<p>My observation has been quite different. I find it too simplistic to generalize all/most people in a certain group to be saintly while most of another group are villians. The AMA, the individual specialties’ trade organizations, the American Hosp Association, etc. are not very different, from say the teachers’ unions in that their primary interest is to protect or advance the cause of its members, and not necessarily the customer. The individuals within these organizations are all over the spectrum just like school teachers or civil servants. </p>
<p>I find healthcare is an industry with fundamentals similar to any other large segment like defense, banking, or education. The players’ primary objective is to keep expanding their share, and it’s up to society at large to make sure that these interests aren’t allowed to go overboard. </p>
<p>Take the conventional worldview of physicians/hospitals and lawyers being at each others’ throats. In reality, lawyers are used as much by providers as the other way around, to legitimize more services that bring in money. There are developed countries where you won’t get a CT or MRI at the drop of a hat because they feel that it’s not money well spent. You wont find the kind of end-of-life spending that we do here. Here we do so because we have developed protocols for defensive medicine that puts money in lots of different peoples’ pockets, and I don’t see doctors and other providers being in any way exempt from participating in these excesses.</p>
<p>Yup, when I was in Germany you went to the doctor and you never worried about who covered what. I will never understand why Americans think we have such a great system. I would give anything not to deal with all the stupid paper work we get here. (Well I guess not quite anything since I don’t still live in Germany!):)</p>
<p>I recently had to take two elderly women on separate occasions to an ER. In both cases, the scope of the problem was beyond what the ER could handle. The ER simply made sure that there was no urgent, life threatening or harmful situation imminent. It then called for specialist to determine the next step which in both cases resulted in hospital admissions and diagnostic tests by specialty doctors and treatments. </p>
<p>As for the billing, hospitals need to get consultants to set up a more business like structure. Hospital bills tend to be sloppy, confusing and idiotic. Any other business would be long bankrupt and I am never surprised when a hospital goes that way. I spent two years daily dealing with hospital billings when my son was diagnosed with leukemia, and I could never understand the danged billing system used. It was sheer insanity.</p>
<p>None of the doctors I know could organize their way out of a paper bag. So while I trust doctors on medical advice (to some extent . . . unfortunately there is a strong culture of lying to patients in the medical profession with respect to the efficacy and consequences of treatment, especially in end-of-life and fatal-disease situations), I certainly don’t trust them to organize the health-care system.</p>
<p>In any event, however, most of the doctors I know are pretty depressed about the amount of time they spend on insurance-company paperwork and procedures, and the effect on their medical practice of games between their practice groups and the insurers. Many – certainly not all, but many, maybe even most – would be happy to have a single-payor system.</p>
<p>When I first became pregnant as an eighteen-year-old, I got on MassHealth, which was far superior to the insurance I’m on now. I was amazed by how good it was. We bought a car seat on our own, but I remember they even offered to give us a free one. They also had the option of having nurses visit after the birth of my daughter to help us figure out new baby care, though we didn’t end up using that. Also, at the time, they provided transportation to obstetrician/hospital visits, though I don’t think they do anymore because of budget cuts. They also gave discounts for memberships from certain gyms. I didn’t see a single bill for anything, I didn’t need referrals to go see various doctors or specialists, and I paid 3 dollars a month for the prescriptions I was on until I got off MassHealth. Anyway, that’s why I didn’t know the way things are billed. I haven’t had any issues necessitating hospital visits since then.</p>
<p>*hey also had the option of having nurses visit after the birth of my daughter to help us figure out new baby care, though we didn’t end up using that. *</p>
<p>I had that with my first- I was under the impression that because she had stayed in the NICU for two months, that it was required. They were public health nurses and it was helpful. ( they also gave CPR on babies instruction, which kinda scared me to death- she was just over 3.5 lbs when she came home from hospital but I guess she had regained her birthweight which was just under 2.5lbs, I was afraid of breaking her ribs)</p>
<p>With my 2nd, although she was born in same hospital ( & was also in the NICU briefly- because she had aspirated meconium) I didn’t have the same option, although I sure could have used it!</p>