After many, many years of persuing his dream at a costly medical school, he is then saddled with the cost of opening a practice (and all it entails), purchasing medical malpractice insurance at a very high premium and then the fun of hiring a staff to fight insurance companies for what ends up to be a reduced payment for his services. He said the days of “afternoons on the golf course” are long gone. He must work 12 -14 hours a day to keep his practice afloat.

 

So, here’s the dilemma as I see it. We need to come up with a healthcare plan that will reward the hard work and dedication of healthcare professionals while addressing the need for affordable healthcare for all. I haven’t forgotten insurance companies – I just no longer see a need for another middle-man. Cutting costs already…

 

 

~  Michelle
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7 Comments »

  1. ok…right. We all agree there’s a problem. So what do we do about it? Medicare for all? Not a bad idea, in my opinion. I pay just a few dollars (yes, single digit) shy of $1,000 per month for my health insurance, and I’m healthy, if corpulent. 🙂 No pre-existing conditions. I think we have to take the “for profit” motive away from our pooled insurance carriers. So much money is wasted by the necessity of thiese big insurance carriers to make BIG profits. So I suggest: Medicare for all who want it. Transition into this system by offering a choice, your current carrier, or medicare. For those that can or will do neither, we already have Medicaid for the poor. For the less poor who have not opted in to an insurance program, when they need to use society’s health resources they can either go into debt, as they do now, or opt into the Medicare program to lessen the debt, possibly with some back premiums paid up front. But those are details which could be worked out.

    Comment by kate — June 5, 2009 @ 10:26 am | Reply

  2. Good points, Kate! However, it leaves the current problem of many healthcare providers unresolved – the cost of time consuming administration and billing requirements.

    Comment by Michelle — June 5, 2009 @ 12:35 pm | Reply

  3. Amen! You’re dead-on that one of the root causes are the explosion of prices in recent decades that make health care near unaffordable for a big chunk of the population (45 million or so). Health care ought to be a right in this country, and it should not be something predicated on profits. If we can find a way to fight endless wars overseas we should at least be able to “socialize” our medicine (as the kook-wingers call it). Dang right we are going to socialize it; we have already done that with the banking system. Kate I think you’re right in saying that a public plan could compete, just like in the health care bill coming to Congress. Single-payer ultimately is the way to go if we really want to drive down costs, but in a nation still obsessed with the “free market” (again not so “free” after the bailouts), it is a hard pill to swallow. Thankfully, our government finally seems poised to do something about this festering problem. Make sure you call your representatives and let them know your ideas, your stories, and how you think this broken system ultimately should be fixed. Thanks for the post, Michelle!

    Comment by thistleseed83 — June 5, 2009 @ 1:07 pm | Reply

  4. I used to work for a mental health clinic when I was in college. I did the billing for Medicae and private insurance. Here is the rub: when the gov’mnt took over mental health care in New Mexico after rising private insurance costs, the costs still rose. Medicade had to turn the system over to the private companies to run Medicade to keep costs down.

    Administrative costs, illegal immigrants bleeding the system white, fraud, waste and the aging population are the perfect storm. While new technology will help, no one can command costs to come down.

    Face facts, preventative care would stop punch a lot of health care problems. sadly the doc you spoke of who had to fight insurance companies would have to fight the government under a single payer system.

    Private insurance companies and government bureaucrats have the same answer when you submit a bill: “NO” To keep costs down they both try to nickle and dime the patient and doctor.

    Single payer would be a nightmare. We need industry and the government to work together.

    The plans floated in congress would just waste money and create a forest of paperwork.

    Comment by chockblock — June 5, 2009 @ 10:46 pm | Reply

  5. Thanks for your comments thistleseed and chockblock. I, too, worked short-term for a healthcare provider a few years ago. One of my tasks was medicaid billing. What a nightmare! A large majority of our submissions were being denied so we’d resubmit – only to be denied again. Then I took care of my mom (she wasn’t eligible for Medicare yet) when she developed breast cancer. She had a mammogram 2 months prior to being diagnosed so it wasn’t for lack of her trying to do the right thing. For the 14 months she survived the cancer, it was one battle after the other over insurance stuff. I took care of it because I couldn’t let this add any more stress to her life. I won’t even dare to bore you with my opinion of the mental health system. What a waste… I truly feel I have fallen into the endless pit that is our current healthcare.

    Comment by Michelle — June 5, 2009 @ 11:35 pm | Reply

  6. I am continually amazed that our country always goes for the “cowboy” solutions. We want to stand alone and refuse to consider the solutions that have been found in every other industrialized nation.
    Insurance companies add about 30% to the const of our healthcare, but so does the fact that we have been slow to accept available technology for administative costs, over testing because that is where doctors can make up the reducsed dollars for insurance companie and governement programs.
    It is time to get real about our healthcare. socialized medicine – the government already pays 65% of all healthcare costs.
    Npr has an excellent series on their website of the pluses and minuses of the avaialble healtcare costs in many diferent nations. I am reminded of a friend that chose to fly to the formed Czech Republic for an operation he needed. Counting airfare and all other expenses he still sve over $5000 in 1985 – can you imagine the savings today? – – steve

    Comment by steve — June 7, 2009 @ 9:44 pm | Reply

  7. To whom it may concern,

    I am a speech-language pathologist that works for a pediatric brain injury program through Children’s Hospital of Michigan in Detroit. I am compiling a work book to educate children with brain injuries and am interested in including one of the images from your website. I would like to request your written permission to reprint and distribute your images to individuals with brain injury and those in the community who are involved in their care and rehabilitation. Your response to this request is greatly appreciated. The image I am is the red apple.

    Sincerely,
    anicodemi

    Comment by anicodemi — June 16, 2010 @ 4:11 pm | Reply


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