I'm Not Buying This

The uninsured . . . universal health care . . . can't pay for health care . . .

Sometimes the noise is deafening. Of course most of the time the complaints are without merit.

Here is one of those. The New York Times published a report on overcrowding in ER's due to (at least in part) the number of uninsured.

One emergency room doctor in Iowa, Dr. Thomas E. Benzoni, said he recently saw a mother come in with her two children for what he thought was routine care. When he asked her why she had not gone to her family doctor, she said she did not have health insurance.

You don't need health insurance to go to a doc for routine care. This is tantamount to saying you can't get your oil changed in your car because you don't have auto insurance.

“I don’t know what else she was supposed to do,” Dr. Benzoni said.

Here's a thought. Why not pay for the office visit out of pocket?

Certainly much less expensive than paying ER charges for a routine visit. That can turn a $100 office visit into a $500 trip.

Until hospital ER's do a better job of triage, and turning away those who do not truly need emergency care, this problem will only get worse.

It is like the folks who call 911 to get the phone number for Domino's Pizza.

Time to stop coddling these folks and force them to grow up.

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Cancer Closes In

It always amazes me when talking with a prospective client and they tell me they don't really need Rx coverage since they don't take any medication.

Or they say they just need something for doctor visits since the don't plan on getting sick.

My response is always, "Go through an emergency room and ask for a show of hands on how many had PLANNED on being there 24 hours ago."

I figure if they can be flip so can I.

The problem is, none of us ever PLAN on having an accident. Otherwise, it wouldn't be called an accident, would it?

And no one PLANS on getting sick . . . especially something like cancer.

Heart disease is still the number one killer, but not for long.

Cancer is closing in.

Globally, an estimated 12.4 million people will be diagnosed with some form of cancer this year and 7.6 million people will die, the U.N. World Health Organization's International Agency for Research on Cancer said in a report.

It is worth noting that is a GLOBAL estimate, not U.S.

U.S. stats may be different, especially the death ratio.

Trends that will contribute to rising cancer cases and deaths include the aging of populations in many countries -- cancer is more common in the elderly -- and increasing rates of cigarette smoking in poor countries.

Apparently those Surgeon General warnings don't appear on cigs sold in poor countries . . .

However, cigarette companies are finding new customers in developing countries. Seffrin noted that 40 percent of the world's smokers live in just two nations -- China and India.

So the Marlboro man is now speaking Mandarin, I suppose.

Decades ago, cancer was considered largely a problem of Westernized, rich, industrialized countries. But much of the global burden now rests in poor and medium-income countries.

Many of these countries have limited health budgets and high rates of communicable diseases, while cancer treatment facilities are out of reach for many people and life-saving treatments are seldom available, Boyle said.

So other countries, like maybe places with universal health care, might not have as many options for cancer patients.

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More Questions than Answers

What would you do if you found out that your physician was prescribing placebos for your acute medical condition? That's far from a rhetorical question:

"(A) new survey finds that many U.S. doctors regularly prescribe placebos even in everyday patient care ... Patients are almost never aware that they are getting a placebo."

My first question is: who's paying for them? If the carrier's being billed, wouldn't the EOB (Explanation of Benefits) give away the game? And if it's not being submitted, then the patient's paying out of pocket for the fake; but are they being charged for the "real McCoy?"

And if this is supposed to be for treatment, how's it being coded? Again, wouldn't the EOB give some indication of what was going on?

And if the treatment consists of a series of placebos (or even some placebos and some med's), how is the provider being reimbursed? Aren't there some ethical considerations in what's being charged for what is essentially a phony treatment? Or has "First, do no harm" devolved into "Don't ask, don't tell?"

[Hat Tip: Holly Robinson]

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Flip Flop

Twenty years ago the primary health related concern was how to treat AIDS.

68 percent of the respondents said AIDS was the nation's biggest health woe while 1 percent cited the cost.

Today the worry is about the overall cost of health care.

Concerns about the access and cost of health care far outweigh the worrisome challenges posed by obesity, cancer, heart disease, AIDS and diabetes,

55 percent - said the availability and financial challenges of the entire system

One positive about this survey . . . those polled indicated a worry about the cost of health care, vs. the cost of health insurance.

The two are related, as the cost of health care drives the cost of health insurance.

But this observation caught my eye.

"Health care has never saved a single life. That's more of a theological question. What health care is supposed to do is delay death, overcome disability and pain, and provide medical security

I'm not sure I buy that initial statement . . . health care has never saved a life.

I suppose you can argue the back part of the statement supports the first part. If you save a life it does not mean the individual will never die, so it is true that health care just delays death.

Still, it is a convoluted statement.

In 2007, total national health care expenditures topped $2.3 trillion, or 16 percent of the gross domestic product

But don't overlook this.

providers also suffer; some $60 billion a year in medical bills goes unpaid,

That figure is understated.

The unpaid bills don't include cost shifting. Most bills that are not paid by the patient or a third party are simply added on to the bills of those who DO pay for their care. The rest result in a loss to the provider.

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Grand Rounds: Presidential Q&A Edition

Alvaro Fernandez hosts this week's round-up of the best medposts at the SharpBrains blog. In a fascinating and creative twist, he presents his 'Rounds as a Question and Answer session with our President-Elect.

Very cool!

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Collateral Damage

[Welcome Tenant Manager Online readers!]

Home foreclosures.

Job loss.

Bank failures.

Health care providers are feeling the squeeze like many others.

Georgia hospitals, doctors and other medical providers are reporting financial pain from an increase in patients who can’t pay bills —- or who postpone care.

That trend stems, in part, from the rise in Georgia’s unemployment rate, which has swelled the ranks of those without health insurance. In addition, many Americans who have insurance face higher deductibles and other out-of-pocket costs, making a medical bill harder to pay.

I understand, but I also have a problem when health insurance is tied to your job.

If money is tight, I understand raising deductibles (which is something that should be done even if money isn't tight). I have difficulty with those who can afford health insurance but simply refuse to buy it. There are people who believe it is the responsibility of their employer to provide health insurance. If they don't have a job with insurance, they don't feel a compulsion to pay for it themselves.

That makes no sense to me.

The recession also has caused more people to cut back on elective surgeries, scheduled procedures and appointments, and prescription drugs, according to surveys and medical professionals.

Again, some of this makes sense, some not.

I can understand postponing elective procedures.

What I don't understand is cutting back on necessary meds.

People will sometimes cut back or eliminate BP or cholesterol meds. They claim they don't feel any different when they skip the meds so they feel there is nothing wrong with skipping the med.

Why not look for a lower price med rather than stopping meds altogether?

Dr. Harry Strothers, a family physician in East Point, said many patients with chronic diseases are canceling appointments or not showing up. He cited a woman who had an abnormal mammogram.

“She has put off seeing a surgeon because she has a 20 percent co-pay to pay,” Strothers said. “She doesn’t have the money.”

Delaying necessary services can cause more problems later, Strothers said, adding that patients are also not filling prescriptions.

“Going without a medication for hypertension, diabetes or high cholesterol will take its toll later,” Strothers said.

Some things are not worth scrimping on.

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