Posted by: guinness222 | August 5, 2017

American Health Insurance Problems,….and pitfalls!!

This is not your normal rant, it is a personal observation, by a PATIENT,  of the deterioration of ATTITUDE in most hospitals,brought on by the hospital administrators AND the Doctors them selves under the “insurance guidelines”, or “profit motivation”, I am going to presume. (Help me out here if you have any light to shed upon this  comment. I am concerned about it, and it’s impact on us here in America, land of the free, and home of insurance companies and hospital administrators.)

In the winter of 2007, or so, my wife who had a few minor medical issues found an internist she raved about. His practice was “closed” to new patients as he was that good and that popular. But during the winter of 2008-2009 my wife came home from an appointment, and told me he was going to open up his practice a little and as she had asked if he could take me on, and he agreed.

He WAS a REALLY GREAT Doc, apparently his wife had died of cancer, leaving him to raise two girls AND be a Doctor at the same time. He is  deeply religious, in fact he is  Greek Orthodox, which is a very demanding Christian/Catholic sect. It has it’s own “Pope/Patriach” and “hierarchy”, and many customs and much pageantry, which has some significant differences with Roman Catholicism. (Maybe in another blog, but not today!)

BUT he was a super “Doc”, and I got on very well with him, and it only took a couple of visits for me to know this was a man whom I could trust with my body and those  of my family. He was the “straightest of straight shooters I have ever met, no he pulled no punches with you either, without being offensive or having that self-righteousness of “I’m the Doctor,…respect me!”.

I went to one of those “Lifescreening” sessions, at our local church in the early fall of 2008, as did my wife, A “Copies of all our results will be sent to your Primary Doctor, as well as to you.”  My wife got hers, but I didn’t, so a few weeks later, I started pursuing them and was getting the standard, “we mailed them out to you four weeks ago, you might want to check with your Doctor and see if they went to him as well, if not we can re-send them to you, at a modest printing fee!”

Anyhow before another day went past, my “new Doctor” , had called that  evening about 8 PM, AT HOME, and indicated to me that there seemed to be some blockage in my left Carotid Artery, and he recommended I contact a colleague Dr. Stuart Harlin” who was a vascular surgeon, (He said he had already sent him the data, and given me a “Referral”, and called to alert him I would be calling), it could be nothing, or a poor reading, so I’ll send him copies as well)

So, as the story go, I called him, and he booked an appointment to see me in a week or so. Three days later I get a call from “my Doctor” AGAIN asking me to see another Doctor at the Pensacola Sacred Heart Hospital, inn Pensacola,  (about an hour and a half drive away) So I call this Doctors office and they already have me “pencilled in”,for an appointment, within the week! (Now I’m getting nervous!).

Long story short, (and the details are in a couple other blogs I’ve written if you want the “gory details”) it resulted in putting the carotid problem on hold and getting a triple bypass first, and within two weeks!! (OK, I guess it was that serious!!)

But I’m still here, and working fine, trying to eat right, goodbye MacDonalds, BurgerKing, Taco Bell, and a bunch more, as well as tying to stay with an exercise regimen, (that’s harder than the food, believe it or not!!)

As I was recovering, adding new words to my medical vocabulary, like “Cardiologist”, “Interventional Vascular Surgeon”, “Ultra-sound Technician”,……you get the picture! Then I had a problem with fluid buildup in my chest cavity that essentially allowed body fluids created as a healing mechanism, by the body, to accumulate in the chest cavity, where the lungs were supposed to expand and fill with air, (essentially the same thing as drowning was occuring!) Long story short, lots of Hospital time involved. But I survived, or “lived to tell about it”, as they say, and have been doing well, ever after!

Fast forward 5 years, the best “Doc” I’ve ever seen has now moved on and left “THE SYSTEM”,…..but I changed gyms and ran into him a few months ago. He was doing the Stair stepper, and I was on the treadmill next to him doing my 4 miles a day. We both recognized each other and we stated chatting. SEVERAL big reasons we are where we are righ now surfaced and we chatted on as we worked out. Ever since the cancer gripping this country, “OBAMACARE” started metastasizing in the body of America, we have been doomed. For example Doctors are paid by the computer codes they enter into the “BIG BLACK MONSTER” and it is either a “short visit” (10 minutes or less”, or an “extended visit”) enter the proper diagnosis code, (which of course the computer will crosscheck, and if you are within the parameters authorized you will be credited for the visit, a $$$ value will be attached and you will be allowed to charge that amount, of course all you really need are ten more “girls” in the office entering it, correcting the errors, and THEY deal with you if you call and have a problem, etc. or are being told YOU have to pay because the “BIG BLACK BOX” has ruled it thus!!

Then he asked me a strange question! “What do you think the biggest prescription drug being  prescribed will be over the next five years? I wasn’t in the know so I ventured a guess, “How about Antibiotics?”,…..He leaned over looked me straight in the eye and said, “Marijuana and opiods”. I was shocked to say the least!

As we talked further, he told me they are the “FEEL GOOD” drugs, and,….that’s all the health insurance and “management folks” want us to prescribe, to para-phrase him,….Just keep the patients happy and quiet until they die,…surgeries, REAL Doctoring  and the like are the farthest this away from what  they want! They don’t want to “CURE” them, or “FIX” them, it costs too much, long term wise, and the “potential LIABILITY”, is far too big! The $200 you bill today is a lot easier to get than the cost of a surgical procedure, or the profits if the Hospital or Doctors, ergo the INSURANCE COMPANIES, are in peril!!

A Doctor is going the way of the old “TV REPAIR TECHNICIAN” anyway! Just give the Patient a full battery or X-rays, CT scans , MRI’s and what ever equipment we have that we can charge unknown costs to use on patients and bill the Government and Insurance Companies. Just move the money to the facilities, so we can buy more equipment and testing things,  to ramp that $200 a day room up to a few thousand for a five day stay! If you have to do a surgery, Get them out of the hospital ASAP, so we can “turn the tables (i.e. BEDs AND OR’s)  faster”!!

It also creates more jobs, Visiting nurses, Visiting Angels, and more billable to the government and profit back to the company owners, and investors, equipment rentals for patients at home, new “walk-in'” showers, ramps and other ancillary industries!!

The “BIG PHARMA” crew has figured out how to skirt the laws and regulations with “Speaking engagements” at conventions out of country to avoid taxation, etc., vacations to Hawaii for 5 days to give a 20 minute talk on the “appropriate efficacy of prescription writing and specific product justification”.

How is it, for example, that my local Hospital features “STARBUCKS” coffees in the ‘cafeteria’, at upscale pricing as well!!

And we wonder why Congress is screwed up and we can’t get healthcare reform done, and why Congress is allowed to “OPT OUT” of that which they mandate that “WE THE PEOPLE”, except them of course,  MUST  have for healthcare and health insurance.

CONGRESS: GET THE HELL OUT OF HEALTHCARE,  LET THE INSURANCE COMPANIES FLOAT IN THE FREE MARKET!! YES, THERE ARE “RISKS”…..but isn’t that what business is all about, and “to the victor go the spoils”. If you can’t figure it out you will eventually fail, but don’t pull the entire “WE THE PEOPLE,…” down the tube with you and your greedy investors/ LOBBISTS AND BIG PHARMA!

Will there be another REVOLUTION? I  doubt it. We stopped teaching our youngsters the why of the last one, and the reason this Country is what it used to be thirty or forty years ago, …and for the 200 YEARS before today, that “WE THE PEOPLE,…(at least the uneducated, and ignorant who don’t know principals other than the “Right to have “SAFE ZONES” to protect them against the realities of life, and hurt feelings, where everyone gets a trophy for breathing!! That’s where the bulk of the “NEW” millenniums going to lead this country are coming from,…..GOD HELP US ALL!!

As Patrick Henry said, “Give me Liberty, or give me Death!”

-30-

rev: August 6, 2017

 

 


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