Commentary – State of HealthCare

This post was written by admin on July 30, 2009
Posted Under: General
Broken Health Care System

Darn! The Insurance Company Only Lets Me Have One

This is no new revelation.  Our health care system is broken.  Period.

Our big insurance companies and their lobbies are the ones that have broken the system.  Some blame our doctors.  Some blame the hospital administrators.  Now we have huge legislation underway that will bring about revolutionary change to the health care crisis and stabilize and make health care available to all.

The solution?  A Universal HealthCare INSURANCE program! Did you notice that, Insurance.  That is not going to solve the problem.  The US Government has bailed out a giant Insurer in its efforts to stabilize and revitalize the economy.  Bottom line as long as inusrance is involved, there will be no solution to the healthcare crisis.  Insurance companies should sit back and process the claims from the multi-billion dollar pool.

One of the problems with our health care crisis is in fact doctors.  But this is a small handful of doctors.  A small handful of greedy doctors that process and double and triple bill.  I cite this real example.  We used a doctor for an ortho surgical procedure.  The doctor billed the insurance company 3 times for the single procedure and the insurance company paid the procedure 3 times.  Even after bringing this error to the attention of the doctor and the insurance company, it was still paid.  But if a consumer accidentally submits his or her own claim 3 times he will be dropped from his insurance and will be most likely referred for insurance fraud.

There was a local doctor here that was prosecuted for insurance fraud.  She was billing insurance companies four and five times for the same procedure on the same patient and getting paid.  She was caught, was forced to pay back 1.1 million of the 9 million that she fraudulently billed and was never disciplined by the State Medical Examiner’s Board and still has a successful practice, and of course her Bentley and 4 million dollar house.

More recently, I have been having trouble sleeping.  I have a wonderful relationship with a doctor that is in the business of healthcare mostly for the sake of delivering honest and practical solutions to the medical problems people have.  We tried every OTC method for sleep.  It did not work,  Finally we had to resort to a prescription solution.  It was instantly denied by the insurance company.  We had to go through substantial proof of the attempts at alternative methods before they would approve the medication.  But wait, most medical plans exclude alternative methods and medicine in their coverage.  So why did we have to prove that we tried alternative methods such as Simply Sleep or Melatonin or other herbal methods including a question about acupuncture and yoga if they are not covered anyway?  Seems this is a circle that is closed that we just run around in.

So how do we fix healthcare?  There is no great revelation here.  Instead of letting the insurance company dictate the appropriate protocol for a patient and condition, let the doctor, the health care provider direct that.  After all, the Insurance Company just has a standard protocol on a particular condition.  But, the reason we have 10 or more different medications for the treatment of cholesterol is the same reason the doctor needs to be able to make the appropriate decision for a patients’ well being.  What works for one person will not always work for the next.

Why do we have so many people going to Mexico or India or the Philippines for health care?  It is because the doctor, the provider is able to work and treat outside the directives of a company that only sees those that are covered by their insurance as person with a need or a problem or an issue.

Our health care system is broken and whatever the US government does to try and solve the problem, it is not going to work.  Universal Health Care will only work when the power is given back to the doctor and the patient and will only work when the doctor and the patient can work in tandem.

So to fix the problem, instead of running from doctor to doctor, find one you are comfortable with. One that you can establish a relationship with and stay with him or her.  The vast majority of doctors are honest and trustworthy and truly have your best interest at hand.  Because of the Insurance Companies, the fees a doctor must charge are pushed up.  This is not a doctor’s greed but the trickle down effect of the greed of Insurance Companies.


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