Docsplainin' -- it's what I do

Docsplainin'--it's what I do.
After all, I'm a doc, aren't I?

Saturday, September 12, 2009

9/11 still killing

I get my news on the internet these days, and as I was browsing blogs with my morning coffee in my hand today, I found this. "This" is an epic Fail on the part of this entire country to appropriately care for 9/11's first responders and the residents and workers in the immediate neighborhood.

But as if "this" wasn't bad enough, I looked up the law proposed to remedy it, and that was worse. "That" includes Congressional findings on the aftermath of 9/11. A few high points:
  • On average, a New York City firefighter who responded has lost 12 years of lung function.
  • Nearby buildings are, as far as anyone knows, still contaminated with "caustic" dust, to which workers and children are still being exposed daily
  • All told, a half million people were exposed
  • Nearly a third of the firefighters were still sick five years later, and 65% of them are scraping by on less than $15,000 a year because they can't work.
  • Many lost their health insurance, Workers Comp has been jerking them around, and a lot of folk are going broke paying for their own care--or going without and dying.
And guess what? There's a lot of posttraumatic stress! Well, duh.

Go read the bill, please. And if it shocks you like it does me, contact your legislators and ask 'em to vote for it.

For my part, I will treat--absolutely free of charge--one person who can demonstrate to my satisfaction (a) that hir psychological problems stem from their presence at or near the Twin Towers on 9/11, and (b) that s/he does not have the financial resources &/or insurance to afford treatment on hir own. I'm on Main Street in Woodstock, GA.

Call me: 770-924-1818, extension 307.

It's the least I can do.

Thursday, September 10, 2009

A few facts

This will break your heart:

22,000 people between the ages of 25-64 die every year due to poor health care provision/ lack of health care.

Between the time Mr. Wilson yelled, "You lie!" and the time you and I go to bed tonight, 60 people will have died for lack of care. Could be my son, or your grandmother.

For some more statistics along these lines, visit Prof Susurro's blog.

Silly Season

I wish that the President could simply have declared that the Silly Season was over, as of last night.


At the first commercial break, however, some PAC or other ran an ad with a woman actress telling how Canadian health care denied her life-saving treatment, and she had to come to the US for top-of-the-line care. It ended with a tag-line to the effect that no government should come between us and our doctors.

There are three lies in this:

#1. We are not replicating the Canadian system, thank you very much. The public option as currently proposed is not government-run healthcare, but a single-payer model.

This would, by the way, save a metric shit-ton of money. Unless you are in health care yourself, you have no idea how much time and money we fritter away verifying benefits for a dozen of different insurance plans every day, applying for pre-authorizations, recording pre-auths in the billing software, getting re-authorizations every few weeks, billing, re-billing, going to different websites to bill different payors, printing hard copies of all these transactions, paying for electronic billing services' monthly charges plus transaction fees, tracking payments, filing appeals, entering different insurance company discounts in each policy-holder's books, applying to be on panels, renewing memberships on panels, submitting to audits by insurance companies of our books and clinical charts, billing patients for the portion insurance does not cover, and explaining patients' benefits (or lack thereof) to them. We spend on staff, training, computers, printers, storage systems, phones, software, paper, postage, and space (a portion of our overhead expenses such as rent, utilities, tenant's insurance) for this work in addition to the time away from patients and continuing education. And after all that, we write off thousands of dollars in uncollectible fees when it turns out that the insurance companies won't pay for what their policies and pre-auths indicated that they would and the patients don't have the resources.

But I digress.

#2. We do not have the best care in the world, as the ad claims. We spend more than other industrialized countries, for some of the worst results in the Western world. Higher infant mortality rates, for example, than anybody in Western Europe--or Canada, for that matter.

#3. The current system does not give you and your doctor complete control of medical decisions, people. Ask anybody who's ever been denied coverage by their private-pay, nonsocialist, for-profit insurance company for the medication their doctor prescribed, or a treatment their doctor recommended. Ask anybody whose private-pay, nonsocialist, for-profit insurance company dithered about pre-authorization until a critical treatment window was missed. Ask anybody who's gone bankrupt paying for their own treatment because their wonderful nonsocialist, private-pay, for-profit insurance company refused.

Heck, some of you have never even met your primary care physician. Our current system is so expensive to the practitioner and pays so poorly that they all use so-called "physician extenders" now. You see a nurse-practitioner or a physician's assistant. Not that there's anything wrong with them, but let's don't pretend we have direct relationships with our physicians under the current system, ok?

And the ad conveniently forgets that up until Congress made it illegal, it was our citizens organizing bus trips over the border to Canada to get affordable medications. It also conveniently overlooks the recent 'health tourism' trend, in which U.S. citizens go abroad for affordable surgeries.

No, I'm afraid the silly season is far from over.