Tuesday, October 21, 2008

So...What Can We Do? A Follow Up on the Right to Health Care.

It has been brought to my attention (thanks, Lindsey) that my last post on the right to health care kind of put a problem out there without any solutions. So, in hopes of stirring your thoughts and maybe starting some conversations on the subject, I am putting out some of my own answers to the question...."What Can WE Do?"

1. EDUCATE YOURSELF ABOUT YOUR OWN PERSONAL HEALTH CARE ISSUES. We need to find out the facts. Here are some things I'd encourage you to find out for yourself...
What does the CEO of my insurance company make not only in salary but in bonuses and perks?
(Your money goes to fund those salaries and you have a right to voice concerns to the company if you think their pay practices are out of whack. This America, by golly.)

What is your prescription coverage? (If you are fortunate enough to have that.) Can your doctor prescribe the medicine that he deems appropriate? Does your coverage mandate generics? (There can be a significant difference between generic and original brand name drugs. Sometimes it makes no difference, sometimes it does but your doctor prescribes a specific medicine for a reason. They educate themselves about drugs for this very reason. They want what is best for you.) Many insurance companies will actually fax or call your doctor about a medicine he prescribed and try to get him to change his mind or make him justify why YOU NEED this medicine as opposed to different (read cheaper) one. At times they will even ignore your doctor's decision and recommendation because it is not in THEIR protocol for YOUR specific problem. This, to me, verges on trying to manage your treatment without the privilege of ever laying their eyes on you physically. HOW do they know better than your doctor?

***I'd like to mention something here...Yes, insurance companies are for profit in a country where making money without restrictions is sort of the point. The difference is this--most of the things we pay for in life come with some sort of guarantee that we will get what we pay for (more or less). Insurance does not. If I pay for a loaf of bread, I'm going to walk out of the store with a loaf of bread. If I purchase insurance in order to avoid the financial strain that can come with ending up in the hospital with an injury or illness, I'm not guaranteed that I'll get what I paid for. There are restrictions, hoops to jump through, red tape and tactics that are utilized by the insurance companies that are designed to confuse and eventually wear down their customers to the point that they no longer pursue obtaining the coverage they think they have been paying for. They do it to you as the consumer and they do it to your doctor in the hopes that he is too busy to jump through their hoops as your advocate.***

What is your recourse if you are unsatisfied with the performance of your insurance company's coverage of you?

What does your doctor's office charge for your visit and what do they actually get paid by your insurance company?

2. EDUCATE YOURSELF ABOUT THE BIG PICTURE. Here are the questions that I recommend finding your own answers to...

What is the truth about socialized medical systems? How do they function in other countries? Are the citizens of those countries able to get what they pay taxes for? Are they happy with their care and the time table in which they receive that care? (Please note my opinion that Michael Moore is not an expert in the field and his everlasting wisdom on the subject matter leaves a lot to be desired.)

***My current questions that I'd like to pose to Mr. Obama are these..."If I can (a) stick with my current insurance or (b) buy into the government endorsed, government run insurance for a lot less money than I'm paying now, what do you think I'm going to be forced to do? How will I be able to justify paying more for my insurance for less coverage? And when no one can justify paying more for worse coverage won't that simply create a monopoly (so to speak) for the government backed insurance? Where is the capitalism in that? Won't we all be forced more or less to go the way of socialism and government dependence? And if my taxes go to pay for the coverage of others utilizing a system that I have chosen not to utilize, won't that mean that I will essentially be paying twice for health care (once via taxes to fund this bad boy insurance plan of yours and again to pay my chosen insurance company for my own coverage?) " Folks, I don't know where the answer lies for this problem but I do know that medicaid and medicare in general are the biggest red tape, hassle providing, pain in the tail systems that my husband deals with day in and day out. Who here wants your doctor to work for the government and live by their rules for your care, anyone, anyone? Not me.

There maybe a way to have a more comprehensive health care system for those who cannot take care of themselves but there needs to be accountability for those who abuse the system. My fellow Americans, we cannot perpetuate the welfare/medicaid mindset for a few more generations and still have a country where people take any responsibility for themselves. These helps were designed to help you achieve a better way of life, not to become a way of life in and of themselves.****


3. DO SOMETHING LOCALLY THAT WILL AFFECT THE BIG PICTURE. Change starts with small steps towards a greater goal. The point is this...the healthier we are collectively the better off we are in general. It won't cost you as much (barring an unexpected illness) to get health care if you are relatively healthy to begin with. Teach your children that we each have a responsibility to take care of our bodies and minds and if we do not do that, there will be health consequences in our future.

Can you join or start a movement in your community or state that is trying to ban smoking in public places? help kids lead a physically fit lifestyle? help teenage mothers get parenting education and good prenatal care? teach good nutrition? (The list here is virtually endless.)

Too overwhelming? Start with yourself and your family. Are you leading a healthy lifestyle? Are you teaching your kids to eat healthy and be fit? Are they learning good hygeine skills (like washing hands to prevent the spread of germs)? Do your kids see you exercise? Do they help you choose healthy food at the grocery store? Do they know the difference between a "sometimes" food and an "all the time" food (as we say in our house). Be a good example.

SHARE with others the facts that you have learned. As the saying goes..."Knowledge is power."

4. If it does come down to a reformation of the health care system, we all need to become as politically involved in the process as possible. That may mean that we CALL OUR REPRESENTATIVES, WRITE EMAILS, GET ON MESSAGE BOARDS, TALK TO OUR NEIGHBOORS, GO TO TOWN HALL MEETINGS, SEEK OUT OUR LOCAL HEALTH CARE PROVIDERS TO ASK WHAT YOU CAN DO SPECIFICALLY AND PRAY FOR OUR LEADERS TO MAKE A GOOD DECISION IN THE END.

And by all means...VOTE.

5. Here are some additional ideas and comments from Doc...
a. He says that medicaid and welfare should come with restrictions that somewhat force some responsibility. For example, if you are on welfare, you should have the requirement that you do not buy or use tobacco or drugs. Why should our taxes go to support your nicotine or drug addictions? You are free NOT to utilize the system of help if you do not want to live within the perimeters of responsibility that come with that help. And as a utilizer of that system, there should be some sense of responsibility to provide some sort of restitution whether that be community service, monetary reimbursement once you are on back on your feet or helping out the next generation of people who are standing in line to utilize the same programs that helped you. This whole "take care of people without any sort of accountability thing" is detremental to our society. It (and poor parenting) are producing generations of selfish people who believed they are "owed" and that have no motivation to better themselves.

b. In regards to the "What Can I Do?" question, consider a Medical Savings Account and High Risk (Catastrophic) Insurance. Simple economics say that if we collectively purchase less insurance, the prices will have to decline significantly. This may not be such a great idea if you may become pregnant or have a pre-existing health care issue, but if you are a healthy family who does not spend as much in a year on health care services as you are paying your insurance company, this may be a good road for you to take.

Me again...I'd really be interested in hearing what all of you readers have to say about this. Please comment, pose questions, give ideas...let's get a productive conversation going about all this!

3 comments:

SondreLyn said...

I agree with what you are saying, and as I have said before, I am on both ends of the spectrum.

We have really GREAT health insurance. When we lived in England, which has national healthcare, we saw the difference. People may think if the government provides healthcare it will level the playing field. It DOES NOT! National healthcare in England is not pretty. There are many services not available to everyone simply because it does not make good economic sense to provide these services. For instance, need a bypass? Smoke? or Over 80? Too bad, so sad, can't help you. But if you have MONEY and can BUY good healthcare, it is certainly available to you. So where is the level playing field? The good healthcare is still being provided to those who can afford it. I could go on and on. My husband was treated for a back injury. The difference between the hospitals he went to and the care he received was leaps and bounds above what I saw just normal everyday Brits receive. All because we have good insurance that we BOUGHT and brought over with us from the US.

The number of staph infections in UK hospitals is enormous. Why? Because in-patients are housed in enormous wards and healthcare workers go from patient to patient without ever washing their hands. There was a huge push to impress on healthcare workers the need to wash up between patients while we were there. They talked about installing those little push-button hand sanitizer dispensers between patients and at doors but THE COST was prohibitive. Such a little thing, but such a BIG thing!

Sorry, I could go on and on!

The Unconventional Doctor's Wife said...

Sondre Lyn, THANK YOU for your insight! This is the type of stuff we need to know about. It sounds like the rich still receive better health care in England simply because they can afford to purchase it. We have the most amazing health care services (and frankly sanitary health care workers and hospitals) in the world. I understand that we should help those who are less fortunate. Definitely. But how do we do it without broad abuse of the system? Thanks for sharing your experience!

p.s. Mental note... Pack a bottle of Purel if I ever go to England.

Jo said...

Hi, I just happened to come across your blog. I see what you are saying here about abuse of the system, and that is irksome. But I think accessibility of health care is a MUST. When I was in my parent's household, I was covered under their policy and had really great health insurance. But later, after college I went to graduate school. While getting a master's degree, I was only a part-time student, (and working part-time) and therefore not even HMO health insurance was offered to me (a student had to go full-time in order to be offered coverage). So...... Anytime I needed to go to the doctor for the next four years, I had to go to a walk in clinic, and it cost me 90.00 dollars just to be diagnosed. Also, when I broke my ankle and went to the emergency room, it cost me close to 6,000.00 out of my own pocket. And keeping yearly OBGyn appointments? Forget about it. I couldn't afford it.

I now am married and live in Canada where as a spouse of a Canadian I receive socialized healthcare free of cost. While it has its downside (waiting longer in waiting room to see a doctor, waiting months for an elective surgery like knee replacement), the system IS more of an even playing field. We ALL get care. We all have to wait in line equally. People with extra health insurance coverage on top of their free socialized medicine, simply get more of their prescription costs covered. I think this system is MUCH better than the USA in terms of availability to all. What I DO see as a problem is that a lot of Canadian doctors are moving to the US because they get paid a lot more, and then there is a doctor shortage in Canada, which makes the waiting longer for patients.