Sunday, August 2, 2009

What are we going to do......

Well, there is alot in the news about the cash for clunkers and more stimulus money for that. Car makers posted a profit this qurater, thanks to it. There is talk of four day school weeks and mandatory unpaid leave for teachers. School nurses will be a thing of the past. No more cops or firemen are being added to your community's rolls. The big incentive to create jobs for renewing the infrastructure has uncovered that most of our bridges are sound and they really don't need repair.

Healthcare needs repair. How, by whom, for whom? I don't have the answers. My insurance carrier has just decided that I don't need my evening eye drops for my advancing glaucoma more that twenty nights a month even though I have an order from my eye specialist and an average month has 30-31 days. I might die blind if I don't get the treatment I need. The IV therapy that I receive once a year doubled in price from $1800 to $3600 this past May. I have a $2000 deductibe and my healthcare insurance premium is paid at the HMO level so I pay more for the PPO that decides what medicines I deserve and how much they cost me, out of pocket. I have a pain in my leg where I have a cluster of varicose veins and I am not vein ( pun ) but my insurance plan doesn't pay for the treatment I need to get my leg to stop aching. And I have used up my flexible spending account for this year. Last May.

I am not alone. We are all reeling from the cost of gasoline to the cost of food. And because there is a drought in Texas everything they grow there ( alot of food ) including livestock is going to be very expensive any day now. We expect to pay for gasoline and food; we know that we have to pay for cars and clothes and entertainment. When did we decide that we were entitled to healthcare just because we are alive? I remember when I was a young medical consumer and a young healthcare provider and we paid the doctor when we got sick and needed care, no co-pay and no limits on visits and no referrals. If we needed medicine, the doctor ordered it and we paid for it. We all had major medical policies that we used as health insurance against a medical emergency and or hospitalization. We expected to pay for anything else. Doctors were our heros and sometimes they even took it out in trade.

Somewhere along the line ( someone told me it was the Kaiser Foundation in the late sixties )Health Maintenance Organizations were pretty rapidly given the right to decide who we used for our provider, what we were entitled to receive for medication and whether our procedure was even really necessary. I know about insurance and Medicare fraud and greedy doctors too. But why are the medical consumers the losers? Why is it that the insurance companies are doing as well as the pharmaceutical companies and healthcare workers are working harder and harder to make their overheads?

Complementary and alternative medical providers have always been fee for service, but for a few chiropractors with an insurance company or two on their side. People are paying an awful lot for alternative care now, out of pocket, because they are losing faith in tradional western medical care. Dentists and psychiatrists, plastic surgeons never really expected to collect from insurance carriers. People pay.

I haven't been asked to sit on any government panel to try to fix the problems but I have a lot of experience being in the profession for thirty years and I am a medical consumer. So I won't tell the government or the insurance companies what to do. But I am going to tell you.

GET INVOLVED. KNOW WHAT YOU NEED and where you stand on the issues. Get your ideologies ( whatever they be ) together and become part of a voice because this is America and that is your right. And while you are at it, please don't go to the hospital without an advocate who can understand what is happening to you and make it someone who is not afraid to speak up and out. Ask your medical providers what their plan of care is for you and don't assume that your insurance company is going to say okay to it. Check you benefits and appeal if you have to. Your doctor and the staff will help, if you ask nice; it's not their fault. Call the insurance commissioner if you think that you aren't getting what you are PAYING for. And get everything in writing, note who and when you spoke about what.

BE A GOOD MEDICAL CONSUMER. Ask for what you want and need after you fully understand what is planned. This is a very good time to practice assertiveness for yourself and your loved ones. This is a very good time to notify your government representatives about who you want deciding what happens to you and your family. No, I don't have all the answers nor do I have a crystal ball but I do know that this is no time for apathy or ignorance. Your health and maybe your very life will depend on it.