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The Medical System
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Jan 14, 2022 08:42:27   #
jerryc41 Loc: Catskill Mts of NY
 
Our medical system is not getting better. While my son was at work, he got a cryptic email from CVS saying that they couldn't contact his doctor to get a Rx refilled. This happens every time a Rx has to be renewed. I can always get through, so why can't they? I called my doctor, and I got a recording saying that because they were overwhelmed by Covid, I had to go to the "Patient Portal" to renew the Rx. I'm signed up on the portal, but my son isn't, and I saw no way to sign him up. I can't visit the office in person because I must have an appointment, and I have to phone them when I get there so they will let me in. I wrote a letter to the doctor, and I'll mail it when I go out. Is this progress?

My doctor's office joined a large group - Health Quest - after the founding doctor retired. Then that group joined a larger group - Nuvance. Now it's Nuvance Health Quest, which includes hundreds of practitioners and several hospitals. Besides that, the local hospital has also joined a group, and it's now Health Alliance. Health Quest, Health Alliance - life used to be simpler - and easier.

I watch an English doctor report on Covid every day. The US is leading the world in hospitalizations - way more than any other country. He said this is partly because so many Americans have other health problems, like obesity, and our healthcare system is so costly that it leaves many people on the verge of needing hospitalization, anyway. Getting Covid, even the milder omicron, pushes them over the edge, and they must be hospitalized.

A couple of years ago, I cut my thumb. After having it washed and bandaged at the ER, I received a bill for $3,897. Fortunately, my co-pay was only $75.

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Jan 14, 2022 09:12:49   #
David Martin Loc: Cary, NC
 
Pharmacies generally don't call doctors offices any more. They request refills electronically. There are a number of steps along the way, including the pharmacy's software interacting with intermediary software, which then in turn interacts with the doctor's office software. Failure is common.

The era of doctor-owned independent practices is largely over. Groups are bought out by larger groups. Hospitals form groups that are bought out by larger groups.
Unknown to the public, the owners of many of these mega-groups are actually investment firms, and they run doctors' practices and hospitals in such a way as to maximize profits, even if that means running them into the ground. Quality healthcare is not necessarily on their list of priorities.

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Jan 14, 2022 09:20:50   #
Longshadow Loc: Audubon, PA, United States
 
I've had that happen with CVS for once or twice. Maybe they didn't receive a response in a "timely fashion" and wanted to warm .
I waited a day or two, it went through. One time I called the Doctor's office, they faxed a renewal. They didn't provide an excuse, I didn't ask. I just explained that CVS hadn't received the renewal response for some reason.

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Jan 14, 2022 11:42:01   #
Real Nikon Lover Loc: So Cal
 
I am in healthcare and work in one of the largest systems in the United States. It is a mess. Between Unions and Conglomerates there is a concerted effort by the globalists to implode the healthcare system to bring about socialized medicine. It is all political and the only way it will get fixed is by exposing it. USA welcome to the Canadian healthcare model. It's at our backdoor.

As for me... everyone in my family is a healthcare professional of some sort. We have for years had a pharmacy that is second generation family owned and operated. They contact our MDs directly and I am generally able to get any Rx within 24 hours. They use a combination of electronic and voice contact with the MDs. The holdup isn't usually the MD or the pharmacy...it is the damn insurance company not wanting to pay for the Rx. Its all about the money.

I have really fantastic insurance (Blue Cross PPO) for what is available today. Even with that, I still pay for a separate concierge plan with my MD. He went to that model. Yes it costs me money out of pocket ($1600 year) but I never wait to get care, I get customized care and when I go in he spends quality time talking to me about my care, laying out a plan with goals and providing tests that I wouldn't otherwise get. The concierge plan has been nice during COVID because when I go to his office I walk in and no one else is there because it is by appointment only. I am in and out and generally it is 1-1.5 hours the doctor spends with me going over me head to toe.

Sadly even in medicine...you often get what you pay for.

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Jan 14, 2022 12:11:59   #
srt101fan
 
Real Nikon Lover wrote:
I am in healthcare and work in one of the largest systems in the United States. It is a mess. Between Unions and Conglomerates there is a concerted effort by the globalists to implode the healthcare system to bring about socialized medicine. It is all political and the only way it will get fixed is by exposing it. USA welcome to the Canadian healthcare model. It's at our backdoor.

As for me... everyone in my family is a healthcare professional of some sort. We have for years had a pharmacy that is second generation family owned and operated. They contact our MDs directly and I am generally able to get any Rx within 24 hours. They use a combination of electronic and voice contact with the MDs. The holdup isn't usually the MD or the pharmacy...it is the damn insurance company not wanting to pay for the Rx. Its all about the money.

I have really fantastic insurance (Blue Cross PPO) for what is available today. Even with that, I still pay for a separate concierge plan with my MD. He went to that model. Yes it costs me money out of pocket ($1600 year) but I never wait to get care, I get customized care and when I go in he spends quality time talking to me about my care, laying out a plan with goals and providing tests that I wouldn't otherwise get. The concierge plan has been nice during COVID because when I go to his office I walk in and no one else is there because it is by appointment only. I am in and out and generally it is 1-1.5 hours the doctor spends with me going over me head to toe.

Sadly even in medicine...you often get what you pay for.
I am in healthcare and work in one of the largest ... (show quote)


I'm happy that you have good health insurance, but your post leaves me a bit confused (not hard to do!).

You seem concerned about a shift to socialized medicine. And you highlight the benefits and cost of the concierge plans. And then you bemoan the fact that in medicine you get what you pay for.

How do you suggest we handle the inequities in the health care system? Or should we just accept the status quo?

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Jan 14, 2022 12:39:45   #
Real Nikon Lover Loc: So Cal
 
srt101fan wrote:
I'm happy that you have good health insurance, but your post leaves me a bit confused (not hard to do!).

You seem concerned about a shift to socialized medicine. And you highlight the benefits and cost of the concierge plans. And then you bemoan the fact that in medicine you get what you pay for.

How do you suggest we handle the inequities in the health care system? Or should we just accept the status quo?


And what are the inequities? Come to Los Angeles! Healthcare is all free! Spend your money on healthcare or don't. It's just that simple. The US has some of the best healthcare in the world. People travel outside of the US to get healthcare and then end up regretting it. They usually do this because of the cost. I cannot tell you the number of people I have met, known or dealt with that went to "X" country and came back with a nightmare surgery, infection, secondary illness. It goes on and on.

Your right I am concerned about socialized medicine. It sucks. PERIOD. I bemoan nothing. My point is if you pay for a Toyota you will get a Toyota. If you pay for a Cadillac you will get a Cadillac. Same is true in healthcare.

Nowhere in the Constitution does it guarantee healthcare for all. It is not a right (at this point). It is a benefit often negotiated by unions for workers (LA SEIU did a great job on this) or added benefit at time of employment.

Is it morally or ethically correct for society to create health inequities? Not my decision.

I have worked over 40 years, earned and paid for everything I have. Including healthcare. Nothing was given to me. NOTHING. If I were suddenly broke and zeroed out I would do what I have always done... find a way, survive and dig out of the hole.

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Jan 14, 2022 12:50:11   #
Longshadow Loc: Audubon, PA, United States
 
Key operator: You get what you pay for.

BTW - Aren't we paying for "socialized medicine" via taxes? Not really "free" is it.

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Jan 14, 2022 12:56:59   #
TriX Loc: Raleigh, NC
 
Absolutely the US Healthcare system is broken, not from a medical standpoint, but from an economic and equity standpoint, and Covid has only made it worse.

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Jan 14, 2022 13:08:37   #
srt101fan
 
Real Nikon Lover wrote:
And what are the inequities? Come to Los Angeles! Healthcare is all free! Spend your money on healthcare or don't. It's just that simple. The US has some of the best healthcare in the world. People travel outside of the US to get healthcare and then end up regretting it. They usually do this because of the cost. I cannot tell you the number of people I have met, known or dealt with that went to "X" country and came back with a nightmare surgery, infection, secondary illness. It goes on and on.

Your right I am concerned about socialized medicine. It sucks. PERIOD. I bemoan nothing. My point is if you pay for a Toyota you will get a Toyota. If you pay for a Cadillac you will get a Cadillac. Same is true in healthcare.

Nowhere in the Constitution does it guarantee healthcare for all. It is not a right (at this point). It is a benefit often negotiated by unions for workers (LA SEIU did a great job on this) or added benefit at time of employment.

Is it morally or ethically correct for society to create health inequities? Not my decision.

I have worked over 40 years, earned and paid for everything I have. Including healthcare. Nothing was given to me. NOTHING. If I were suddenly broke and zeroed out I would do what I have always done... find a way, survive and dig out of the hole.
And what are the inequities? Come to Los Angeles!... (show quote)


Thank you for the clarification; helps me understand your point of view. By the way, my reference to your "bemoaning" was based on the word "sadly" when you said "Sadly even in medicine...you often get what you pay for."

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Jan 14, 2022 14:17:33   #
DirtFarmer Loc: Way too close to New York City
 
jerryc41 wrote:
...A couple of years ago, I cut my thumb. After having it washed and bandaged at the ER, I received a bill for $3,897. Fortunately, my co-pay was only $75.


A few years ago I cut my index finger with a chain saw. It was a light cut but there was a lot of blood.

I dumped some hydrogen peroxide over it, wrapped the finger with paper towels and held them in place with duct tape. Then I put on a glove and went back to work.

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Jan 15, 2022 05:44:04   #
John N Loc: HP14 3QF Stokenchurch, UK
 
Real Nikon Lover wrote:
Your right I am concerned about socialized medicine. It sucks. PERIOD. I bemoan nothing. My point is if you pay for a Toyota you will get a Toyota. If you pay for a Cadillac you will get a Cadillac. Same is true in healthcare.


I can't understand this hangup with 'socialised' medicine. You have no problems using the same system for Education, Waste Collection, Police, Fire etc. It's not like it's FREE as many of you believe. During my working life I paid into it every single month, as did my employer. It's not 'Socialised' it's paid for by all of us - and we all hope we don't need it - but if we do we are not going to go Bankrupt because we used it.

I'm not saying the NHS is the best, nor the French, Canadian, Australian et al. But there's a reason why no other Country (that I know of) uses a similar system to yours.

But should I want to, I can still go PRIVATE if I want - I still have to pay into the National System though, most often at a lower rate than your insurance premiums, no middleman rakeoffs here.

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Jan 15, 2022 06:46:23   #
Walkabout08
 
Many years ago I traveled to Montreal for laser treatment of my myopia. I paid out of pocket for the treatments which were done by the head of ophthalmology at McGill Un. medical school, using the latest German equipment. The cost? Less than half the price charged by US surgeons using older equipment. And I had great outcomes.
If you do the research you’ll find that in aggregate we in the US pay more for our healthcare and in aggregate have poorer outcomes than other high income countries. We have to stop believing the fantasy that the U.S. has the greatest healthcare in the world. We don’t.
My spouse is a primary care provider who’s nearing retirement. She’s been with the same office now for 35 years and her internal medicine practice has morphed from a physician owned and directed one to one that’s owned and managed by the largest healthcare conglomerate in Massachusetts. Her practice is managed by people who are bottom line directed. Her days are filled with more patients to see, with less time per patient, with less clerical help. It’s like the old TV show I Love Lucy with Lucy and Ethel on the production line at the candy maker. The patients just keep coming even though the providers can’t keep up.

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Jan 15, 2022 08:08:28   #
f8lee Loc: New Mexico
 
To anyone interested in learning just why the US health care system is so broken, I recommend the book "An American Sickness: How Healthcare Became Big Business and How You Can Take It Back An American Sickness: How Healthcare Became Big Business and How You Can Take It Back " by Elisabeth Rosenthal. As an MD herself, she points to the 5 main contributors to the problems we all face....the insurance companies, big pharma, the hospital corporations, the FDA and the AMA. Well worth a read...if only to open your eyes as to what is going on.

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Jan 15, 2022 08:11:00   #
srt101fan
 
John N wrote:
I can't understand this hangup with 'socialised' medicine. You have no problems using the same system for Education, Waste Collection, Police, Fire etc. It's not like it's FREE as many of you believe. During my working life I paid into it every single month, as did my employer. It's not 'Socialised' it's paid for by all of us - and we all hope we don't need it - but if we do we are not going to go Bankrupt because we used it.

I'm not saying the NHS is the best, nor the French, Canadian, Australian et al. But there's a reason why no other Country (that I know of) uses a similar system to yours.

But should I want to, I can still go PRIVATE if I want - I still have to pay into the National System though, most often at a lower rate than your insurance premiums, no middleman rakeoffs here.
I can't understand this hangup with 'socialised' m... (show quote)


Thank you for providing your perspective on the. UK health care system. Helpful for those of us that don't yet have cast-in-concrete opinions!

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Jan 15, 2022 08:43:21   #
sb Loc: Florida's East Coast
 
There is no question that you can get the best health care in the world in the United States - if you have the money. But our healthcare system is being so overwhelmed that it takes a long time to get non-emergency care.

When I first practiced medicine I worked in a small town on the border of Canada. Very rural - 90 minutes' drive to the nearest traffic light. The nearby Canadian residents would have to travel 110miles round-trip to see a Canadian physician (not easy in winter!) so the two of us docs in our town were asked to register with the Canadian (New Brunswick) Medicare System as providers. Half of my patients were Canadian, and half were Americans.

First: none of my Canadian patients thought they had "free" health care - many could tell me how much of their income tax went towards their health care. Not one ever complained about their Medicare system. Most expressed great appreciation that they were covered no matter what - if they changed jobs, lost their job, were unemployed for the season. Their parents were covered if they needed home care or if they needed to go into the nursing home. No one went bankrupt because of their ill health or that of a family member.

Second: Quality of Care: The most expeditious care could be had for my American patients with insurance. Referrals to medical specialists required going more than two hours to the northwest to Bangor, Maine or two hours to the northeast to St John's New Brunswick for the Canadian patients. I had no problems making referrals for my Canadian patients. The problem was that over half of my American patients had either no insurance or Medicaid. Medicaid (not Medicare) is the state-run program for poor people. It reimburses very little. Doctors will sometimes agree to see Medicaid patients as part of their charitable work in their community - this works OK unless a big part of the practice becomes Medicaid patients. (At that time I could drive 28 miles to see one of my Medicaid patients in the hospital, examine the patient, review their blood work and x-rays, write orders, and drive back to the office - and I would get paid $8.50. I spent more than that on gas.) The half of my practice that had no insurance or who were covered by Medicaid were a huge challenge to get the care they needed. I would sometimes have to pester or beg the specialists to see them. Their care was delayed unacceptably. I couldn't order tests for them that they couldn't afford - sometimes they couldn't afford the gas to get to Bangor for specialized testing or to see the specialist.

So - people argue against nationalized healthcare by pointing to long delays in getting hip replacement surgery in Canada. While that is true (too many orthopedists have left the cold north and moved to Florida where they can make more money and be warm...), I have patients who put off joint replacement for years. I have patients who cannot afford needed joint replacement in the US and go to foreign countries for it. National health systems may ration care such as hip replacement also so that they can squeeze in folks who break their hip and need emergency surgery. They have a more fair and equitable system. Everyone here worries about "the government" making decisions about their health care - but instead we allow big business to control our health care.

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