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Daily Archives: August 15, 2009

Health Care is a hot topic! The illusion of Choice!

Where ever I am, what ever I am doing, I usually have some sort of audio, video, or readable news feed going on in the background. For some reason, I think better with noise in the background.

I have heard some really weird statements arise during the recent debates on health care reform. One of the funniest is the people arguing that they want to be able to choose their health care plan. If you are fortunate enough to work for yourself and have a lot of money, you are one of the few who can make that choice.

If you work for a large company that provides benefits, you have an illusion of choice. Large companies negotiate with Insurance providers for the best rates. Some companies change provides every few years in order to garner those savings. Employees seldom have any real say in what is provided and the costs. If you have ever wondered why you are suddenly paying more in premiums, or why services have changed, or why co-pays are suddenly different, this is usually the answer.

Big business wants to get the best deal, Insurance providers want to save the most money…you, the employee are caught in the middle and have very little to say in the matter unless you decide to change jobs. I have worked for companies where the doctor I had used for years was no longer on a provider list because the insurance program had changed. I have seen people have to wait for surgery because their doctor is having to argue with the insurance companies over whether the surgery is needed or not. In one instance, a friend with a long family history of cancer was told that surgery to remove a football sized tumor wasn’t needed because it did not ‘appear’ to be malignant. Sitting on top of a timebomb, my friend was fortunate to have a physician that kept pushing and pushing until the insurance company gave in. This is NOT an uncommon scenario.

Now that the health care debate is really going, all of a sudden, insurance companies are coming up with better rates, better options, and better coverage. Why haven’t they done it before now? Can they be trusted to police themselves? How can you be sure that it will not be GREED that stands between you/your family and the type of health care that you need.

If these companies were capable of policing themselves, why haven’t they already done it. They’ve had decades to do exactly that. Now, they expect us to believe that they can set aside corporate greed in order to best serve Americans?

Give me credit for a bit more sense than that. If it were consistent through human nature to ‘do the right thing’, we would not need police officers, we would not need laws, we would not need attorneys, and we would not need comprehensive health care reform. Unfortunately, GREED drives so much of our economy that the decisions made are often based on what is best for the Company, not what is best for the People.

There are plenty of other areas of commerce where GREED can continue to drive things, we do not need it in something as basic as health care. Providing health care for all is an investment in our future. Can’t we, as one of the richest nations in the world, afford to see that everyone has basic medical care? We send supplies and people all over the world to help other people, can’t we set aside fear and prejudice to help our own? Isn’t it the right thing to do?

Isn’t it the right thing to do to promote and encourage health rather than ‘fight disease’? Is it better to prevent a war than it is to fight in one?

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Posted by on August 15, 2009 in Health Care

 

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Fear is the disease that Health Care Reform will not help without knowlege!

“Pulling the plug on grandma????” Please! Give me a break. What is being discussed is a process that most good physicians already do as part of patient care. The issue is not about ‘pulling any plug’. It is an issue about pride, dignity, choices, and the rights of patients to know the condition of their health and the pros and cons of treatment options. The part of the health care bill that is alleged to give this “pull the plug” scenario life is one in which the doctors that are doing this can get paid for the time they spend.

For the patient and family, it means that they will have an opportunity to choose to obtain information as to various treatment options available and how it will affect them. Then, the patient and family can make decisions based upon knowledge rather than guessing.

Many years ago, while working as a paramedic, I responded to a call where an elderly woman had fallen. She couldn’t get up and her spouse was unable to help her do so. Although she was not seriously injured, we patched up a few scrapes and transported her to the hospital for a thorough checkup. The spouse spoke with me for a few minutes before we transported his wife and the words he spoke have been etched into my brain. With tears running down his face he said: “This ain’t living, they’re just keeping us alive with all this medicine, but it ain’t living. This is Hell.”

I sat with him at the Emergency Room for a minutes before I had to get back on the road. He spoke to me of his concern that despite having living wills, if something happened to them someone might ignore it or fight to have extraordinary measures that neither he nor his wife wanted to have used on them. He said that he had lived his life with pride and he wished to leave it the same way. He added that neither of them wanted to be stuck on a bunch of machines and be just lumps. Nor, did he want to be filled with medicines that kept him breathing but unaware of what was going on around him.

Over the years, I met other patients that wanted to hang on to every possibility in hopes that something would change. They did not care what medications, machines, or anything else was needed to keep them alive.

What the bill being discussed offers is an opportunity to make sure that people with terminal illnesses have an opportunity to understand exactly what the process holds for them and allows them to make choices about both quality and quantity of life. It does not promote one of those over the other, rather it provides an opportunity for patients and families to work with physicians to make sure that the wishes of the patient are known, and family members will be aware of what to expect.

In the decades since I went on the ambulance call noted above, I have had friends and family members where these discussions with health care providers have occurred and decisions have been reached. Although the choices have varied, the ultimate outcome was consistent. The patient and/or family members were provided with information that helped them to understand the process and to have realistic expectations. Decisions were made, removing unnecessary stress, and creating an environment where a loved one’s last days, weeks, months, or years were as comfortable and productive as possible.

Other situations have arisen where these discussion did not occur and people were not prepared to deal with situations. Stress and frustration grew and became the dominating force for those whose lives were involved in the process. Later, there was regret for time lost feeling fearful or helpless that could have been quality time spent with a loved one if they had better understood what would be happening.

This really isn’t about pulling the plug on anyone. It is about the right to make choices in treatment. It is about the right to have the knowledge necessary to make conscious decisions about how you wish to spend the last of your life. Where the patient is unable to make that decision, those loved ones who will make the decisions need to have every bit of knowledge available in order to honor the wishes of the patient and to make decisions that they will have to live with. The process is about informing…..the deciding remains in the hands of the patient or (where the patient is unable to make such decision) in the hands of loved ones.

Something so personal and private should not be used as a tool by politicians or insurance companies to try to instill fear. It is not something that should be used as a weapon, generating the type of anger and abuse that is being shown on almost every news cast. Something that should be faced with grace and dignity should not be distorted as it has been during these discussions. This type of psychological abuse, promoting and encouraging fear, is just wrong.

If you want to know more about this topic, don’t go to politicians or insurance company representatives for information. Take the time to call someone at a local hospice center or give your own physician a call, or ask a social worker. Talk to those with the experience and the knowledge to give you an answer that will be influenced by the experiences they have had with patients.

For some additional information on the Health Care issue, you might want to check out the League of Women Voters of the United States.

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Posted by on August 15, 2009 in Health Care