Rationed Care is in the Recovery Bill

[Terry Allen Blackburn]

I have no qualms with the need to have an electronic medical record that is universal and accessible wherever I go. I just don't want to see it used to deny us care, insurance of any kind, or, possible disability if the need arises. The most important aspect of good medical care is still the relationship between doctor and patient but, the need for a record that helps eliminate human error is paramount. The other thing that this helps in is in becoming more efficient.

My therapists spend more time with their paperwork than in meeting clients. This is all for the purposes of satisfying Medicaid which is my lowest form of reimbursement to begin with and, the one that stands the biggest chance of landing me in prison for fraud, waste, and abuse. We routinely get audited, and have money retracted for the human errors that can occur with seeing way too many patients. If a therapist forgets to put in a time-out on the session, the entire session amount is retracted. This is why most clinics in the area do not accept any new Medicaid patients. They cannot afford to do this kind of medical practice with the most intensive documentation requirements and the lowest form of reimbursement.

I agree with Justin; this is not as bad as it appears. It is amazing how many patients die because of medication errors or other human factors. A universal record, that has the ready information about a patient, will help this substantially. It does need to be secure enough so that insurers cannot cherry pick their insured. There is a lot of potential for good and abuse with the universal electronic record. I am hoping that the medical ethics committees will sit down and hammer out these details so that this information is on a need to know basis. Unfortunately, insurers get access to this information, and use it to deny coverage on an on-going basis.

I also agree that we need to be more responsible for our own health.

Whether you believe that addiction is a disease or a choice is not as important as the ramifications of the unwillingness of insurers to fund the treatment for the condition. Addiction can be seen as a true brain disease due to the following factors:

The brain produces chemicals in the forms of neurotransmitters that elevate or decrease the production of differing brain chemicals called neurotransmitters. When you add drugs in to the mix, they over or under stimulate the production of these chemicals, setting up a chain reaction to literally hijack the brain. The one inescapable piece of personal responsibility, pops in to the picture, when you realize that all people take their first drink/drug of their own volition. This is unlike other psychiatric conditions such as schizophrenia, bi-polar, depression, etc., where the person is born with the condition. This issue of a person's volition has enabled insurers to deny addiction treatment for many years which has forced the taxpayer to become the biggest funding source of addiction treatment.

Now, imagine if you will, the universal application of this principle. "I'm sorry Mr. Smith but, we cannot pay for your heart disease, as you've had a pattern of eating in an unhealthy fashion for years, in spite of the public knowledge, that eating proper food will prevent the condition you have. Also, you have avoided exercise, as evidenced by your being well over your ideal body weight." This scenario could be applied to Type II Diabetes, Adult Hypertension, Asthma, or any other disease which has a behavioral component. If you are going to apply this to one disease with behavioral implications it should be universally applied. People wouldn't stand for it so it is easy to do this with a disenfranchised population to begin with.

But, in spite of the potential financial implications, we are all ultimately responsible for our own health. If everyone took care of some lifestyle choices we could save billions of dollars annually in health care.

Now, enough of my pulpit. Go eat a cheeseburger.

Terry Newton

[Justin]

Interesting video about author of the Bloomberg piece...

Clarity to healthcare concerns

[sahuaro]

Wow! Thanks, Justin for posting the MSN piece.

I do think that you are right, though, about these possibilities appearing in future proposed legislation.

I have already encountered what happens when "treatment" becomes a computerized program, in dealing with a HMO in which I had to tell the technician on the other end of the phone to get his head out of the computer and listen to what I was telling him about the patient! After a major letter campaign, including contacting the head of the major organization that was the patient's employer, I was able to obtain the care for the patient that truly was appropriate--and I still resigned from the provider panel. My fear is that we will have fewer opportunities to protest if this happens with nationalized health care.

[Justin]

Sahuaro,

No problem! This topic is very interesting to me and I've been trying to keep up-to-date and read everything I can regarding this. I'm trying to stay optimistic, as insurance companies now dictate patient care and patients pretty much have to mortgage their houses to afford healthcare in the US. If you find any other good articles, please continue to post them here.

I hope you are well.

Originally Posted by sahuaro

Wow! Thanks, Justin for posting the MSN piece.

I do think that you are right, though, about these possibilities appearing in future proposed legislation.

I have already encountered what happens when "treatment" becomes a computerized program, in dealing with a HMO in which I had to tell the technician on the other end of the phone to get his head out of the computer and listen to what I was telling him about the patient! After a major letter campaign, including contacting the head of the major organization that was the patient's employer, I was able to obtain the care for the patient that truly was appropriate--and I still resigned from the provider panel. My fear is that we will have fewer opportunities to protest if this happens with nationalized health care.

[sahuaro]

Looks like the preliminary steps were in fact included in the bill:

http://www.nytimes.com/2009/02/16/he...gewanted=print