Obama will ruin Healthcare

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3 Responses to Obama will ruin Healthcare

  1. doctorblue says:

    I hope Obama ruins U.S. health care the way it is today. I’m destitute and disabled still seeking competent medical care because of doctors choosing to appease insurance companies rather than addressing their patients’ maladies.

    If your health system is so great, then you can help me get access to a gastrointestinal surgeon, who can read my radiographs showing I have a redundant cecum that is infected and causing a partial obstruction and that I am in need of surgery. Because non-surgeon doctors can’t read radiographs and have little knowledge about the significance of having a redundant cecum, none will refer me to a surgeon. Surgeons won’t see you without a referral. It’s a dead end catch-22. Under our current insurance-inspired medical system, my life is in the hands of a doctor who does not possess the knowledge he needs to make the correct referral, so that I can get the medical care I need. Check out http://doctorblue.wordpress.com for a factual account of my experiences with doctors. Then prove to me that our health care system doesn’t need to be changed. -Doctorblue

    • Mike Braun says:

      What is it you think Obama will do for you? I read some of your blog and I am very sympathetic to your condition. I do feel people fall through the cracks and we would have to resolve that problem with healtcare. There are solutions out there on the market people can take advantage of. I do not know what state you live in but most states have good social programs to take advantage that are funded by the private marketplace. We need to work together to resolve the problem. However, if you think dealing with the government is going to be easier than a private insurance carrier you are mistaken. In fact, healthcare will get worse. There will be rationing. There will be healthcare facilities that close. It will take you close to 6 months to get an MRI.
      Medicare in its current funding it unsustainable. Seniors talk about the premiums that are charged for senior care but fail to realize how much of it is subsidized. Medicare by iteslf is not enough coverage. Medicare is going to be bankrupt in 2017 and adding to this program will just make it worse. Other countries have similar issues and our looking to create private insurance systems to compete with the single payer systems.
      I read on your blog that doctors are incented to not refer care on or do the least for a patient. It is illegal to have this type of system in place. Doctors are paid in capitation for HMO contracts whether someone sees the provider or not. The funding source is insurance companies look at the volume of patients with diabetes, CHF, and other disorders to determine if additional compensation is needed.
      It seems to me that you need to talk with a your primary, your specialist, or another doctor in order to determine what is the best course of action. I have many clients and it always starts with the doctor. If you can reach out to a Health Advocacy group that also might be a resource. Do a search for Health Advocacy group that may help for a nominal fee. It does not seem like insurance is the issue it seems like you are locked by the provider and what they can do for you.
      http://www.healthadvocates.com http://www.guardiannurses.com
      I hope these can help you.

  2. doctorblue says:

    Mike,
    It seems we’ll have to agree to disagree because our experiences are based on very different outcomes. I have no illusions about my ability to convince you of anything. Nonetheless, I believe the insurance companies have vicarious liability for the negligence of network providers.

    Insurers who advertise and promote a patient’s bill of rights in SEC filings shouldn’t get away with dismissing and ignoring member complaints, which is exactly what CIGNA did in my situation. I have written correspondence to CIGNA and my two primary care physicians and referred specialists complaining about their failure to take my health concerns seriously. (Since I have been disabled the last five years, I think I have point.)

    My blog #8 “Search For A New PCP” provides details about my experiences dealing with CIGNA customer care and the numerous, repeated phone calls it took to correct multiple billing and coding errors and to get approvals for CT scans and diagnostic procedures. Surely, insurers should be corporately liable for failure to properly oversee staff and correct quality related problems, and for breach of good faith and fair dealing in failing to provide the insured appropriate care, as well as for breach of fiduciary duty for failure to monitor, investigate and oversee its management system.

    Yes, I got my CT scans, MRIs, SBFT, colonoscopy, etc. — all showing abnormalities that the insured’s providers choose to ignore, overlook, downplay…What good are they if no one is there to read and properly analyze the scans to form a proper diagnosis?

    The referred specialists made mistakes and the referring doctors chose to side with the specialists without examining the evidence–the reports in my patient records. None of the doctors were receptive to my repeated attempts to convince them to reconsider their decisions.

    On the other hand, using these same records and independent examination, the Social Security Administration employed physicians — whom, I suspect, I have more time to read and analyze reports — found that I was disabled due to disc degenerative disease caused by untreated infections. Unfortunately, Social Security is only charged with determining if someone is eligible for disability benefits and not with securing patient care.

    Based on this experience, I assume that I might have a better chance of getting government paid doctors to listen to me and provide the needed care for a few reasons. 1. There might be more accountability for satisfactory patient outcome. 2. Doctors wouldn’t be paid based on the number of patients seen per day, but on the service provided the patients he did see.

    Perhaps CIGNA is the anomaly among all the other more proficient insurers, but I think not.

    If you read my post #19 “Virginia Workers Compensation Claim,” you’ll see that I didn’t get the lifetime medical care and hand surgery I was awarded due to surgeons’ fear of 1) not being paid by the insurer under Workers Comp, and 2)differing opinions on the surgical procedure needed.

    If you read my last two blogs, you’ll find Virginia does not offer Medicaid to the disabled and that there are no social programs here for those like me. Health advocates do many things, but they don’t find competent doctors and surgeons for patients. (I guess it’s too difficult.) If you know of someone who does, please let me know.

    Because scenarios like mine are, in reality, so depressing, the as-yet-unafflicted choose to believe in a society that “ought to be” rather than open their eyes to the truth and do something to make these beliefs a reality. I’d like to live in a world in which people live by the motto “do the right thing” too. Do you really think someone will reach out and help me get the medical care I need to again become a productive member of society? Do you — in your heart of hearts — really believe that anyone cares?

    It’s difficult to keep hoping someone does when each day I’m faced with so many closed doors from people who rationalize that there are others charged with helping the disabled. It’s a fairy tale. That’s why there are so many disabled homeless people!

    We didn’t change civil rights until the courts got involved. We can’t legislate how people feel. But we can adopt laws that protect the rights of harmed individuals. Health care won’t change until government mandates action through regulation. At least a government-run system would provide an option for obtaining competent medical care, which I don’t have now and didn’t have when I had medical insurance.

    -Doctorblue

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