Ahhhh…the day before Thanksgiving which brings out the amateur drinker in all of use more than New Years Eve. The night that family, former classmates, and friends are all in town with essentially no where important to be the next day. I said essentially, I know that family gathering around the television set watching the Lions, Cowboys, and Broncos run up and down the field makes up for quality family time on Thanksgiving. That being said, I'd like to make a few observations I made while out taking the two youngest ones to the doctors.
We have been discussing health care for a long time now with the goal to improve care, lowering costs, and making it affordable for all to purchase. Some have even stated that it ought to be a mandate for all to carry it like we are required to have car insurance if we choose to drive a car. Well, my appointment – more accurately the boys' appointment – today was slotted for 11 a.m. Now, my second oldest boy did get his flu shot in a relatively timely manner but the well child check up for the youngest labored on. I understand that things come up and physicians come across peculiar and challenging diagnosis. At the same time when a physician is late in arriving to your room they cannot devolve the complete tardiness because HIPPA will reign down on them. All fine and good except when I have to wait, or anyone for that matter, for an hour to go by before my physician enters the room. In the end, I was there with a 3 and 5 year old in a sterile 4'x6' room with no windows or distractions waiting for an hour to have my youngest examined for 20 minutes.
Imagine the number of patients that could have been seen and the amount of wasted billable hours I took up for a well child appointment that lasted 20 minutes when it was all said and done. Perhaps reform needs to be done at this level before we move onto a single payer system. Next my travels took me to the local grocery mart where the annual bells were ringing of the Salvation Army crew. Every year I explain to the children why it is the men and women stand out in the frigid Minnesota winter ringing those bells at the entrance and exits of the grocery mart. Funning thing this time is the gentlemen ringing the bell was multi-tasking. Not the type of multi-tasking I'd expect – ringing the bell, saying "Hi" to the kids, and thanking the donors – instead this fine gentleman was ringing his bell while talking on the cell phone. I heard on CBS one night that some Salvation Army buckets will be set up with electronic card readers so people can donate via credit or debit card. So, unless this gentleman was taking donations from the cell phone, I am missing the point of him having the conversation on the phone while ringing the bell. At least when I left the grocery mart the other gentlemen, from the other Salvation Army bucket, was inside the mart using the pay phone; I assumed he was on break.
After leaving the mart I proceeded to a financial institution to drop off some paperwork which prompted me to go next door for some lunch. In a thoughtful gesture of the restaurant – fast food – I noticed a table with the little handicap sticker on it. What made this table unique was one side was a bench or booth seat with the other side being two removable chairs. As I filled up my pop, I thought what a cool idea and grand gesture it was for the restaurant (fast food) to establish or reserve a table for those less fortunate to be able to use the booth. While reading my paper and eating my food, a mother with two children – probably 6 or 7 years old – entered the fine dining establishment and ordered lunch. As you may have already guessed it, they choose to use the handicap table to eat lunch at. Now, it was lunch time on a Wednesday – perhaps Friday given that Thanksgiving is tomorrow – but for the most part people ordered lunch and took it to go leaving plenty of more suitable options for the able-bodied customer.
To the mothers credit she did tell the boys to use a wet wipe prior to eating to clean their hands off with but it was her choice of table that irked me. I refrained from comment. Just thought I'd share a little of my day with my readers. And offer this up; Do people really understand?
As you probably have read, healthcare is something that I feel very strongly about. Did you know that the US currently is having primary care shortages estimated at 40,000 to 60,000 doctors? This is only going to get higher.
ReplyDeleteWhy the shortage?
Primarily because primary care isn't worth it to most people entering medical school. Insurers routinely reimburse those patients 80-85% of the true cost of the care from clinics, and thats even with "Cadillac plans". When a brand new intern graduates medical school, they can expect a debt level of around $140,000. So, you can expect that doctors will want to be heavily compensated for their care. The trouble is, they are not. Medicare has been mentioned on this blog as a sore spot, but it can't set its reimbursement rate without congressional approval. To insurers, there just isn't any profit in primary care. If congress is to set its rate to primary care any higher, it will have to lower them for specialty care, and now who's angry.
This is one of the serious problems of the far-reaching bill in congress. There is no real built-in incentives to keep doctors in the practice of primary care. However, regulating the insurance companies like the republicans advocate might be worse because they might take their losses out on the physician reimbursements.
I agree that primary caregivers are in short supply and it will only become worse the closer we come to a single payer system. You are correct that the pay scale for primary caregivers is not on pace with those that specialize then again they shouldn't be since not everyone can specialize.
ReplyDeleteShould your elementary school teacher be paid the same as the High School or University teacher that teaches math? The reimbursement rates for the primary caregivers will only get worse since the goal is to standardize reimbursement rates at Medicare rates.
As I outlined on several occassions, we can obtain sustained and quantifiable reform by starting with my 8 point plan without a 2,000 plus page bill. Plus, the implementation of the 8-point plan will not cost taxpayers money nor will it add to the deficit as the two current bills will do.
I have three comments/observations the first one is about Chris' question about do people really understand? I assume that is a retorical question since I know, from reading your blogs, that you know as well as anyone with half a brain that people really don't understand..they don't understand anything outside of their little liberal bubbles. Another thing, about reimbursment, why does a person choose to practice medicine? Is it because they are really interested in helping people or in whatever field they go into or is it all about the money. If a person becomes a social worker or or teacher or own a store why do they choose that field? Could it be more about the money than what satisifies their need to fufill their souls and still put food on the table? Another thing is all about this H1N1 scare. OK, so most employers put in a plan of action, following the recommendations from the CDC, about what to do if you displayed symptoms of the flu. One of the mandates at most places was that you had a note from the Dr. that you were healthy enough to return to work. Does this make sense? We now have a whole sector of society creating a bill at a Dr. office to get a note saying you were healthy! Back to Chris' original question...do people really understand?
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