Thursday, February 19, 2009

Picture this if you will.....

Mom sitting in the living room, back to the dining room, with her feet up for a few minutes after a long hard day in Community Health Care. The 17 yr old girl is helping her 7 year old brother on his homework. Suddenly she exclaims "No! This is so confusing, I can't even understand this problem!"

Yes, this is the same eloquent, well spoken teenager a few blog posts ago! It is moments of laughing hearts that makes being a parent such a wonderful journey.

So, can we talk health care? Our health care system is a disaster. I know that is not a surprise to most of you out there. The view from all sides of this (including from up in the tree) are equally devastating.

I am a health care consumer. I have a chronic illness, complicated by many factors. I have chosen a provider who uses integrative medicine to treat my illness and keep my quality of life relatively acceptable. Because my insurance considers this provider to be out of network, I pay more out of pocket. This is in addition to a multitude of tests, specialist consultations, an average of a surgery or other hospitalization each year, and prescriptions.

I would like to pursue alternative treatments for my illness, such as massage and acupuncture. If I do pursue alternatives, however, my insurance will only pay a small portion if any of that cost if any. Yet my insurance will happily pay for a prescription instead, that will mask my symptoms but not correct any of the underlying problems. In fact, they will only make me pay up to a specific amount each year, then they pay the rest. So it is to my benefit to be more and more reliant upon a pill to fix me.

Yet I am the lucky one in the whole picture. I saw a patient in my clinic today with the same health problem. She is unable to work due to her condition (partially because of inadequate care?) so she has to access the community health care center. She does have health care, but it is with a provider who is so hard pressed to even begin to meet the overwhelming need that she squeezes more patients into a day than my primary provider does. (This is partially due to the lower reimbursement rate by Medicaid and Medicare, and the need to increase quota in order to stay afloat as a clinic.) In fact the need is so great that on top of the higher number of appointment slots she has created, she double books over half of those appointments to accommodate the awful flu sweeping the community, the children who must be hospitalized, and the very ill.

As frustrated as I get with my reality as a health care consumer, I am even more devastated to watch daily the disastrous system that has evolved in an attempt to meet the needs of a huge segment of our population. This segment is growing bigger daily, due to the state of the economy, and more and more families loosing insurance. So to meet the increasing need, the community health care system is being spread thinner, thinner and thinner. Our culture, our country, our political leaders, have fed into a system of insurance companies, copays and deductibles, and it has lost sight of the purpose. The need is the help people restore or maintain health, to have a good quality of life, to be able to contribute and be functioning parts of society. Yet that need is met by the few, by the desperate, by the "system".

I am quite tired tonight, after a day in the trenches. I know my thoughts are not quite coherent, and I may edit this later, but I see the need daily. I see the crisis before us, I experience the frustration of not being able to fix the problem. I feel inadequate every single day. I can't possibly get every patient back to see the Dr while also doing vaccines, returning 30 calls, finding 20 charts, calling the hospital 3 times, drawing blood 12 times, and trying to find a specialist to see 4 of our high risk patients. Really, if each Dr in my clinic sees 32 patients in a day (which is the approximate goal established in order to make the clinic viable) then we can't do it. We can't do it with the resources we have, the manpower we have, the facility and the energy. it is draining, exhausting and discouraging. I want to be part of a system that really meets needs, that provides what our people need.

The system needs fixed............

1 comment:

  1. A Health Consumer, these days, is a healthy person if/when they've been able to find the appropriate Professionals.


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