Sunday, November 23, 2008

Health Care

So I know I said in a previous post I wouldn’t say more political stuff but there has been some recent events happening that influence how I feel. I work with two people. Both with kids that suddenly pop up with bad nervous system disorders. One of them just moved to Scotland. Of course the UK’s system is very different than here, so hearing the differences were sobering. The first is how hospital beds are handled. When she was feeling better, they said she could go home but they would keep the bed reserved for her through the weekend. It might sound more expensive but people are more likely to leave sooner if they are not worried about returning if needed. Imagine if they were to throw out the revenue per bed model here. The other thing was that the hospitals were built into malls. Imagine reducing the stigma of visiting the doctor down to just being another errand. Doctors catch the problem faster making it cheaper to treat. So what is the verdict. My co-worker’s child in Scotland is on an aggressive drug and is getting better. The co-worker here is still having problems with the insurance company getting authorizations for all the specialists. In Scotland she had to stop being a student temporarily but was still able to get the same care. Here, he couldn’t work so there was also a large delay switching from work insurance to medicare, all the while his father is busy with paperwork, searching out the right specialist, and bills, making two people not being productive. (Trust me, I work with him and was picking up some of the slack.)
Now I am aware that what I am presenting is antidotal evidence, so I can only add my own personal experience: My wife gets a prescription and fills it. After a few weeks it is not working and she is getting worse so she goes back to the doctor. Apparently the pharmacist didn’t fill the prescription correctly because it was not on the insurance formulary. The Insurance company had listed a similar drug which the pharmacist gave without saying anything. The only problem is the two drugs were similar in every way except what my wife needed. Luckily (there could have so many other things gone wrong) it was only 2 extra weeks of being sick and not something more serious, but an insurance accountant should not have a say if my wife gets the medicine she needs.
In another experience she found out she needed to see a specialist. The only problem is that it was specialized enough that they didn’t take insurance. Apparently the insurance companies try to get out of paying the doctors as much as reimbursing patients. So even with full health insurance we were still headed for bankruptcy. (As it turned out by a total fluke, my wife’s work had an extra rider that paid directly to the hospital for that specific specialist. I guess someone high up also needed it and added it to the company health plan.)
I am just saying the system is broken. I think an obvious example is all the pharmacies that find it easier to give some drugs away for free rather than deal with insurance companies. It is not a good idea to give financial incentive to the insurance companies to give worse care to people. The USA pays more than any other country and we still end up 16th in care. (It’s in the 30’s if we count the un/under insured.) I can only guess for other countries that the extra cost of having everyone in a country covered is absorbed by the lower cost of paperwork and catching things sooner is cheaper.
The conservative people I know like to call it “socialist health care”. I like to point out we already have a socialist fire department. They learned long ago that if they were to try to bill people to put out a fire, people would call to late. The fire, or in the case disease, would spread making it more expensive/impossible to control. If other countries pay less, and get better health care, better satisfaction with their medical care, faster service even with “rationing” (Another term I hear a lot.) and still cover everyone, than you can put me down for socialist health care. Now I realize I live in a liberal area and hear a lot more of that side of the issue, but just from personal experience and from the people I know, I just don’t get the arguments for leaving the medical system the way it is. Because the way I see it right now is that we are paying more and getting less.

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