Health Insurance Hostage
I recently posted the following on my personal and author facebook pages:
HEALTH INSURANCE HOSTAGE
Cut and paste or share if your or your spouse’s primary reason for staying in your current job is because of the health insurance coverage your company provides. Healthcare should not depend on where you work.
The resulting discussion prompted me to post this blog article.
If people could have the jobs and careers they want without having to worry about losing healthcare coverage, then the jobs so many are miserable doing now would be open to others who may actually appreciate and even enjoy the work. When I think of all the jobs that would become available if healthcare weren't connected to them, and all the new local businesses and social entrepreneurship that would no longer be inhibited as a result, I get nauseated. Seriously.
The entire American healthcare setup is irrational and rigged, if not just plain crazy.
I am pretty sure my 7YO got a hairline fracture in his thumb last weekend, but I wasn’t going to keep him out of school so I could wait in a doctor’s office for the privilege of paying $30 of the ~$200 (more if X-rays were involved) that would be charged to my Health Insurance Company for the doctor to confirm (or deny) my fears and attach a splint that I could just as easily have done myself at home. Not only did I not want to waste my own money, I didn't want to waste my insurance company's money and facilitate the increases in insurance premiums and deductibles that everyone is facing. Meanwhile, most doctors we’ve seen over the years are quick to tell us no concern is too small for an appointment, as if rising costs were of no concern (which, of course, they aren't for the medical practices that benefit from them). Meanwhile, many of my friends’ health insurance plans cover what appear to be nonessential massages, acupuncture, chiropractic and other generally ‘elective’ procedures.
I grew up with horses, and we didn’t call the vet until we’d tried all the common-sense solutions, ourselves; our vet preferred it this way. This is how it should be with health care. We should at least have the option of paying an advice nurse or physician’s assistant or appropriately trained medical practitioner $1/minute (total, not copay) to diagnose and even perform common treatments for colds/flu, warts, sprains, hairline fractures, etc.
My insurance company once paid an urgent care center over $200 ($80 copay from us) for a medical doctor to run water over a puncture wound in my son's foot after he stepped on a nail (turns out his tetanus was up to date). We faced similar charges for a medical doctor at a different urgent care center ($80 copay) to tie up a wound on my son's head using his own hair and some glue that I later discovered is used in veterinary medicine and easily purchased online.
And then there's the ridiculous cost of having a social conscience: for instance, actually getting the lab work that should be required before treatment with ever-resistant antibiotics.
While on vacation a few summers ago, both my brother and I came down with a horrible stomach bug. He went to his doctor, paid his $30 co-pay, and, on his way home, picked up his prescription for metronidazole, an antibiotic and antiprotozoal medication that treats giardia among other microbial human parasites. As is common practice these days, my brother’s doctor opted for the pharmacological shotgun approach, deciding not to obtain the tests required to determine whether or not my brother’s body actually carried the microorganisms targeted by this medication.
Likely because my physician worked for the UNC Family Medical Center (part of the Medical System at the University of North Carolina), and despite the fact that we now knew that metronidazole eliminated my brother’s identical symptoms, my doctor encouraged me, in good faith, to provide a stool sample for laboratory testing before facilitating antibiotic resistance by taking a medication that may not be applicable. Despite my severe symptoms (I was worried about driving myself to the doctor that morning) and the distasteful experience of providing a stool sample on demand (particularly under the circumstances), I agreed with my doctor's reasoning (I watch Frontline: http://www.pbs.org/wgbh/frontline/film/trouble-with-antibiotics/) and abided by it.
After two painful days, my lab results came back positive for giardia, as expected, and I received a prescription for metronidazole as well. I was glad that I could confirm the diagnosis for my brother, particularly because it prompted him to have his well tested (it was negative). But I was not at all happy when I received the ~$300 bill for the lab testing, particularly given that we had switched to a high-deductible insurance plan. I had no idea it was so costly to do this right thing. Sadly, were I to go through it again, I would demand the medication and forgo the lab tests, like most other Americans, thereby adding to the hundreds of millions of drops in the bucket that is antibiotic resistance.
We need consistency among medical practices across the country - as determined by medical professionals, not legislators or health insurance companies - in diagnosing and treating medical conditions displaying the same symptoms. Not only would it prevent patients from demanding (and getting) unnecessary and costly tests and treatments, it would enable doctors to make socially conscious as well as medically sound decisions without the fear of unreasonable and expensive lawsuits. Ethically sound medical liability insurance companies should welcome a change like this, shouldn't they?
On a broader scale and whatever the short-term cost, the US health system needs medically trained professionals to perform an extensive *independent* audit and provide a comprehensive proposal for substantive changes or, better, a complete overhaul that is presented transparently to Congress and the American Public in real time. Our legislators are not knowledgeable or experienced enough in medicine and health care to do this themselves, yet the President continues to demand that they do so, inevitably involving health insurance and healthcare companies with clear conflicts of interest in the process.
Like so many Americans, I am heartsick over this situation on a daily basis. I can’t imagine my stress and heartache if my or my loved one’s life literally depended on it.
Please communicate to your legislators (right now) your experiences and any policy considerations that have crossed your mind as a result. If they don't listen, then please contact your local Press. There is power in numbers. It's the least (and maybe the most) we can do.
