June 18, 2012On the “Opinion” page of today’s Daily Herald Newspaper, Froma Harrop’s article, ‘Modern’ America needs health plan” starts off on a course I think we can all agree upon. Harrop states we need to drop the liberal, conservative, Democrat, or Republican labels and seek a modern America. I also agree with her statement, “what we have now is a top-down corporate control of health care.” As I read on, I thought this writer really had her act together. Harrop continued, “Insurers, drug makers, sellers of expensive equipment, hospital executives, labs and others unnamed prosper by exploiting the chaos in our health care system.” Now, we are getting to the meat of the problem. Yes, corporate America digests a large amount of health care dollars long before they reach the patient care arena. Unfortunately, it was at this point that Harrop took a wrong turn. Instead of continuing her attack on corporate greed and going after the huge profits the insurance companies siphon from the pool of health care bucks, Harrop goes on the attack about perceived medical waste.She states, “They get payers (be they private or government) to purchase $50 drugs when $10 drugs are just as effective.” I don’t know what century Harrop lives in but I can guarantee you that, if I can effectively use $10 drug, I’m going to use it. In a world of prior authorization, insurance controlled drug benefits, my staff and I have to jump through hoops to get my patient a $50 drug even when the $10 drug failed.“They make money if the patient has to be admitted to the hospital,” according to Harrop. Again, Harrop lives in a different world than my patients and I. Reimbursement for hospital stays are dismal. If that wasn’t bad enough, Medicare is starting to penalize hospitals and docs for readmissions to the hospital within 30 days of a discharge.Next, Harrop attacks surgeons who “push” unnecessary surgery. The surgeons I know are so afraid of malpractice litigation that they spend half their time dissuading patients from having surgery and the other half telling them all the really bad things that can happen during surgery.Finally, Harrop goes after “unnecessary” CT scans and the exposure to radiation they promote. She states, “They casually order CT scans without much thought to the expense or the patient’s exposure to radiation.” What a pile of +*&%! Ordering a CT or a MRI scan can be a very painful and expensive experience. Last week, I treated a patient with a severe, persistent, and threatening headache. I ordered a CT and my staff set about the process of getting the test “prior authorized.” After 15 minutes of inputting data into the insurer’s computerized prior authorization program, we were instructed to call an 800 number.“This is XYZ’s physician line. Press 1 if you are calling to check on a claim, press 2 if you just want to waste your time, press 3 if you want to waste your boss’s time, press 4 for prior authorizations of cardiac testing, press 5 for prior authorization of nuclear testing.” There is no button for “human.”To make a long and miserable story short, we responded to each question and then we were placed on hold. In 30 seconds, the entire process started over again. Yes, we were in computer hell (an eternal loop). I have been in practice for 30 years and can truthfully say I never “causally” ordered anything. Harrop dreams for a medical world ruled by the government. It’s called Medicare and it’s not the gift Harrop is wistfully hoping for. Medicare is fraught with red tape, a rule book no one could possibly understand, and the promise of more regulations to come. Oh yes, Medicare is broke.Universal health care will be autocratic. As a doctor, I will deliver the care the Universal Ruler mandates and you will receive what you are given by the system. Yes, you and I will be part of a herd and treated accordingly, and I thought this great country was born and thrived on individual rights. Stupid me!
Warning, do not “casually” give in to the Harrop’s of this world. You may never be able to get back what you lose. One more thing; get healthy now!