Wednesday, April 13, 2011

Tribute to those who lost the battle with American Health Care.

In a recent article talking about what happened the Budget meeting that was held locally, it was mentioned that Racine Residents share state budget concerns and told some personal stories.

Previously, conservatives have stated how even if the health system isn't perfect, that it's still a pretty good system, and that people don't die from it. Well, I've told the story about my friend, who had died from complications from diabetes. The damage that it did to his health made him unemployable. Yet he was still "too capable" to be disabled, and without a qualifying situation, such as being disabled or raising a minor child, he couldn't apply for medicaid. He was basically at the mercy of being able to get anything free, though even getting a primary care physician was impossible, because they want $100 up front. Without a job, he didn't have that for groceries, much less for 1 doctors visit. There's only so much that the health care clinic can do, and they're even at the mercy of receiving donations. Too bad places like these don't have what it takes to have the medical supplies and meds come in from the manufacturer. And no, he couldn't just log online to google it. With no steady income, because he could only get odd cash jobs, it's not like he could get a computer, much less pay a monthly fee to go online. Plus how is he going to be able to pay for internet services if he can't buy insulin needles to save his life?


In the article, a man describes how he lost two different friends to lack of health insurance, and is afraid of what it will do to others who can't get on it. Remember, if you don't have insurance, it costs you $100 up front to even see the doctor.


These cuts could also end up meaning that anyone with special needs would have to wait to be put on hold indefinitely, even if they qualify, because they can't get on the program in the first place. We never know when we will have a disabled child, so there is no way to pre-plan for that. Depending on the need, costs can be sky high out of pocket. Without the help of state or federally funded health insurance to defer some of the costs, the financial output can literally cost one their home. This really shows what a broken system we have.


Even with help with medicaid, or even regular insurance, too often, it's still too broken of a system. Each insurance company has it's way of deciding what is covered or what is not covered. Then, the medical providers are considered "participants". So rather than just signing a contract, doctors often have to pay, to be a so called member to participate in collecting reimbursements from that insurance. That, in conjunction with the fact that medicare and medicaid don't pay asking price, those providers who are at a small clinic or at an independent office can't afford to accept a lower reimbursement AND have to pay into the insurance program to participate.


While I'm not blaming doctors, what does perturb me is the fact that here it is health care, and the health care system, yet the bottom line is the dollar. So money is really more important?


All too often, I hear about how the referrals and prescriptions are just messed up. One time, an uncle of mine was prescribed an antibiotic called ciprofloxacin (cipro). Because the two most normal antibiotics are either penicillin based or tetracycline based, the insurance refused to cover it. Even though the doctor had a reason for prescribing that one for the purpose of what my uncle had. Thing is, he had regular insurance through a reputable company, since he worked in the factories when they were still flourishing here in Racine. My aunt was working in the same company in the office department.


I don't know whether to blame insurance or clinic policy, but, here is a snafu. Here is a perfect example of the fragmented health care system in this country. My primary physician is this really nice doctor who will spend as much time as the patient needs to get the job done thoroughly. But because he's in high demand, it's not always easy to get into an appointment with him. Because I'm diabetic, though, he's still in charge of my overall health, but, I go to the nurse practitioner, his associate, for my diabetic issues. She is also the one who takes the over flow for the doctor, and is a bit easier to go see.


I had a medical problem that I'd gone into the nurse practitioner for. Upon visual, had diagnosed it with one thing, and did testing on it to verify and sent me out with a script. Fine. The script didn't work. I called and the next appointment was about 2 weeks away, and the problem was getting so bad I ended up going to prompt care, which was absolutely no help. So I ended up asking for another appointment, and got one with this one's associate. She never looked, never did testing, nothing. Just said it was a diabetic problem and I should follow up with my "regular" nurse practitioner and sent me out the door. I was getting frustrated, because the problem was making me want to crawl out of my skin.


I'd been doing my best to go OTC with what I could do for relief. No avail. I see my "regular" nurse practitioner, and she gives me a different script, and says if this doesn't work, I'd have to go to a specialist. It didn't work. So I'd had to call the specialist myself, and that was another 2.5 weeks away. It was VERY frustrating. So in the mean time, I went into a different walk in clinic, and that doctor was very good, and did testing, I got a diagnosis and a couple scripts, and guess what? They worked! He was insistent that I get this taken care of ASAP, because to him, if my situation were any worse, he was going to put me into the hospital. Too bad he is walk in only, and NOT a primary care person.


The specialist actually agreed, and well, she was stern about ensuring I followed up as well. Then agreed that I need more of a specialist than her, and both the walk in and this one had said to go to an endocrinologist for my diabetes, and that treatment would help me with all of these other problems.


I was frustrated to my limits, because I'd not had much luck with this particular nurse practitioner before. She'd already misdiagnosed an eczema problem before, and then now, I just felt as if she were ignoring the problem. Too often, I felt as if I were rushed out, and I'd already seen her twice for this same problem, yet, rather than visit the diabetes, she's ignoring that too. There was another time that I'd felt if she really wasn't hearing me out, either.


So, I'd made the appointment, and had to bring my mom, whose a registered nurse with me, to help push the fact that we can't sit on this and just see. My mom had buttered her up and did some name dropping, and then rather than send me to an endocrinologist, she actually was going to try to be more proactive about the situation.


So finally, 6 appointments with 4 different medical professionals, over 7 weeks, it took a walk in physician and a gynecologist to push the medical testing, and my mother to come babysit during the appointment to ensure that the next course of action got taken.


I'm not shy to speak up, as most people know. I don't just sit back meekly, and this is how I was treated, or shall we say UNtreated. So, if this is the case, how many people are out there that can't get their medical problems to a point, especially if they're putting 100% faith in their care giver, and they're just sitting back passively?


I shouldn't need a babysitter. My mom has had problems with a doctor treating my grandfather, and this was way BEFORE the national Obama care was put in force, so no, these are NOT new problems.


The medical system is VERY fragmented. I've also heard from clients and more, about how just to get necessary home care supplies, that they have to go through hoops just to get them. There's the state medicaid. Federal medicare, if you qualify. Then there's the county social worker, then the local Human Services, and if you have a home care agency, you have a nurse and possibly a social worker through there. The way I see it? There is 1 Indian (the patient) and about 10 chiefs who don't necessarily communicate to each other in the process. The primary ought to be the one out there ensuring that all is taken care of all the way, he should be the head chief, and the other staff should be sub-chiefs underneath, all cooperating to take care of the Indian.


Here are possible solutions, such as going to a free market program, to which our current system is NOT. There are business men and attorneys making the rules at the top of the insurance and health care clinics & hospitals. Thing is, if I want business or financial advice, I'll seek the business man. If I need legal advice, I'll seek an attorney. When I need medical advice, please leave that to my doctor.


I could go on, but I think most of you get the picture. Leave a comment, and civility or stay out.


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