Shutdown!

President Obama is rockin’ the shutdown thing. He is stirrin’ up the stink pot.  Like a rock star at a concert, he stirs his followers into a frenzy.  A frenzy of fury against the Republican party.  The angrier and more frustrated Americans get because of the shutdown inconveniences, the stronger the frenzy will grow.  Seems like kind of a sweet deal for him!!  At every turn, he points fingers and lays blame.  And I’d be willing to bet that he’s enjoying every minute of it.

Elaborating on the fact that the FBI, Homeland Security, CIA, (et al) are short-staffed, makes us even more susceptible to terrorist attacks.  Which means that, God forbid, if there IS some kind of terrorist event, the Republicans will be blamed for that as well.   Everything that is a bad thing in the eyes of Democrats is the irrefutable fault of the Republican Party.  I suppose they get points for having Their Guy in office, and maybe that gives them the upper hand with The Media, (since we all know who runs the media anyway…) but do they honestly think that their enemies The Republicans don’t feel the same way about them?  That everything is their fault? For every rock slung in one direction, there’s an equally nasty rock slung from the other.

I don’t understand why the shutdown is the sole fault of the Republicans.  Mr. Obama said today on his lunch outing that “this could be over today”.  Yeah.  It could be over today if he gets HIS way.  Why is it okay for the Dems to stand their ground, but the Repubs are the bad guys for not caving? 

All that said, to be fair, I’m quite certain that if the roles were reversed, with a Republican-seated president, things would probably play out the same way.  The Rep president would be blaming the shutdown on the Dems.  It’s all in the spin.  I get that.

Reading articles and listening to political discussions (though I have learned not to believe anything I hear or read) is interesting – but even more interesting than the articles/interviews themselves are the responses from readers/listeners.  Every article/interview is, of course, heavily biased – which makes it fun seeing how people respond.  Balancing it out, realizing that real truth lies somewhere toward the middle of the extremes of both sides, I find it very interesting (and often entertaining) to read or hear the viewpoints of people from all walks of life. 

I was listening to talk radio today (with my cynical filter on high alert), and heard the story of a couple from Mississippi who has been taking WWII Army veterans to DC twice a year for the past three or four years. They spoke of their many trips with these veterans and how emotional it is, and how much it means to them to go. We heard the story earlier in the week about how they wouldn’t be allowed to visit the memorial because of the shutdown.  When they arrived, and were able to get in despite it being closed, they were astounded that there were more guards walking around keeping people out than there are normally guards on site when it is open.  How much more did it cost the government to “shut it down”, than it would have cost to just keep it open?

Another caller said her parents are in France this weekend celebrating their 50^th wedding anniversary.  They were planning to visit the memorial at Normandy and the cemetery where two of the caller’s great uncles were buried, and the hospital where another great uncle was treated.  The parents texted their daughter last night telling her these places were closed.  The trip of a lifetime, to pay respect to their family members, and they didn’t get to go.

Jan Brewer posted that she had offered to use state money to keep the Arizona portion of the Grand Canyon open.  The federal government declined her offer.  Several businesses have reportedly offered to do the same, but their offers have also been declined.

Madness.

Regarding Obamacare: I read an article earlier today that said “They are trying to keep people from getting health care. This is the disaster the Republicans hope to prevent by shutting down the government.” And “The reason the Republicans are prepared to go to the wall to stop Obamacare is simple: They are terrified that people will get it and like it.”

Really?  That’s the best they’ve got?  Republicans are “trying to keep people from getting health care”?  and they are “terrified people will like it”?  Those are some of the more  asinine  statements I’ve heard to date. 

  

I believe you’d be hard pressed to find any American, regardless of party, who would not agree that our healthcare system is broken and needs fixing.  Healthcare in America is a big black hole.  Most people blame the providers for ‘overcharging’.  And there are some who do.  But the picture is so much bigger than the cost of an office visit or an ER visit.  The major players in the black hole are Insurance Companies, and perhaps the biggest player (though his part is often unrealized by John Q Public), is the One Call, That’s All attorney who comes into your living room every day and night with promises to make you rich off the negligence of someone else.  Without tort reform, this will never change. Yearly malpractice premiums could feed a small country of starving children, and have resulted in the closed doors of practitioners and Emergency Rooms in many places throughout the country.

Those of us over the age of 45-50 can remember a time when, if you had three insurance policies, and you broke your arm, you might actually end up making money.  The insurance companies cottoned onto that and started coordinating benefits, and put a stop to that practice.  Then insurance companies started dictating what fees they would pay for certain diagnoses and procedures.  

I have worked in healthcare for 37 years – in many different capacities.  My first job as a medical assistant was in 1976, when the world was a much different place.  Doctors had time to take care of their patients, and the receptionist didn’t have to worry about calling five different automated phone numbers to see whether or not the patient could be treated at their office.  If a patient needed lab tests, x-rays, or even surgery, it was scheduled, performed, and the insurance company paid for it, far more often than not.

I’ve done my time as a receptionist as well.  I’ve made those endless phone calls to automated numbers, left messages for someone to call me back – while the patient sat in the waiting room for someone behind a desk hundreds of miles away to grant or deny our treatment.  I had to hold my tongue as a young mother screamed at me that I was prejudice against her because our office didn’t accept Medicaid, and what was she supposed to do? Our office did accept Medicaid for patients who met certain requirements:  those who were seen in the ER when our physicians were on service call.  This patient did not meet the criteria, and was referred to the office of the physicians who were on call when they went to the ER.  As the courteous receptionist I tried to always be, I attempted to explain the mutually agreeable arrangement between our office, the ER, and the other specialty providers in town, but she continued to scream and yell.  The irony here was that (at that time) with Medicaid she could take her kids to the doctor whenever they were sick, with very few limitations – but I, as a single mom working my rear end off, couldn’t afford to take my child to the doctor every time she sneezed, even though I had insurance.  If not for medication samples and the kindness of my bosses treating her when she was sick, it would have been really tough for me.  So, what I wanted to do, instead of stand behind the window and try to calmly talk to this mom, was to follow her out in the parking lot and scream at her, and tell her that I was a single mom trying to take care of my child too, and for her to get off her butt, get a job and stop depending on the government, and then I might be able to feel a little compassion for her.  But, thankfully, my better judgment won, and I maintained my professional composure. (And kept my job. Ha!)

Oops… not sure how/why I got off on that tangent.  My blood pressure went up a little bit just recalling that incident.

As a medical transcriptionist, I’ve spent many hours composing/transcribing letters of appeal to insurance companies who have denied benefits, or pleading with a bureaucrat behind a desk somewhere to allow a patient to have a medically-necessary procedure/surgery. 

As accounts payable, I have seen the astronomical amount of money it takes to run an office.  Numbers are not my forte – and those were some really big numbers!!!

As accounts receivable, I have seen the tremendous amounts of money written off based on the insurance companies’ “usual, reasonable, and customary” allowance. (Don’t kid yourself.  The insurance companies are a bigger part of the problem than they will ever be the solution.)   

As collections manager, I have spoken on the phone with patients who make every effort to pay their delinquent accounts, and also with those who couldn’t give a rip about what they owed. 

And on the subject of “doctors charge too much”.  Lordy.  I truly don’t need to get started on that.  This post is much too long already.  But I will.

Tell me.  When your loved one is in the ER after an accident with a bone protruding through her leg, or your child has been diagnosed with leukemia, or you have been diagnosed with a detached retina with imminent blindness – the most important thing in the world is getting the very best medical care available.  At that moment, money is not an issue.  Life and well-being trumps everything.  Many of us pray, but even for those of us who do, in these moments, the next miracle worker under God is the physician, and we want the best.

Until we get the bill.  Then we are sometimes overwhelmed, and/or outraged.  Especially when our insurance company tells us “your doctor charged too much”.  Who hasn’t heard that before?  Just another finger-pointing blame game.  You don’t hear “we need to make a big fat profit, so we’re only going to pay a miniscule portion your bill”, rather it’s “your provider charged too much.”

Yeah, your doctor “charges too much” because it doesn’t matter what he charges, most insurance companies will only pay pennies on the dollar, so the write offs for insured patients are huge.  Then there’s Medicare and Medicaid, whose reimbursement formulas are laughably pathetic.  The private pay patient, then, is left with the inflated cost, with nobody setting usual, reasonable and customary fees for him/her.  Many of these patients are hard-working, responsible people who will faithfully make payments every month for years on end in order to clear their account.  Is that fair? No, of course not.  It’s part of what needs fixing.  Other self-pay patients have no intention of paying one thin dime from the minute they walk through the door. Is that fair? No, of course not. That’s another part that needs fixing.

As patients, we complain that the doctor wasn’t in the room with us five minutes, never touched us, barely made eye contact, then charged us $120.00 to refill our blood pressure medication.  Maybe that’s because for the five minutes he spends in the room with us, he must spend at least another 10-15 minutes making sure everything is perfectly documented, arranging for whatever testing we may need, writing a letter to our insurance company begging for approval, reviewing prior test results before he walks in the room, etc.  There is so much more that goes on behind the scenes that patients do not see.

Do some doctors make a ton of money?  Yes, many of them do. And, while I have my favorites, and some not-so-favorite, I haven’t yet met a doctor who did not deserve every penny he ever made, and then some.  There is something wrong with people who think it is okay for an athlete (who may or may not even have graduated high school)  to make millions of dollars every year for doing something he’d be doing for free in the empty lot down the street anyhow – yet the man or woman who trains for 10-12 (or more) years to remove the plaque from your arteries, or re-route those arteries so that you can live another 30 years – has to justify living in a nice home, or driving an expensive car.  That is crazy talk.  We don’t begrudge movie stars, rock stars, country stars, or billionaire entrepreneurs their lavish lifestyles, but the surgeon who transplants a liver into the belly of our dying teenager has to fight with an insurance company to be paid for his services? Again – crazy.

Nancy Pelosi told us that we must pass the bill, so we can find out what is in it.  The article I read today said  “The lack of adequate cost controls and other problems like it are items that can be fixed once the program is in place.”

Umm.. sorry, that doesn’t offer much comfort or reassurance.  Like they have “fixed” Medicare, Social Security, and the Post Office?

It will be interesting to see how it all plays out.  So many unanswered questions.  The logistics just don’t work.  Earlier rants on this subject can be seen here.

I do not like President Obama as the leader of our nation – that’s no secret.  However - as I say often: I only vote Republican because I don’t want to vote Democrat, and right now, there is no other viable choice. Party affiliation aside - the behavior of our elected officials is despicable.

I’ll end this post by saying to my Democrat friends who are on board with Obamacare:  I pray you are right.  I would like nothing better than for Obamacare to be the answer to healthcare that we have long needed.  I hope my concerns are for naught, and I would love nothing more than for all of the Republican doomsday predictions to be wrong.  I would happily give credit where credit is due.  I don’t care if it’s a donkey or an elephant.  I think I speak for many who oppose the ACA:  Now that it has been forced upon us, prove us wrong.  Please.

But in the meantime, get your act together, put on your big boy/big girl britches, stop blaming each other, get back to work, and fix this thing.