Saturday, September 29, 2007

Sicko, redux

I first wanted to post about this back on July 4th. Gives you an idea for my free time follow up skills... ugh.

I've done a lot of thinking about this since I saw the movie, and had numerous discussions with people "on both sides of the aisle," as the cliche goes.

Most doctors I work for predict the change is inevitable, but no one is quite sure what it's going to look like or when it will really happen.

My friend who accompanied me to the movie is an avowed liberal. And the wife of a doctor. I asked her, "Are you really saying you'd be okay with his salary being cut?" No one has those numbers, but I do wonder what the reality would be like in a universal health care system.

Having just stayed most of yesterday in the ER, I could only imagine the revolution that would take place if you removed all those administrative folks from the mix. At our local hospital, they even have a specially designed scanner for health care cards. Last time I was in with one of my kids, I commented about it to the admissions person. She said, "Yeah, it's great when it works." Sounds similar to most health care plans to me.

I can recall battling (and battling, and battling) between our insurance company and a health care provider when my son was being tested for developmental problems. Even though the billing was going out of the same hospital program, each doctor's coding was different. So some were covered, and others (on the same team) were not. The insurance company told me the doctor's office was coding improperly. The doctor's office told me they were following directions from the insurance company. When I asked the insurance company which codes the doctor's office should be using, they said, "You aren't allowed access to that information. Only the doctor's office can know the codes." So hours of wrangling meant we wound up footing the bill.

Note to Michael Moore -- The revolution may not be as far away as you think. When several well-heeled (we'd call them "high maintenance" ladies-of-the-lake (and of a "certain age," as the French would say) at my local coffee shop were discussing out of network coverage for when they're in their winter homes (Florida, Arizona, New Mexico), and cited as a horrific example one of Moore's case studies in the film, I knew we might be making progress. No one knew the anecdote came from his movie. But someone had repeated it with enough fervor to make it spread like a rumor in the game "Telephone." It was the story about the woman whose ambulance ride wasn't covered (following a traumatic car accident) because she hadn't gotten pre-approval. "Can you imagine?" they said to each other.

After seeing the movie, yes, I can.

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