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Healthcare I
The study of medicine is a science. The practice of medicine is often sloppy and dangerous. We can no longer believe in our doctors with blind faith, but must educate ourselves and manage our own health. Unbelievably, more people in the US are killed by medical errors each year than are killed by auto accidents. While the cost of US healthcare exceeds that of any other country in the world, the quality of healthcare is rated lower than the forty some European Union countries, Canada, and many of the poorer countries.
Most of us grew up with great admiration and faith in doctors, which provided a sense of security for individuals and families. If we became ill, we knew we could depend upon our doctor to help make us well and even save our lives. Unfortunately, many doctors have joined clergymen, politicians, and corporate CEO’s in becoming tarnished gods, no longer worthy of our trust and thus destroying the sense of security that our society once knew. While Americans try to hang on to their belief that their's is the greatest nation in the world, there is a growing awareness of how the important people in our lives cause us harm and have betrayed us. Catholic priests by the dozens (thousands?) are charged with molesting our children. Billionaire corporate executives committing fraud and destroying our life’s savings while wiping out investors who put their trust in them. Corporations producing and marketing products that are knowingly toxic and dangerous to our health, making billions of dollars while making us sick. Sodas and high energy drinks laced with caffeine and high fructose corn sweeteners being poured down the throats of our kids, interfering with their sleep, making them obese, and causing them to suffer side affects that we don’t yet understand.
Then there is the US government whose members we elect to represent us and make our lives more safe and secure, but are more inclined to represent the special interests who are only interested in profits and often knowingly harm us. When we hear about the priests and other clergymen who molest kids, or that a billionaire like Madoff is headed for prison for bilking even his friends out of billions, or when Bush pardons one of Cheney’s staff members after he commits treason by betraying an undercover CIA agent, and the list goes on, we might chuckle--like what’s new? However, the fog is clearing and our awareness of this dangerous world that was created for us by the most wealthy men in the world is causing us to become anxious and insecure. Discontent is brewing as Americans are waking up. Will I be next to lose my job to workers in China and India? Will I be forced out of my home because I can no longer make the payments? If I become ill, will I be able to find a doctor who is willing and able to help me? If I need help, will I have to go into debt in order to pay the exorbitant healthcare bills? How will I get my kids through college? Up to now, Americans have been very patient and have not made the demands of their leaders that are so common in other countries. When workers in France feel they are not being treated fairly, they take to the streets and raise hell until their concerns are addressed. They cannot be ignored or things can really get out of hand. I realize that we might not feel these activities are justified. However, it gets attention, brings negotiators to the table, and problems get resolved. Author William Blum writes very depressing books about the inner workings of the US government and publishes a monthly newsletter. He once wrote about the latest illegal antics of then President Bush and said that if a leader in any EU country pulled the stuff Bush was pulling, the people would be marching in the streets. However, Americans are brain dead. As Bush took us into Iraq, Blum could not understand how Americans could allow their president to be such an outlaw. It is truly amazing how tolerant and complacent we are, perhaps a condition of so many good years.
Though we don’t have much control over the world that has been created for us, I find there is one area where we can assert ourselves and this is in taking control of our health and healthcare. However, it requires some changes in our basic knowledge and belief system. If we are going to maintain our health, we must educate ourselves about our bodies, diets, and prescription and non-prescription drugs, many of which are toxic and dangerous. We must learn to manage our own healthcare and not place our faith and trust in someone just because they wear a white lab coat. No amount of education can offset faulty character, lack of caring, arrogance, or the dedication to profits over people. What is most crucial is that we must give up our old thinking and learn to believe in our ability to know how we feel. If we have been feeling ill for two days and a doctor sees us for ten minutes and tells us we are fine, something is wrong and we have wasted our time and money. We might have risked further complications and even death. Though they sometimes don’t like it, for after all, some do feel that they are gods, we must have the courage to question their judgment. Rather than putting our faith and trust in drug companies and healthcare businesses, for which most doctors work, I firmly believe that we must take charge of our own healthcare. Because of their good health and lack of experience, many people are not aware of how sick the American healthcare business has become. Those who best understand our healthcare system are those who have experienced it directly or through friends and loved ones. Over the years, I have shared my own stories about my difficulties with obtaining decent help from our healthcare system, in person and through Internet newsgroups. And I have been amazed by the number of stories that exist that involve doctor negligence or error. Many of these stories are similar to my own.
The worst and most tragic story I have ever heard relative to doctor incompetence and inability to think independently occurred in early 2009. A young boy was ill (I have no details about his symptoms), so his parents took him to Urgent Care. The nurse checked his vitals and the doctor looked him over briefly. When this cursory look, which is so common, did not reveal any problems, the doctor told the parents that the boy was fine and sent him home. When the boy became ill again, his parents took him back to the Urgent Care, where a doctor again told them that the boy was fine. I will assume he was seen by whatever doctor was on duty. The boy continued to be ill, so once more they took him to Urgent Care, with the same results. The parents wisely believed in their son when he continued to complain, so decided to take him back to see a doctor--for the fourth time, to no avail. The doctor could not find anything wrong with him and told the parents to put their son to bed, wrap him in warm blankets, let him rest and he would be fine. The parents obeyed the doctor. The next day when the parents went in to see their son, they discovered that he had died in the night. The autopsy revealed that he had been suffering diabetes and that he had died of insulin shock and coma. Is it really possible that these doctors could ignore the boy’s complaints, the desperation of his parents and fail to perform a simple blood test to try to diagnose what might be wrong with him? A simple cheap test that would have saved his life? What I have learned from my own experience is that doctors at any office or clinic share the same patient files with other doctors. So, if one writes in a file that the patient is fine, the next doctor is likely to save time and support his fellow doctor by following suit. Most doctors today belong to businesses they’ve created with other doctors, where their quest for profits soon takes the focus off their dedication to the health of their patients. Arrogance causes some to feel that they know more about our health than we do. Unfortunately, many are just incompetent and lazy. There are lessons to be learned from stories like this. When we or our children feel ill, and we discover that our doctor, or doctors at some clinic, are not listening to us and helping us, we must believe in ourselves, ignore their opinions, and seek help elsewhere. This should preferably be an office that has no ties with the one that failed us, for new doctors should not see files created by the previous doctor(s).
My favorite girl cousin called me one time and told me that she had been suffering lots of chest pains and was worried about her heart. She had called her doctor, I think on a Thursday or Friday, and he told her to come in early next week and he would do some testing. I became alarmed and told her that she needed to call a cardiologist and discuss her symptoms and tell him it was an emergency. Or she should check into the Emergency hospital immediately. Like most people, she placed her faith in her doctor and said she was going to wait to see what he found out. My aunt called that weekend to tell me that my cousin had died of a massive heart attack. We sometime listen to our doctors at our own risk. In this case, her doctor demonstrated his incompetence by not calling in a cardiologist or advising that she report to Emergency immediately. Though I hate to think about it, doctors that refer patients to other doctors or Emergency without seeing them first, cost their business at least one office visit. If doctors want to think like businessmen, we must join them. My cousin’s mistake was putting her faith in her doctor and allowing him to make decisions about her healthcare for her. Sounds strange, but this isn’t always wise. Each year, three hundred thousand people die of heart attack on the way to Emergency. I believe this happens because primary doctors often don’t listen to their patients and clogged arteries feeding the heart are not easily detected. Tell a regular doctor you are having chest pains and he might blame it on gas, heartburn, etc. Tell a cardiologist the same thing and he will most likely want to do an angiogram, which is the only way to be sure. In my opinion, anyone with symptoms they feel might be related to their heart should call a cardiologist immediately. These are one of the few specialists who will find time to see you immediately--sometimes meeting you at Emergency.
After eating a couple shooters (raw oysters) one evening, a man became quite ill and his system became intent upon expelling whatever bug had invaded his system. After a few days of being ill and still running a fever, he checked into Urgent Care. After explaining his symptoms to the admitting nurse, she told him that the doctor would probably want a stool sample to determine what type bug he might have, which sounded like the proper thing to do. The young doctor who saw him was a bit arrogant as he told the man that he probably had the flu. However, he wasn’t going to prescribe any antibiotics or because they were being abused, which I happened to agree with. Instead, he recommended that the man get some over-the-counter medications to deal with his symptoms. Some days later things hadn’t settled down so, thinking about what the nurse had told him, he called his regular doctor and explained what was going on and asked that she just order a stool sample test at the lab. A couple days after the test, his doctor called and asked where he had eaten the raw oysters. Antibiotics were prescribed and so it goes. Had the doctor at Urgent Care dispensed with his god-like image and followed his nurse's wise advice, his illness would have been diagnosed with a simple inexpensive test. Can anyone explain why it is that doctors so frequently ignore all these simple diagnostic tests that are available to them? The good news from this story is that when the man doubted his doctor’s opinion, he took it upon himself to follow through.
I was out walking one day and stopped to talk to a neighbor lady. Being I had had what was probably a similar neck surgery, I asked about the light scar near the bottom of her neck. She told me that she had suffered from a ruptured disk that had been repaired. Anticipating the answer, I asked how long it had taken for doctors to diagnose the problem. She told me that for two years doctors told her she was suffering mental illness and it wasn’t until the problems became quite pronounced that they did an MRI and discovered the ruptured disk. I said, Welcome to the club. With me it took them three years. Ruptured disks do not always cause pain, but can cause migraine activity, seizures of various severity, visual aberrations, numbness and tingling in extremities, etc.
The main focus of today’s healthcare system is on profit. I was walking at the mall one day when I saw one of my previous doctors that I heard had retired. We stopped and talked for awhile and I told him he was too young to retire and that I would miss him. He said that he loved practicing medicine, but that the group he belonged to placed too much emphasis on the business and making money, so he quit. There was a time when doctors had their own offices and ran their operation, often with the help of one or two nurses--sometimes their wife. Just as they have done with most other jobs and professions, the businessmen, efficiency experts, and computer system engineers have taken over US healthcare. On the surface, the theories and logic seem to make sense. In the legal sense, the only time a doctor is practicing medicine is when he is with the patient and trying to help him. Greeting the patient, moving him to an exam room, fetching his file, checking his vitals, asking what’s bothering him--all this can be done by nurses or clerks, thus ostensibly utilizing the doctor’s skills more efficiently. This all makes sense until one analyzes what has happened to modern doctors’ offices. A clerk checks you in at the front desk. Her work life consists of sitting at that desk eight hours a day, answering phones, and checking in patients. A different clerk or nurse pulls your file and escorts you to an exam room. A nurse comes it, takes your vitals, reads on the computer monitor what the front office clerk typed into your file and asks again about your complaints. Prior to entering the exam room, the doctor reviews what the front clerk and nurse have typed into your file and asks again about your problems. He rarely takes notes, but when he’s finished with you, he goes to the dictating station and dictates his diagnoses and recommendations, etc. This recording goes to a medical transcriptionist who types it into your file. This is a general overview and I’m sure things vary slightly from office to office.
In this scenario, it is easy to see what happens. Several people are involved in your healthcare and have access to your patient files, which they can change without the doctors’ permission. There are at least four opportunities for error: front clerk, nurse, doctor’s dictation, and transcriptionist. If you pay attention, you will notice that several people in the doctor’s office have authority to make changes to your file. About six years ago I was checking into my doctor’s office and the receptionist said, Are you here about your left shoulder? I said, No, I am here about my right shoulder. She said, Oh, I’ll change that in the computer. A couple months later I checked into the same office and the receptionist said, Are you here about your left shoulder? I said, No, I thought we fixed that last time. I am here about my right shoulder. She said, Oh, I’ll fix that so it won’t happen again. What’s the problem with this? We have office clerks changing our patient records on their own. What if I was having memory problems and could not recall which shoulder it was I was seeing the doctor about? I have read about doctors who are banning together and complaining about the modern computerized offices they work in and the chance of errors.
How about the doctors? There was a time when they did much of what the businessmen and efficiency experts call “clerical or nursing work.” They checked the patient’s vitals, allowing more time with him. The patient discussed his symptoms with only him, minimizing chances for “communication problems.” They kept handwritten notes that were identifiable as their own which no one could change. With the help of the businessman, efficiency expert, and computer engineer, the doctor has become responsible for a bewildering number of patients for whom he does not have complete control.
One of President Obama’s major initiatives is a “digitized national healthcare record system.” I shudder to think of what it would be like if doctors all over the US had access to all my files, with the misdiagnoses, faulty opinions, and sometimes stupid statements that some doctors might have put there. I highly recommend that all patients call their doctors’ offices and request copies of their files, which they are required by law to provide. Patients can otherwise go to their doctors’ offices and sit and read their files. While they placed faith in their doctor, they might discover that he wrote such things as, He was faking his symptoms. Or that the patient was just suffering stress or emotional problems. There is a legal requirement that patients can fill out forms and comment about what has been written in their file, which becomes part of their record.
Though I’ve been talking about the darker side of medicine, I know that most of our doctors are professional, of good character, well educated, and competent. I’d like to close by saying that my current doctors are great and that I feel fortunate to be able to work with them.
Healthcare II
We hear many debates about which countries provide the best healthcare.
These discussions often become derailed and bogged down in expressions
of fear of what are perceived as the “socialist” ways of the European Countries
and Canada. The purpose of this article is not to argue the merits of capitalism
vs socialism, especially since most countries are really made up of both.
The EU countries all have national healthcare plans; the US has a mediocre
federal healthcare plan for seniors plus state and county healthcare plans
for certain individuals who qualify. So, in light of what exists in
countries today, most cannot be defined as “socialist” or “capitalist”
simply based upon their healthcare systems. Perhaps some readers can provide
insight into these definitions. My purpose here is to discuss
the merits of the practice of healthcare in the US vs other countries and
I can speak only in generalities, for in the healthcare business, many
individuals are involved and humans do make mistakes.
Many of us have sought help from Emergency Hospitals for either ourselves,
family members, or perhaps a friend. Unless one’s life is in immediate danger,
the routine is about the same, which can be demonstrated by the following case
I am familiar with. A woman was with a friend when her friend began feeling
light-headed, confused, and weak. She was losing her ability to walk. She took
her friend home and put her to bed and stayed with her. When her friend started
talking incoherently about bits and pieces from memories of her past, she became
alarmed and decided to take her to the Emergency Hospital. With difficulty,
she got her dressed and into the car for the drive across town. People at Emergency
helped her friend from the car into a wheelchair and they were ready for their
first challenge, that of getting past the man at the entrance to whom she had
to explain her friend’s symptoms and answer his questions. This can be tough
when we know someone we care about is having serious problems and we are in
a hurry. Once inside, they had to stop at a desk and provide the required
personal and health insurance information to the business clerk. Then they
were ready to sit and wait for someone to take her back to the exam area.
They remained in Emergency for several hours while doctors performed various
tests, some of which turned out to be very expensive. A doctor finally came
out to see her friend and told her they could not find anything wrong with
her, so he was releasing her.
Three months after her visit to Emergency, this woman suffered a stroke
due to a lack of blood supply to her brain. A primary doctor determined
that the blood supply to her brain was being cut off due to clogged carotid
arteries, a very common problem. The doctors
at Emergency had missed failed to diagnose the problem. This was inexcusable
inasmuch as her symptoms would easily lead one to suspect such a cause, which
can be detected by listening to the arteries with their stethoscope and,
more accurately, performing ultrasound tests. Their error might have resulted
in much worse damage to this woman’s brain. Unfortunately, as is often the
case, the Emergency doctors would never learn of their mistake.
I was watching part of the congressional debates about healthcare
and became quite discouraged at the lack of honesty and distortion of the
facts. In a true democracy, after the people elect their representatives,
it is assumed that these representatives will resolve their differences and
work together for the welfare and security of those they represent. However, politicians
in the US have gradually evolved into representatives and spokesmen for their
corporate sponsors and lobbyists. I sat listening to a Republican congressmen
expounding upon the terrible socialist healthcare in Europe and Canada and
how healthcare in America was best in the world, which he had to know was false.
One congressman stood up and said that healthcare in Canada was so terrible
that many Canadians had to come to the US for their healthcare. It was quite
obvious that this man was totally ignorant or, more likely, was a spokesman
for the health insurance industry that cannot stand the idea of losing control
of the healthcare in the US and the billions of dollars it provides them.
I have friends in Canada and have visited there many times. While
there, I frequently have opportunities to talk with people about their national
healthcare plan. The consensus seems to be that they are happy with their
healthcare, especially since everyone is covered, and can’t believe that
American healthcare is so poor. They especially cannot believe that so many
Americans do not have healthcare insurance. Any Canadian citizen can see
their doctor anytime they want at no charge. The concern some have is with
the waiting period for procedures such as knee or hip replacement. If it
is not critical, they might have to wait for many months. Those who don’t
want to wait and who can afford it do indeed seek help in the US. Because
of the risk of infection and/or rejection of the implant, this might not
be wise.
My sister once fell and injured her knee, which caused her problems
for years. When knee replacement became commonplace, she enquired of a doctor
if such an operation would relieve her problems. Though in my opinion her
health history would suggest she avoid such an operation unless absolutely
necessary, she followed her doctor’s advice and underwent a knee replacement.
Unfortunately, she developed an infection, which required very heavy doses
of antibiotics administered via an IV. After the infection continued to resist
treatment for many months, the artificial knee had to be removed and replaced
with a rod until the infection subsided. Sometime later, after the infection
was cured, her doctor installed a new knee. Though the surgery was a success,
she again developed an infection. After many more months in nursing facilities
receiving IV antibiotics and taking pain medication, the knee had to be removed
again. Her upper leg was then fused to her lower leg, which left her with
a much shorter leg--that would not bend. Though she had still been able to
walk prior to these surgeries, the infections, antibiotics, and pain medications
had kept her bedridden for a couple years before she finally died of liver
failure, which I assume was caused by the infections and heavy medications.
All surgeries have their risks and because of stories like these, it might
be wise to not rush into any procedures unless absolutely necessary.
We can argue all day about what we think we know about the healthcare
of other countries, but most of our information comes from special interest
groups and dishonest politicians. There is really nothing better than
experience. I have always believed in national healthcare systems whereby
our well being is not in the hands of corruptible large corporations and
investors, but instead, in the hands of our representatives that we can
throw out of office if they fail us. However, I had no experience with such
systems until my visit to Italy a few years ago. While on an extended visit
there, I came down with what I thought was the flu, which evolved into the
worst respiratory infection of my life. It became so bad that I spent all
day and night coughing and sometimes having difficulty breathing. My eyes
became red and infected. During our stop to visit American friends in Verona,
I was in pretty bad shape, so they took me to their Emergency Hospital. As
we headed across town to the hospital, I started thinking: I was a foreigner,
my insurance was no good here, and I would have to figure out how to raise
the cash to pay them. Emergency hospital visits are not cheap. I thought
about telling my friends that I would just tough it out, but I was becoming
desperate. We arrived at a very old building whose appearance wasn’t up to
the standard I expected. A good paint job would help.
As we entered, there was no one at the door to convince I needed help
in order to gain entrance. There were no clerks at desks requiring personal
and insurance information for them to type into their computers. I looked
around and there were no computers. On one side of the room was
one congenial looking man sitting in a booth who seemed to be in charge of
checking people in and out. Most Italians speak at least some English and
when he asked what was wrong, I patted my chest and explained my bad cough.
He made a copy of my passport, made some handwritten
notes and told me to have a seat. There were no computers in the room. Within
five minutes a friendly nurse in a real white nurse’s uniform called me into
the exam room. She did not question me about my symptoms, but proceeded to
take my vitals. We were soon joined by a doctor who talked with me and examined
me while the nurse drew blood for testing and then leaving an IV in case
the doctor wanted to administer antibiotics, which is much more efficient
than trying to get them past the stomach. Their drawing of blood for lab
testing surprised me. They were not just going to guess what was wrong and
write a prescription. Being I was so ill, having a nurse and doctor in the
room caring for me together was an experience I will never forget. The sense
of caring was something I had not experienced from doctors in many years.
No clerks, no staring at computers and typing instead of paying attention
to their patient, no one under pressure to rush in order to please the business
manager and investors. People were able to perform the work they were trained
for, and heaven forbid, what they dedicated their life to. They were clearly
healthcare professionals, unencumbered and stressed by the demands of the
business manager. For the most part, doctors in the US work in business groups
where they are required to be doctors and businessmen, creating a situation
that can often lead to terrible conflicts of interest. The only thing
worse would be if a doctor was also required to be an attorney.
The doctor made some handwritten notes and told the nurse to send me for x-rays
of my respiratory system, again preferring testing rather than guessing. When
he reviewed the x-rays, he told her to send me to the Pneumonia Clinic. It
was quite a hike across the large hospital, but when I got there, I was seen
immediately by a nurse and doctor. No clerks and no computers. After the doctor
talked with me and performed his exam, he made some handwritten notes, wrote
a couple prescriptions, and sent me back to where I started.
I thought I was finished, but as I started to check out with the same
man in the waiting room who had checked me in, he looked at me with
great interest and asked if I was OK. I nearly melted and surprised myself
when I told him, No. These people seemed to really care. He asked me if anyone
had checked my eyes and when I told him they had not, he called the nurse
who had worked with me originally and told her to send me to the Ophthalmology
Clinic. Back across the hospital I went. The doctor put my head in one
of those devices that hold you still while they do
their exam. He shined the bright light in my eye and let out an expression
in Italian whose meaning I could only guess. Holy something or other. He
then proceeded to flip back my eyelids, clean out my eye sockets and apply
medication. Sounds gruesome, but it actually felt good. The doctor made some
handwritten notes and wrote a couple prescriptions and sent me back to the
waiting room. The man in the booth called me up to see him and I waited while
he went through all the doctor notes, x-rays, and lab reports. When he was
satisfied with the care I had received, he put it all together in an envelope,
handed it to me, and with a big smile, he said Buon giorno. I thanked
him and we walked out.
As we left the hospital, I asked my friends why I hadn’t been charged
for all the work they had done. After all, I had seen three doctors, had
blood tests, and x-rays. They told me that doctors are normally supposed
to charge foreigners, but feel it a waste of time, so don’t bother.
It is obvious that, though they might work for the government, they are treated
as professionals and are in charge of their own work. They do not have “efficiency
experts” defining their work for them, they are not managed by businessmen,
and they do not have to submit to the demands of a computer system. They
are not plagued by worries about profits, but can focus on the patient and
the practice of medicine, which they spent so many years training for. This
does not mean that there are no government procedures and controls; but it
does mean that the doctors’ work is most important.
All European Countries have had similar national healthcare programs for decades.
The cost for such great healthcare, for every citizen of the country, is about
half that of the US, while the quality is much higher. In all studies, Europeans
are healthier and live longer than people in the US.
I recently watched a DirectTV film of an interview with TR Reid about healthcare. He said that all European Union countries provide free healthcare for illegal immigrants--because they want to keep people healthy.
Most US citizens do not know that it was not always intended to be this way. At the end of World War II, European countries instituted government reforms intended to meet the people’s needs for security and a decent life. One of these reforms was the implementation of universal healthcare. After the war, President Franklin Delano Roosevelt aimed for a “Second Bill of Rights” for the American people. One of these “rights” was universal healthcare. He outlined his “Second bill of Rights” for a newsreel at the end of what would be his last State of the Union address in 1944. However, certain powers made sure this part of his address was removed and the American people remained unaware. These same powers prevented President Clinton from implementing universal healthcare and are currently fighting President Obama’s attempt to do likewise. The only way we will have universal healthcare comparable to that of European Union countries is when Americans learn the truth and stand up for their rights.
Healthcare III
Health Insurance Plans
The American healthcare billing and insurance payment system can best be described as chaotic, bewildering, and nearly incomprehensible. And for those without health insurance, it is totally unfair and cruel. I spent my corporate life in engineering and management positions, yet there is nothing I dread more than receiving my Medicare and gap health insurance packages at the end of each year when once more I am faced with having to read through the thick brochures about the various plans and options and try to select those I feel best for me. Medicare coverage is so complicated and difficult that the average senior citizen is easily discouraged and tempted to just leave things alone, in which case, for better or worse, coverage will be the same as it was last year, whatever that was. For those who want help, they can seek out one of the volunteers stationed at various stores who explain the plans and assist with making enlightened choices. Failure to make the “right choices” can result in thousands of dollars of out-of-pocket expenses.
Cost and Billing Practices and Inequities
For those who have insurance, doctor fees and other medical expenses are negotiated
by the insurance company and provider. Because of the substantial differences
between what doctors charge and what insurance providers will pay, some doctors
will not accept Medicare patients because they feel the reimbursement is too
low.
Following are some examples from my own insurance provider statements:
Doctor Fee Charged Insurance Allowed
$430 $136
$3,591 $542
$485 $151
In this case, the actual doctor fees charged to the insurance company were$829
How about those who have no insurance? They are charged the regular fees, which in this case would be $4,506. Though they are having to pay this out of their own pocket, in this case they will have to pay five times what the insured person and his insurance company will have to pay.
This is the system that the US government, health insurance corporations, and healthcare providers have created for us.
For those lucky enough to have health insurance, variations in coverage among employers and insurance companies are endless. Some companies and businesses provide health insurance options, while others do not. If one is lucky enough to work for one that does, after retirement he will receive Medicare plus his corporation’s health insurance coverage. However, many will have only Medicare and gap insurance will be their responsibility. If a married man is receiving Medicare plus gap insurance from his company and dies, unless other arrangements were made, the company’s insurance for his wife will end, for she was part of his insurance plan.
When patients visit their doctors and run up large medical bills,
though the doctor and business clerks are aware that the patient has no insurance,
they will not voluntarily discuss their special billing plans or the discount
programs that might exist--at that office. Instead, they often recommend
the patient put the charges on their credit cards, which can result in high
interest rates, late fees, and if it gets out of hand, can ruin their credit
and get the collectors after them. However, if the patient is having trouble
and talks with someone in the doctor’s billing department, they can often
work out arrangements where they make monthly payments with no interest.
Some doctor’s offices have special programs whereby patients can apply for assistance. I am aware of one case where an unemployed patient found out about such a program and applied. He was approved and subsequently advised that he would receive a 50% discount. At first glance, it would appear that the doctor was willing to sacrifice his time and was being very generous. However, take a look at the above figures comparing the cost discrepancy between doctor charges for the insured and uninsured. Under the “assistance” program, the uninsured patient’s costs have been reduced from $4,506 to $2253, while the insured patient’s cost was $829. Well, perhaps the doctor wasn’t being so generous after all.
For those who cannot pay for healthcare, there are other federal, state, and county assistance programs available--to those who are willing and able to search them out and deal with the bureaucracy and stress of the application and approval process. I am certain that most people in need are not aware of such assistance and it certainly isn’t something that is broadcast. This can be tough on those suffering from serious illness--usually people already facing other challenges.
The US government stands alone in its contempt for its citizens
The US is the only modern country without universal healthcare coverage. To
add insult to injury, in the US poor people without insurance coverage are
charged much higher fees than those with insurance. Adding to the anxiety and
insecurity of this already broken system are the myriad government and individual
healthcare provider programs which are available, but not readily made known
to them.
Unlike any other modern country, Americans cannot depend upon their
government, health insurance companies, or healthcare providers to watch
out for their welfare. Healthcare in the US is owned and operated by
businessmen, whose first priority is profits. Doctors and patients are often
lost somewhere within the system that was created for them by the profit
seekers.
No political party or president can change the sick American healthcare system
until its citizens wake up and demand universal healthcare equal to that of
European Union countries.
Revised: 13 April 2010 Vancouver, BC