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TAG | access to care
I have never been shy about expressing my opinion concerning healthcare reform. I have always said that I am a huge supporter of healthcare reform but not a supporter of the bill that was recently passed. It may be a good start but it has some serious flaws that I feel if corrected would free up lots of money to take care of the currently under served population.
Maybe it’s because of my past experience working in the emergency room but the waste and abuse of the system by some patients gets under my craw more than I can even express. If you spent a couple of hours as an observer in an ER you would be absolutely sickened by the way the system is abused by some. I recently sent an email to this effect to someone and got an interesting response. In fairness to all I decided (with her permission) to print her response.
I am fortunate to be a friend and student of a nice lady named Nora Johnson. She is a medical billing advocate. In other words, she scours medical bills for mistakes and saves patients thousands of dollars. You may have seen her on CBS News, CNBC, The Wall Street Journal, Smart Money Magazine, and the list goes on and on. This lady is no slouch. In addition to a top notch education, her experience and resume make her an expert. And like one of the television commercials of the past says, “When she talks, people listen.”
I appreciate Nora allowing me to print her words of wisdom. She did not write this for publication and I did not check for spelling or grammar so read it for content only.
| “From a non-physician standpoint, but one who is involved in the daily plights of patients who can’t afford healthcare, permit me to share my perspective.
I have no love for healthcare insurance providers. I view them as subscribers to the modern day Machiavellian business philosophy of ‘profit justifies the means’…or ‘profit makes right’. It doesn’t take much of an intellectual leap to deduce why 45 million Americans can’t access the health care system…and why a substantial portion of the ‘have nots’ rely on Emergency rooms. It is a fact that Emergency rooms are the lowest or no-profit revenue centers for hospitals. It is also a fact that some patients abuse the privilege of accessing emergency rooms. What is completely overlooked by critics are the millions of uninsured people who, when diagnosed with cancer or other major illnesses, cannot afford chemo or radiation or any type of continuing treatment. Emergency rooms do not provide ongoing treatment for chronic diseases. I have talked with too many people who fall between the cracks in our current system. Too rich for Medicaid or charity care, and too poor or sick to afford astronomical premiums. The cannot cough up $200 thousand dollars IN ADVANCE, to pay the likes of MD Anderson or any cancer hospital for the first series of treatments. I believe these people constitute the majority of these 45 million uninsured…or under-insured. And, even if they don’t, are the rest of us willing to consign their plights to——you don’t deserve to live? From their perspective death is their reality, and potential life saving treatments are a privilege of the wealthy, or the lucky who have health care coverage through employment. I can hear the refrain——-let ‘em get jobs and work like the rest of us! Don’t be too cocky about your coverage through employment. This too is vanishing as self-insured companies are breaking under the cost burden, downsizing staff, outsourcing to the rest of the world, limiting employees to part time thereby escaping the mandate to provide health care coverage, decreasing coverage in general, and shifting more health care costs to the remainder of the employees. What about those folk who worked hard all their lives, and took the promise of early retirement and continuing health care coverage till Medicare kicks in, only to find their employers determined at some later date, that a good way to cut costs was to eliminate coverage for retirees? By now, many of these folks between 50 and 65 have conditions that virtually eliminate them from Blues, United, Cigna, Aetna, (BUCAs) coverage…or maybe if they can pay $3K a month for premiums. Even then, the BUCAs will do what they can to disqualify and deny these insureds from coverage——–after accepting months/years of premium payments. We cannot be so naive to imagine that the private profit making sector is going to care about anything or anybody other than profits. Hospitals are huge profit making businesses, and not-for-profit hospitals are even worse! I know how these bandits bill!! I know how they demand full payment from the uninsured when virtually 95% of their patient load doesn’t have to pay even half for the same services. So count them out of caring for non-paying patients, or doing the right thing because profit trumps compassion and responsibility. Does this mean that Obamacare is the answer? No, it is only a beginning, and one full of holes; the most glaring of which is the healthcare profit mongers are still in control, and do not have meaningful sanctions to counter their new and creative ways to deny claims payment. The health of our nation cannot be consigned to monolithic entities that worship the profit gods. Obama missed the boat by not having a government agency compete with the BUCAs. Yeah, yeah, that’s socialism———-as is Medicare, Social Security, Medicaid, etc. For those who denounce socialism, please forgo your Medicare and Social Security and put your money in the same bag with your righteous indignation. What is true and evident is that our population of 45 million uninsured/underinsure Americans have made no progress, were denied healthcare and have died within the last few decades that subscribed to various economic policies, beginning with the trickle-down theory to business’ self-regulation. Now that’s a hoax promulgating the fox guarding the hen house theory that many bought into, excepting perhaps, the have-nots. If you are poor (http://www.partnershiptoendpoverty.org/PovertyGuidelines2009.pdf, ) sick, unable to access health care to survive, lost your home and believe that Obamacare or a dose of socialism will ruin our country, stand up and be counted. …I can’t hear you! If you don’t qualify, what is your responsibility to your countrywomen and men? Said better by many: “Any society, any nation, is judged on the basis of how it treats its weakest members; the last, the least, the littlest.” How will America be judged?” I told you. Whether you agree with her or not…this is one smart lady. If you are interested in a CBS story with Nora here is the link: http://youtube.com/watch?v=huOcg9uN5pw bjmdjd Material modifications since posting: none |
access to care · health · Healthcare Reform · Nora Johnson · underinsured · uninsured
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Universal Coverage DOES NOT Equal Increased Access To Care
No comments · Posted by bjmdjd in Rants
All I hear is how once we have everyone covered by some form of health insurance there will be this big improvement in access to care. Have you tried to get an appointment with a primary care physician lately? It’s hard enough if you have a doctor and nearly impossible if you don’t. What this shows is that there is a drastic shortage of family physicians and internists. What happens from a numbers standpoint if 46 million people suddenly have coverage and feel that they can go to the doctor? Who is going to see these people? The system can’t support the number of patients that it is trying to see now. The only good thing that I can see coming out of this is that the emergency rooms and ER physicians who are absolutely swamped will finally be getting paid something for the patient care they are providing. When I worked in the ER back in the mid 1990′s our physicians group had a collection rate of 40%. How many businesses do you know that could operate on a 40% collection rate? I have heard nothing in Washington about how to increase the number of primary care physicians. They are trying to replace as many as possible with physician assistants and nurse practitioners.These providers can take care of many simple patient problems and don’t cost near as much in salary as a physician while they can generate almost as much income. But as most everyone realizes there is no replacement for a physician’s education. If there were, physicians training would last a couple of years like that of these mid level providers. It takes 4 years of medical school and at least 3 years of residency training (after 3 – 4 years of college) to produce a new family physician or internist. Add to that the disrespect that primary care gets in the training programs and from other providers, the salary disparity with other specialties, the burdensome reams of paper work, and the long hours.There is not much incentive to go into primary care. I have a friend whose daughter just graduated from pharmacy school (5 years TOTAL training) and she started at a higher salary than a family physician friend of mine makes after 15 years in practice! Yeah, all doctors are getting rich! If you are uninsured and think healthcare reform will mean that you will have your own doctor, think again! bjmdjd
Material modifications since posting: none
access to care · family physicians · internists · primary care physicians · universal care
