Continuing the medical topic with Pammy

Medical bills are going sky high, the insurance companies are racking up the $$$’s because they aren’t the ones who are going to be hurt in this fiasco…it’s the people.  I had EKG/blood work done for a procedure in April and because the surgeon had to go out of town and my surgery was delayed for over seven days, the tests had to be redone…yet first results turned out outstanding with no problems…it’s all about money, money, money.  I’d rather have good reliable health care but the doctor’s have to cover their collective keisters by ordering all the tests in case some tort lawyer says they didn’t use a big enough bandaid.  I think though that we are going to long for these days of the health care like it is now instead of what’s coming down the pike…i.e., no health care at all after age 50ish or if you have pre-exsisting. 

Heck, I just picked up a medication that my physician prescribed for me for a slight kidney infection that was giving me a back ache: good grief – there is a four page (no joke) warning sheet that goes with it…can cause seizures, dizzyness, swelling of lips, face, etc., rapid heartbeat, and it goes on and on and on – wonder if the cure is worse than the symptoms.  It’s suppose to be antibiotic, but the side effects of this stuff is scary.  It’s even suppose to be good if you breath anthrax germs when you read in the fine print for goodness sake! What every happened to a simple little antibiotic drug?  When I first read the warnings I was really tempted to call my doctor and say – "ahhhhh how about just plain ol’ cranberry juice instead?"

Good luck and God bless on your surgery next week!  We all will be waiting for ya to get back on line with us when you are feeling better!

I went in for a knot in my upper arm.  Doctor said it was probably an infected duct so gave me a prescription for a $75 antibiotic cream. That didn’t work so I went back and they wrote another prescription for another antibiotic.  That didn’t work so went back and my doctor was out sick and the nurse practitioner I saw could tell I was very aggravated about the whole thing and sent me to a dermatologist  the very same day who took out the cyst in the office and said that there was no way that antibiotics would have done anything.  She didn’t know why they had waited almost a month to send me to see her.

Most insurance requires you do the most simple, inexpensive test first and procede from there to what will really tell you what’s wrong.  The insurance companies are telling the doctor’s what tests to do, in what order.  We need someone to rein in the insurance companies.

I was working at a hospital when the HMO’s first came out.  I have several friends who are doctors and one joined the HMO.  They paid them X amount of $ to care for a patient and if they spent that amount it was fine but if they spent less they got a bonus from the HMO.  They also got a bonus for keeping patients out of the hospital so they usually just prescribed medication and didn’t order tests when indicated. 

A hospital got paid for diagnosis.  If you came in with pneumonia they had a set amount they’d give the hospital and they could do what they wanted within certain guidelines to test and treat you.  If it cost less for your care the hospital kept the extra.  If, heaven forbid, you developed something else while you were in the hospital the insurance wouldn’t pay to treat that because you were already being paid for the pneumonia without a lot of red tape.

I lived in Chicago and Michael Reese Hospital was one of the first HMO’s which later became Advocate and is now Humana.  The original plan was The Michael Reese Health Plan but those at hospitals called it The Michael Reese Death Plan.  One of our first in patients who was on that plan came in with flu like symptoms.  She’d been to her doctor several times over the course of a week for various symptoms that kept getting worse and each time she was prescribed antibiotics and told to go home and rest.  Her husband had to call an ambulance to bring her in and she coded and died within 3 hours of being admitted.  One of the on-call docs that evening was appalled.  One blood test showed she had Toxic Shock Syndrome and if her doctor had been treating the patient rather than watching where the money went she would still be alive. 

I do think doctors order too many unnecessary tests but I’m not sure it’s really to run the bills up since the doctors don’t gt paid for tests done at a hospital or clinic, only if they’re done in their office.  

The reason doctors order them is because people have gotten to quick to file malpractice suits. Doctors want to cover all the bases, even the unnecessary ones to cover their butts.  As long as the system allows malpractice suits for the littlest things and blames the doctors if something that’s a complication happens there will be unnecessary tests.  I’m sure we’ve all seen the commercials for a law firm that tells you it’s your doctors fault if your child is born with problems or special needs.  You know sometimes those things are a fluke of nature and no doctor could have prevented them from happening but there are law firms who thrive on getting people to sue if they don’t have a perfect baby.  You smoked for 50 years and develop lung cancer, well let’s sue the tobacco companies because they made the cigarettes BUT they didn’t put those things in your hands and force you to smoke.   No, I’m not a smoker and never have been.  I hate smoking of any kind and have seen the effects smoking can have on a person but it’s not the tobacco company’s fault, it’s the smoker’s fault.

Sorry, I’m going off on a tangent here. 

According to my SIL military doctors are even worse than HMO’s.   Her husband was in the air force for years, full retirement.  They lived on base most of that time and she was having some female problems.  It took over a year or military docs and they found nothing, went to a non military doc and she was diagnosed with cervical cancer.  She had a hysterectomy and thankfully she’s a survivor, over 10 years now but still scary.

We have a blood disroder in our family, Spherocytosis.  The RBC’s are irregular shape, fragile and break down in the spleen which leads to anemia and at times hemolytic crisis.  One of the treatments is removing the spleen.  The blood is still odd and fragile but no longer breaking down so the anemia is gone.  Many in my family have had their spleens removed for this and a cousin a couple of years older than I was had his removed around 6 months of age.  He was in the navy for years and during one of his many physicals during his career a navy doc asked him about his scar. He told him about the blood and spleenectomy and the doctor argued with him that they don’t remove your spleen for that. 

I guess that’s an inside look at healthcare when the government controls the doc’s

 for years; passage of current Health Care Reform simply opened the door and welcomed him in.  Talk about a Pandora’s Box …. this is the worst one yet. 

and scary too.  I used to have an HMO ten years ago, but then they (CALPERS), decided we were "rural", even though there are 100,000 people in the town and more in the little surrounding bergs, and we are 25 miles from the capital. which is pretty big.  So they put us on a PPO, cranked up the premiums per year, increased the prescription costs  – (doubled of what it cost HMO folks just 25 miles a way), tacked on an annual $500 per family member deductable, increased the doctor’s office visit payments by 75%…they said but you don’t have to be referred by your physician to a specialist….let me tell you something, every specialist wants a referral from your primary care physician – they will not see you at all with out a referral.  I’m more worried every day when I see this kind of stuff that you guys have bee writing about and what is coming…