Healthcare.
This morning, the parent company of my hospital put out a long and rambling explanation of why they are against nationalized healthcare. Once again, I find that I am torn on the issue and quite fearful of what will happen.
Let's start with the basics:
- Everyone needs access to good healthcare. This should be a right, not a privilege and not a mandate.
- The authority that should decide what treatments are paid and which are not should not be publicly elected, politically appointed, or paid based on profits.
- Medical litigation is a problem.
Everyone needs access to good healthcare. This should be a right, not a privilege and not a mandate.
As anyone who has ever needed a doctor but couldn't afford the bill will know, our healthcare system is broken. Brian and I once had to make a decision about what to do with Zack when he was running a 107 degree fever and we could not get it down. We had tried Tylenol, Advil, and alcohol baths. It was not going down and we finally decided to take him to the ER. He had been sick for several days, and we had been managing his symptoms. Had we access to medical care at that time, we could have avoided a costly bill. Instead, that bill went unpaid and the cost was passed on to other patients at that hospital.
The thing that bothers me most about Obama's rhetoric on healthcare is the idea of it being a mandate and fining people who do not invest the money the government gives them into healthcare. I'm sorry, but this just won't work. If you have a choice between using that money (however illegally) to feed your family or provide healthcare, which are you going to do? This is one place that I think Hillary Clinton had it right from when Bill was elected.
If there is not the ability for each person to walk into a clinic of some sort and get treatment, then the uninsured will continue to be seen in ERs, which cost (on average) 4x as much per visit. That cost will continue to cause our healthcare costs to skyrocket as our population ages and we face a growing healthcare shortage.
The authority that should decide which treatments are paid for and which are not should not be publicly elected, politically appointed, or paid based on profits.
Insurance companies suck. In January, Sorcha woke up one morning with a nasty cold and appeared to be having trouble breathing. Not wanting to face a hefty ER bill, we took her to our clinic where they said that she was retractring and needed to go to the ER right away...They even called ahead. (Small note: retracting is something you do in your throat when you aren't getting enough oxygen...it is easily seen from the outside.)
Turns out, she had an RSV-type virus and was treated and released. Our insurance denied the claim because they felt an ER visit was not medically indicated BASED ON A NUMBER! This is the ICD-9 code. Unfortunately, there is no code for "infant with retraction and RSV-like virus", so it was coded as a respiratory virus. Typically, such things are easily treated in an office.
Well, after calling them and forcing them to contact the office that sent us to the ER, they reversed this decision, but it was a huge nightmare. Because they believe (and are forced to since bottomline is what matters most) that people go to see doctors and have themselves admitted to the hospital for fun, they have to deny every claim they can.
I have another story, but I can't tell it. Just suffice to say that they just generally go by what the codes say and never look closer. There has to be a better way.
Medical litigation is a problem.
Okay, let me start by saying I don't think we should remove the right of the individual to sue over their medical care. However, I do think that there should be a medical arbitration board in each state or the ability to sue through the medical licensure board.
I have seen some truly complex medical cases, and many of them are not straightfoward that the medical provider did wrong. However, often times these are settled for larger amounts than they warrant because the plaintiff is going to look sympathetic to a non-medically trained jury.
I am not saying that juries are comprised of idiots, I am simply saying that the severely complex nature of many medical lawsuits make it difficult for any jury that did not go to some form of medical school to truly and completely understand what is going on or what happened. (Remember Terry Schiavo? There are complex medical explanations regarding her condition, but most people never actually listened to alot of it....Would a jury have? One would like to think so...)
Further, I do not believe that one can simply "cap" the medical litigation amounts and call it a day. When truly gross negligence occurs, people should be able to sue for large awards. However, there needs to be some sort of heirarchy to determine what gets heard and what doesn't.
Most litigation for hospitals is still being settled and for large amounts, which the cost is DIRECTLY PASSED ON TO THE PATIENTS!
Now, let's talk about government reimbursement.
Healthcare costs are very high. The government wants to reduce them. How do they typically do this? Limiting what will be paid for a procedure/condition/care, etc. Now, this is all well and good--in theory. But now think of how complex a hospital is. There are hundreds of people employed, many of whom never directly interact with the patient but whose job is still essential to the working of the hospital....people like me. Were my job to not get done, we could lose our accredidation and our right to take Medicare patients. Is the government going to lift those requirements? No. But they are going to reduce what we get per patient.
Which means we will have to lay off some transporters, housekeepers, techs, and secretaries. This will, in turn, slow down care and make the environment less friendly and care oriented. However, there is a good chance that our indigent population (comprised mostly of homeless people and illegal immigrents) will continue to need services that the government won't pay for. This will lead to more cutbacks.
All of this leads to a much less safe environment for our patients.
In the recent stimulus bill, millions of dollars were given to hospitals with EHR (electronic health records) to improve their infrastructure....But no money was provided to hospitals trying to move to EHR. Problem? I think so.
So, I don't see any solution, but I worry that the government healthcare plan is simply going to put us in worse shape.