Scary changes in healthcare

December 20, 2011

How much control do you have over your healthcare?

Now, many of us have limited control over our health, but we should at least have control over our healthcare, right?  I don’t know what the answer is, but it can’t be this.

I read this morning about a plan by a local health insurer to reimburse patients for choosing cheaper care.  Well, that’s the basic idea, anyway.  If my doctor sends me for an MRI at site X and instead I go to the cheaper site Y, then I’ll get $10-75 from my health insurer.

This troubles me in many ways.  To keep myself from rambling, here’s a quick bullet list:

  • Will the care be comparable?  Or will patients lose out?
  • People suffering financially may put their money ahead of their health.  I admit that this is their choice, but is it really a choice?  After all, premiums won’t be cut, so this is their only chance for relief.
  • This may make it harder for doctors to coordinate care.  When I get a test done now, all doctors in that hospital system see the results.  If I get a test done elsewhere, I’d have to get the results sent to all of my doctors, which is unlikely to happen, so the burden would be on me to bring the results of all tests with me to all appointments.
  • There are already health plans that only allow patients to be seen by cheaper doctors at cheaper facilities.  How much farther will this cost-cutting expand?  I don’t get to choose my health plan – my employer does.  If they choose one of these, I might have to change all of my doctors, and it has taken me years to build up a medical team I trust.
  • If cutting costs is so important, why doesn’t the health insurer cap reimbursement payments?  Wouldn’t that make more sense?  Why reimburse one site more than another?

Really, what upsets me is the direction of healthcare changes.  Health insurers and politicians are floundering to find a way to save money and stop the skyrocketing costs to patients and employers.  There is talk of a single payer system in my state.  While I love the idea theoretically, I have seen the way it has been put into practice in other countries, and I don’t trust it.  Really, do I want anyone involved in my government to decide if it’s cost-effective for me to take a certain medication or have a certain test?  No!  I trust them even less than I trust health insurers – I guess I trust the devil I know more than the devil I suspect.  If my health insurer chooses not to cover the cost of something, I can appeal within the insurance company and also to a state board.  If the state were in charge, who would I be able to appeal to?  Costs are too high.  People can’t afford care.  Those of us that can afford it, often pay so much that we must cut back on other things (like ever being able to afford to retire.)  This just isn’t working.

We need a solution.  So many of us are desperate for a solution.  If only I had any idea whatsoever what it might be.

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Leave a Comment » | Educating, Expectations, Frustration, Healthcare, Medication, Politics, Rants | Permalink
Posted by chronicrants

Political interference

November 27, 2011

Politics affects all of us.  It has to.  Government builds and maintains infrastructure (roads, mass transit) and regulates taxes.  Government creates laws and enforces them.  Government controls the big picture and also a lot of minutiae.  It must play a role in our lives, but I question how big of a role.

Because of my illness, I rely on my government to create and enforce non-discrimination laws, to keep the roads and sidewalks passable, and to ensure that the medications I take are safe for consumption.  These are all important.  However, I feel that sometimes government goes too far in “protecting” its citizens.  I will write more later, but for now, think about medical marijuana and assisted suicide.  How involved should the government be?

In the United States, one big problem is that some states have legalized each of these, but the federal government does not recognize them as legal.  That sets patients and doctors up for potential problems, and that’s not fair.  It must be decided once and for all whether or not states can regulate either of these areas.

As far as marijuana goes, I won’t get into whether or not I think it should be legal for general use.  However, for medicinal purposes it should be treated like any other drug.  There should be studies to determine its efficacy, then it should be subjected to an FDA approval process to ensure it is safe for medicinal use.  Why not do this?  After all, it is no more harmful to a person than alcohol, cigarettes, or many prescription medications.  It is not dangerous to non-users as long as second-hand smoke is avoided (it could follow the same rules as cigarettes) and people do not drive under the influence (it should follow the same rules as alcohol.)  I would happily accept government regulation of medical marijuana so that I could trust that it came from good sources.  I can not accept, though, that the government will not even consider it.  Given the choice between the side effects from marijuana or the side effects from prednisone, I’ll choose pot, thank you very much.

Now, as for assisted suicide, the idea that suicide is illegal is ludicrous.  A person who wants to commit suicide should get proper counseling, of course, and be of sound mind.  But if a terminally ill person is in a lot of pain and wants to end their suffering a few weeks early, why shouldn’t they be allowed to make that choice?  And if they are going to end their suffering early, shouldn’t it be done with the aid of a doctor, so that it is done in the least painful way possible?  I simply can not imagine why people have a problem with this.  And I certainly can not see any reason why the government should be regulating it.

These are just my opinions, of course.  Everyone needs to do their own research and their own thinking.  For me, though, the answers seem very clear.  My opinions are strong, so I will definitely be elaborating on these in later posts.  For now, I just needed to vent a bit.

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6 Comments | Educating, Frustration, Healthcare, Intrusions, Medication, Politics, Rants | Permalink
Posted by chronicrants

How broken is our health care system?

November 16, 2011

It is important for everyone to have doctors they feel comfortable with.  For those of us dealing with chronic conditions, it is especially important that we have a medical team we trust and who respects us.

Sometimes I think about leaving the Boston area (the climate here is horrible for me) and it saddens me to think about leaving my family and friends.  But then I think about having to get new doctors, and that terrifies me.  It took me many years to get doctors I like.  In the past year I have had to find a new PCP twice and that has been a horrible experience.  I can not imagine having to start over with a new rheumatologist, a new endocrinologist, etc.  Still, when/if I move, I know that I will have to build up a new medical team.  But that will be my choice, based on my actions.

What upsets me is being forced to change doctors!  To be clear, this is not happening to me personally, but it may be happening to a lot of people in my community soon, and that is very disturbing.

The current health care system is broken on many levels, in many ways.  I would like to say this is an isolated issue, but sadly, it’s not.  According to this article and other reports, a lot of people may have to find new doctors because of a breakdown of negotiations between an insurance company and a hospital.  Corporate negotiations will force people to get new doctors!  How horrible is that?  Now, to be fair, I’m sure patients will be more than welcome to stay with their current doctors if they pay for the costs themselves, but realistically, how many people can do that?

I’m not saying I have all the answers (though I certainly have a few suggestions), but I do know that the system needs to change so that when negotiations break down, patients aren’t the ones being harmed.  It is hard enough to be sick, then to find good doctors, and to negotiate the maze of insurance rules and medical terms and tests and procedures.  To then have that all taken away and be forced to start over, that is criminal.  The Blue Cross and Tufts Medical negotiators must work this out and they must do it now.  There is simply no excuse.

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Posted by chronicrants

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