In light of all the political garbage recently purporting to save American healthcare, I propose that we have the power to save ourselves. Being only partially employed while I go to school, I have no employer backed health insurance, and even when I did, the insurance was still expensive and left a lot to be desired. It started me thinking.
Health insurance should be like other types of insurance, it only covers the disasters. Does your car insurance cover oil changes and windshield wiper fluid? Would you want to pay a higher premium to cover those types of expenses? I would think not. Does your homeowner’s insurance pay for cleaning supplies and new lightbulbs? Of course not. So why do we expect health insurance to cover the little dribs and drabs of regular healthcare?
I have bought insurance through one of the major companies with a $1000 copay, and coverage for hospitalization, and emergency room care that involves a procedure like splinting or admission to the hospital. It costs me about $133 dollars a month, though I am sure that is going to go up when the health care “reform” starts to take effect. I did however, have similar coverage before with another company and when they raised the rate to $180 per month, I switched. Granted, I have no major health problems, even at my age of fifty+. However, I do take care of my health, I don’t smoke, try to maintain my weight at a reasonable amount, and don’t use any chemical substances as happiness substitutes (Alcohol included. My consumption of a glass of wine at a holiday dinner constitutes my drinking).
So, people I talk to say, “Oh my goodness, how terrible, you don’t have access to regular healthcare!”. What CRAP that is! Of course I do. It’s called patient managed healthcare, or PMH. This is how it works.
I wake up one morning and I have a pain in my right side, bad pain. It doesn’t go away for a couple of days. Okay, this needs to be taken care of. I call my family doctor’s office. Note: I did NOT go to the emergency room. Emergency rooms are for emergencies, like gushing arterial bleeding, heart attacks, strokes, knife sticking out of your back. Stuff like that. Not diarrhea, the flu, a pimple on your butt, a cut on your finger, or a headache. Getting back to the story. I call my family doctor’s office, make an appointment for later in the day.
Some people will say, I don’t have a family doctor, or my doctor would never get me in the same day. This is where the PMH comes in. Several years ago, when I first moved here, I asked around for a recommended MD in the area. I went to the one suggested, tried him for a while, didn’t like him, fired him. Next, I asked nurses where I worked for a recommended doctor. (Nurses are the best ones to ask…) A couple of names came up. I called the offices of those doctors and asked to interview the doctor before I signed on with them, one refused, the other agreed. This doctor let me come in that day over his lunch break to talk. Definitely a good sign..we talked for quite a while, negotiated our health care agreement and Bingo, I had a family doctor. The negotiations included the fact that I am a bit stubborn, like to do things a certain way (as few drugs as possible for example, and I like vitamins, etc.) and am not the type to blindly follow directions. He, bless his heart, was good with that and agreed to discuss options with me for every problem, and let me do it my way if it was within his parameters of feasible care, and we would switch to his way if mine didn’t work. I LOVE this doctor. Over the years, I have stopped arguing with him and I trust him now completely. I pay him a reasonable fee for a visit depending on the length of the visit, usually around $50-60. He also has open scheduling so that there is always an opening if I am ill and need to be seen that day. All good.
So, I go to my appointment, he listens to my presenting complaint and history of current illness. A physical exam follows. The differential diagnosis includes the possibility of a kidney stone. The normal route for a kidney stone is a urinalysis, a CBC and a CT scan. The urinalysis is done in the office. The CBC is important since it will tell us if there is an infection somewhere, so that is a must.
The CT scan is expensive, but in the negotiation, we decide the CT can wait, the CBC can’t. The urinalysis did not show blood, which decreased the chance of the kidney stone, but does not rule it out. I went to the lab across the way and got the CBC, it cost me $23.85. I went home with a strainer and some samples of a med to help the ureters relax to help pass the stone. If the stone didn’t pass, or the pain got worse, then we would have to do the CT scan.
Luckily, the pain passed, and if the stone did, it was very small and I didn’t catch it. The total cost for this illness, including the lab, was around $125. If it had been done the usual way, it would have been thousands in ER costs, CTs, etc. Since I was in charge of it all in partnership with my own physician who knows me, the cost was minimal.
The bottom line: each individual should have a HSA where they put, say, 1-2% of their income from day one, have insurance only for catastrophies, and have a family physician or family nurse practitioner that they have a good working relationship with, and a sense of responsibility for their own health and health care. The price of medical care would drop like a stone. If labs, hospitals and imaging places knew everyone was shopping around and paying CASH, good old capitalism and market influences would do their magic. The other bonus is the large reduction in costs for the physicians, with the massive reduction in paperwork.
Oh, and get the fricken lawyers out of healthcare: TORT REFORM. Please! I know that this isn’t the total answer, but it would be a starting point. Some other people are getting the same idea though, see http://www.faircaremd.com/about_us http://www.patmosemergiclinic.com/
There just has to be a better answer than the monstrosity the government is trying to foist on us. My mother just moved back to Europe, the model of socialized medicine we are supposed to emulate, and told me she could not get her colonoscopy or other screening tests there because “they don’t do those screenings for people over 70 years old. They save that kind of stuff for the younger people, because there isn’t enough money.” My mom is over 70, what happens if she gets sick? I shudder to think.