<p>VH,
In my doctor’s office there isn’t any fancy equipment or machines. There is, however, a virtual swarm of workers answering phones, filling out paperwork, entering stuff into computers. Yet 50% of the time, they get stuff so SCREWED up, it takes hours on the phone to get it fixed.</p>
<p>If we actually need a test of some sort (Xray, Scan, bloodwork), we go somewhere else, and we pay out of the nose for it (or the insurance does).</p>
<p>I’m still trying to figure out what’s going on in the typical family practice office, which has 4 rooms with sinks and tables, and 20 “support staff” for 3 doctors.</p>
<p>Bluebayou, as I stated in an earlier post, it is a combination of the insurance companies, the drug companies, and the large employers like IBM. I haven’t yet seen Moore’s film, but it is not that big of a secret how the medical crisis in America developed, if you have been participating in life the last ten years.</p>
<p>Doubleplay, that support staff is also another real issue in health care. Twenty years ago when you went to see the Dr. you were assessed by an RN with four years of college. Today, you are seen by a medical assistant with 3 months of education at a technical school.</p>
<p>Hey folks; been away for a week–just skimmed this. This line stood out, about all the workers in a doctors’ office:</p>
<p>
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<p>Single payer–eliminates the vast majority of that paperwork. Medicare has much lower overhead than the for-profits.</p>
<p>Doctors trying to deal with hundreds of plans, and hundreds of plans paying for thousands of people to administrate them, added to people not just making a “living” but making hundreds of millions as top execs at these plans, added to the unbelievable amount of money pharma spends to advertise drugs you may not need which adds millions to what we pay for drugs to pay for that advertizing (you have no idea what free stuff an unscrupulous doctor–most of them–will take from drug companies to prescribe their drugs) etc etc, all adds up to monumental waste that could be eliminated with a national, single payer system (Britain is not one of the better; save the comparisons.)</p>
<p>Or, we can continue to allocate care to those people who '“deserve” it, and **** the rest.</p>
<p>Doubleplay, I stopped going to family practice Drs. a few years ago. If there is anything wrong with you, they will refer you elsewhere. It used to be that insurance had a “Gatekeeper” who you had to see first, but most have gotten rid of those.</p>
<p>After factoring in the cost of insurance, my health which is excellent, and other costs, I buy catastrophic insurance only and go to a boutique Dr and dentist. I know the care is excellent, it may cost a little bit more, but when you minus the aggravation the drug and insurance companies cause you, I feel it is worth paying extra.</p>
<p>Actually, I don’t quite understand where your company comes into play in deciding to cover or not cover the treatment. In answer to your question, no, insurance companies should not cover treatments that are not effective. This woman, however, was obviously desperate, and was not taking a no from a gatekeeper, beaurocrat, etc. She wanted to embarrass the company that said no, and she succeeded since the company decided to pay for the treatment that some doctor suggested to her. It was one of her last options, and she was fighting for it. Many would fight, b/c the alternative is turn over, and just give up to die. This treatment gave her some hope. I don’t blame an insurance company for saying no to something not known to be reasonably effective in a fair number of patients, but I cannot blame the sick woman from doing what was available to her to stay alive.</p>
<p>My father gave up his practice at 82 after his 25 years with the state, 3 years as the county MD, 3 years at the state university as MD, and 25 in solo practice. He too is ticked off with the profession. My brother was visiting from NYC and our father recounted his last bout with a new stent at our state’s teaching hospital. He was allowed to get dehydrated and he lost BP. He noticed his condition and called for a nurse to administer an IV. After 3 nurses and 2 MDs and being poked all over to find a vein, he told them to use one in his neck, -all of them refused because it was too dangerous. I guess that got his BP up because he told them, his nurses at the state prison did it all the time because the inmate’s normal vessels were so damaged from drug addictions. My father told the crowd to get a mirror and he’d administer the IV himself. He’s 87.</p>
<p>My father had a lot of free meals from the drug companies. They wanted to know why he didn’t prescibe a new sleep aid. He told them that the old drugs cost very little and was effective. They replied that the new drugs were better and had less side effects. He got mad and said that when he tried these new drugs, they gave him nightmares. Its not good to take a sleep aid that helps you to sleep but you are afraid to sleep because of the bad dreams. Not good for a person who already has anxieties.</p>
<p>I am overseeing the care of a family friend, 94. She has fallen twice in a week and within 7 days of taking regular a common heart medication. After the ER trip for a small cut to the scalp, but full CAT scan. We immediately walk across the street to the doctor’s office for an appointment that I scheduled. I asked the doctor about the drugs. Doctor said the drugs were to lower BP and heart rate to prevent strokes. I said that the drugs appear to make her more unsteady. It seems to me that a possible stroke is a better alternative than a sure broken hip and a severe head injury. Doctor thinks a bit, agrees. Off the medication.</p>
<p>A few days before friend’s fall, my mother at 90 decides to pick some peas that I planted for her enjoyment and for the benefit of my older visiting brother and her granddaughter and great grandson. She falls and luckily only tears rotator muscles. Take her to regular doctor after a week of fall. Ask doctor is these BP and heart pills really necessary, he thinks abit and says that her heart rate is a bit low at 62, perhaps we should use half a tablet. Off the medication, same medication that friend was using.</p>
<p>Mom is pretty high stung and ignores Dad’s advice. She prefers an outside opinion.</p>
<p>Northeastmom, I don’t disagree; we’d all do anything we could to get a treatment that’s our last chance. My point was that the story became a legend illustrating that “the big bad insurance company denied her necessary treatment.” In fact, the insurance company was using evidence-based science and saying that the treatment had not yet been proved effective and, therefore, shouldn’t be paid for. </p>
<p>Everyone is so p<em>ssed at everyone else in this maze of a system. And we’re not always p</em>ssed at the right people (or companies) for the right reasons. No one is to blame, but everyone is to blame. It’s a mess.</p>
<p>When I can’t sleep, I just take some Nyquil. Does the trick and no nightmares.</p>
<p>About the drugs, my folks are on so many and they both wonder why they have “bad days” (feel woozy, unsteady, weak). I feel so bad for them, but they do have problems (both have had strokes, and other stuff). It seems like when you get to a certain age, you end up all juiced up. You’re alive, but you’re literally a brewery of chemicals.</p>
<p>Probably the number one mantra all Drs. live by, is that high blood pressure is the most important disease to control. Most high blood pressure medications have side effects and few people can take them and feel well. </p>
<p>Every year, in addition, the AHA lowers what is a “normal” blood pressure. Could they be in cahoots with the drug companies?</p>
<p>I saw the movie last night and it really struck home. My husband was in a terrible car accident last year right across the street from an emergency hospital. Guess where he was taken? We have HMO, PPO, POS – our HMO wanted it on the POS because we didn’t have advanced approval to take him to an out of service hospital. Fortunately, we’re both lawyers and I can be a real ***** about stuff like this. So we got covered, for that part at least. When he had to have more surgery, he went through all the proper channels; got clearance, and because their own doctor said he should go back to the surgeon who did the initial surgery, the claim was denied. We won on appeal, but the anxiety and stress, the hurt and anger, can’t be taken away.</p>
<p>Having lived in France and in England, I knew exactly what was going on when the AMA tried its fear tactics about getting poor care, and having to wait for operations. I remember one snowy evening in England when I came down with a bad case of pink eye. A doctor showed up at my front door at 10 p.m., in the snow to treat me and give me medication. Once I had to go to the emergency hospital for a fall. My leg was xrayed and I was fixed up and back at work in less than 2 hours. The cost for prescriptions back then was the equivalent of $1.00, nothing for birth control. In France, I was able to have all of my care taken care of, and I was just there on a study abroad year. Same great service. Paid nothing.</p>
<p>My mom, who wasn’t on the national health – she was just visiting England – got sick and the doctor came to her hotel room and helped her. How much did she pay? Nothing.</p>
<p>These countries’ health care system are NOTHING like HMOs, but that’s what you hear in this country – if we have socialized medicine, it will be just one big HMO. Which is great for curing Americans of wanting it or demanding it.</p>
<p>Michael Moore’s documentary was not fiction – it was the truth. And I’m really glad I still have my NHI card!</p>