Friday, April 4, 2008

You're not what?

My dad, as previously mentioned, is a physician. He is a retired physician. He started practicing medicine in 1968. We moved from Ohio after his residency, I in utero, to Massachusetts. He became a doctor to help people. He would have practiced for nothing. He was a doctor in the golden age of medicine. Doctors were viewed as god’s. We saw our pediatrician without charge, as a professional courtesy, back in the day. He went to the hospital every morning to round on his patients, before seeing patients at his office. He took every Wednesday off and was on call every 5th weekend or something like that. He took me and my younger sister with him when he did rounds on Saturdays. We had green jello and ham in the cafeteria. It seemed that everyone knew him. It seemed that everyone thought he was a wonderful, caring, physician.

I thought of him nothing more than my father. Just a regular guy, who took us with him when he went to the dump, took us camping and pulled the car into the garage on a night he had promised to take us to the drive in and it rained. When I was in high school and working at a local grocery store a woman, a substitute teacher at my high school, said this to me, “Your father saves lives. You should be very proud of him.” I never ever thought of him that way.

My dad retired when he was 62, not because he wanted to but because the landscape of medicine had changed so drastically from when he began that he could no longer practice the way he had been trained. He had to justify the ordering of tests to medical case managers at insurance companies. Um, who has the M.D. after his name? Managed care has removed the role of a physician to the non-decision making seat. It has become a labyrinth of referrals and lawsuits. The insurance companies get richer, the health insurance companies as well as the malpractice insurance companies.

When did it all become about money? When did the care of humans, of moms and dads, babies, and grandmothers, become about money? When? It may have happened sometime in the ‘80s but I am not sure. I distinctly remember NOT having an insurance card. I distinctly remember going to the doctor and being billed for the services. It wasn’t until I had a job that I had my own insurance, after years of hiding in college/graduate school. I don't think I have been without insurance since that time.

But many people are
without health insurance. More people than I care to think about. I have never been an advocate or politically minded person. However, as a mother that has changed. As a mother I have to be an advocate and I must remain vigilant about social issues. One issue that I take for granted and never even think twice about is health insurance. We have health insurance. I can see any doctor I want for nominal fee. My son can have a Mag 3 test and I will never see a bill. Oldest hadn’t been to the doctor since her last well visit in 2007. We can see the dermatologist for her spot once a year and never see a bill. We are lucky and I know we are lucky. We are healthy and insured. We are an insurer’s best customer.

When did it all become about money? When malpractice insurance went up 200%? Or was it when the student loans the doctors left medical school with became too burdensome? Or was it when pharmaceutical companies began to send the representatives into the physician offices to woo them with dinners and fancy trips for writing prescriptions for their drugs? Or was it when the business world took over the medical industry? Or was it when the politicians got involved? I don’t know when it was; all I know is there are people without health insurance. There are families without health insurance. There are people with jobs that don’t have health insurance. There are people with jobs who make too much money to qualify for state aid. There are people with jobs who make too much money to qualify for state aid who don’t have healthy kids. There are people with jobs whose insurance is sub-par and ridiculously expensive. There are people with kids who need medical attention. Weekly. Who aren't getting what they need.

We live in a country that does not value family, health or the pursuit of happiness. We birth or adopt babies and get a whopping 12 weeks of unpaid, job protected leave. That promotes family. No health insurance? The door is slammed in your face. Pursuit of what? Oh happiness.


I am Trish Marie said...

I just linked to your blog for the first time today, so I won't go all crazy, scary on you for my first comment. Our medical system is run by the insurance companies, not the doctors. Some clerk decides whether or not testing or surgeries are neccessary. I am currently entangled in a nasty battle with my daughter's old insurance company after they approved a surgery (she is deaf, it was for her first cochlear implant), then denied it....AFTER SHE HAD THE SURGERY! Then, they refused to pay out any other bills for the remaineder of the plan year. The doctors, who are caught in the middle, have been wonderfully kind and caring. It is them I feel for. It is them I am fighting this battle for. They deserve to be paid for the work they did. Okay, enough of my rant!

HRH said...

I am married to a doctor who desperately wants to get out of medicine because the current state of affairs. About 79% of the bills he sends out are unpaid. That includes the uninsured. The people that he treats from 8 pm to 6 am are on average 75% uninsured. The doctors continue to see these people because they don't have any choice. The insurance companies continue to grow larger and larger while the doctors work harder and harder for less money and more liability. At some point, and you have already experienced this with your dad, the doctors are going to quit. Then who are we going to see? The insurance companies? And to add insult to injury, we pay for insurance for our family to the tune of $15,000 a year but the deductible is so high the actual insurance benefits have not been helpful. The one year that I had given birth and Ryan needed OT we should have met the deductible, but the insurance company decided that Ryan didn't really need OT and so we paid 100% out of pocket for that too. (I am a PT and my husband a MD, but the insurance company decided our son didn't need OT...) I could just cry over the whole thing. My husband didn't receive his first real paycheck until he was 38 because of medical school, internship, residency and air force payback and then we get here and find out it is hell and we want out. He makes a good living right now, but it has decreased by 20% every year since he started. We could possibly handle the progressive decrease in income if it weren't for the increasing pressures of liability and the increased workload trying to keep a practice afloat. I am so sorry to unload on your blog...but what is happening now totally sucks and it doesn't look promising for the future. Getting the government involved would only add yet another skimming layer...