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Welcome to my blog. Thanks for coming! One day I hope my little piece of internet real estate will be home to lots of family photos, pictures of my scrapbook and card art, with some random thoughts and memories posted on a somewhat regular basis. Mostly my world is very predictable, but occasionally some excitement will find me, so visit often. Who knows what useful (or useless) information you may find here.

cathyb

Wednesday, August 12, 2009

Obamacare


If we could all agree that nobody truly understands Obamacare, we could at least begin the process on common ground. I’m glad to see American citizens speaking up, and letting their voices be heard. It does concern me, however, that the opposers at town hall meetings are being portrayed in the media as hot-headed, ignorant rednecks. There are some pretty nasty rumors about Obamacare that even I, with all my Obabamacare opposition, have a difficult time believing. As the father of young children, I find it hard to believe that his plan would put a lesser value on children. Having just lost a grandmother, I can’t believe he will put old folks out to pasture. Now… that’s not to say that I don’t believe quality of care will take a nosedive, but I believe it will be for every person. Maybe a little worse for the elderly, but probably not so much for children. The point I am pondering is this: I wonder how many of these rumors are actually being generated by the Obama folks, in order to work the opposers into a frenzy? Think about it. His calm, smug demeanor is far more attractive and soothing than the shouting, shoving, sometimes obscenity-laden protests from the opposition. Brings out the shine on his halo.
I’ve worked in healthcare for 33 years, in many capacities, and the changes I have seen are incredible. Absolutely, reform is needed. Even physicians agree!! The cost of medical care is exorbitant, and something needs to be done, I don’t argue that point. However, there are a lot of hidden costs that the patient doesn’t see. When we are admitted to a hospital room for an overnight stay, the price of that room is all encompassing, paying for a myriad of things that we would never imagine. The room fee pays my salary, and the salary of my co-workers in transcription and Medical Records. It pays the janitors, the cooks, the nurses, the radiology techs, the maintenance guys, all of the administrative offices, insurance clerks, coders, the electric bill, the phone bill, gas and water bill, laundry bill so we can have clean sheets… and the list goes on. Same concept as a hotel bill, except there are more folks to pay. That $13.00 Tylenol we took pays for the pharmacists, the pharmacy techs, the nurse who gives it to us, the Dixie cup that holds our water. When our doctor bill arrives, we may say that he only popped into the room for five minutes. What we don’t see is the time it takes him to write up admission orders, make sure the mandated information is in the chart for every order, and all the required dictation is done. The chart may lie unfinished in Medical Records for a week or two, requiring multiple visits by the doctor, or multiple access to the file via computer from his office, to make sure all the necessary forms are completed and signed.
The same thing holds true when we go to the doctor’s office. Absolutely, the bill is far more than it should be. My last job afforded me a different point of view, though, in that I was the accounts payable person. My goodness. I never knew that running a medical office was so expensive. The cost for durable medical equipment, disposable medical supplies, utilities, salaries, general operating expenses, health insurance for employees (huge!) and then the big daddy… the malpractice insurance. Heavenly days! Yes, doctors make a lot of money. As well they should. When we or someone we love is injured or ill, we want the doctor to do whatever necessary to save them or make them well. They become God, sometimes. When the crisis is over, we get a letter from our insurance company saying “Sorry, we’re only paying X amount, because your doctor charges too much.” So, instead of becoming upset with the insurance company, we get upset with the doctor and complain that he charges too much. There’s something wrong with this picture! When an insurance company pays $1200.00 for an $8,000.00 procedure, that’s pretty shameful. Is $8,000.00 too much for the procedure? Yes, probably so. Back in the day when insurance payments were more proportionate to physician charges, that procedure might have been billed at $2,500.00. It is sad that many physicians and surgeons have to spend a portion of their work day writing letters and making phone calls to get permission to perform tests and/or procedures, and appealing payment amounts. Yet if the physician doesn’t order the round of tests, some attorney is out there foaming at the mouth, encouraging you to file suit against the physician. So the physician has to pay thousands and thousands of dollars for malpractice insurance. I could write for days and days about this issue alone, but suffice it to say… healthcare is one big, black, deep, dark hole, made worse every year by the constant threat of malpractice and litigation, by the insurance companies setting the acceptable ‘usual, reasonable and customary’ fees for services, and by the huge losses incurred by emergency rooms for primary care. Which brings us back to the reality that Americans need access to primary care. Just think about how many ER visits could be avoided, how many patients could avoid dialysis if their BP and diabetes were kept under control, how many hospitalizations for chronic illnesses could be avoided, if everyone had access to primary care.
I’ve tried to look at it from the other side. From the side of those people who don’t have insurance. A poster on the scrapbook board made the comment that many of us are all just one layoff away from being uninsured. Last year she would have been one of the Obamacare opposers, but because her husband lost his job, they now have no insurance, and have several small children. She is afraid of Obamacare, but she is more afraid to be without insurance. I can totally see that. It seems that most of those who oppose it currently have coverage, and most of those who support it do not have coverage. I don’t blame those without insurance for supporting Obamacare, they are being fed a line of bull and are being made to believe that his plan will take care of them. Granted, they may have access to healthcare that they don’t have now, but I absolutely believe that it is not what they are being promised. Don’t get me wrong, I am a TOTAL advocate for healthcare for everyone, but I am opposed to a single-payer system run by the government. There has to be another way.
I don’t know the answer. I wish I did. The whole thing is, I don’t think anybody knows the answer. Mr. Obama just wants us to think he knows (when he hasn’t even read the 1000 page bill his ownself). I believe what we need to focus on right this minute is making sure our representatives SLOW DOWN the process and not be bullied into a vote on this for yet a long while. Acting in haste will only result in the nightmare we all fear, I’m afraid.

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