Healthcare Reform and Stereotypical Docs
Sometimes a group of people plays right into your worst stereotype.
That is what happened last week with the Million Med March. They should have called it the Million Me March. A group of doctors came to Washington to present their idea of health reform. Go back to the early 20th century when patients paid for their health care. Leave the government and insurance out of it.
OK. Perhaps I am not fair. They don’t really say leave the government and insurance out of it. What they do say is leave the doctors out of government plans and insurance plans.
The patient pays cash for services. If the patient can collect from someone else – fine, but leave the doctor out of it. No insurance forms, not prior authorizations, no limits on hospital days. Oh, and no law suits! In other words, they want absolutely no accountability. They walk on water and are not to be challenged.
Stand at the Gate
That is the Stand-at-the-Gate-Until-You-Can-Pay-the-Freight model at its worst.
How many people did the Institute of Medicine claim are injured each year from prescription drug prescribing errors? 1,500,000. How many people die each year from hospital acquired infections? 80,000! How many people die each year because they lack adequate health insurance? 20,000!
Death Panels
These are the worst kinds of death panels – the ones that consist of ignorance, carelessness, and callousness. And they are in charge now.
This model is already at work. Almost every single day we receive a complaint from a member who was denied treatment by a doctor. In almost every case, the member has insurance. There is just some temporary glitch – sometimes real; sometimes imagined.
An imagined glitch would be when the member presents the wrong ID card.
A real but particularly infuriating glitch happens when the carrier has the wrong gender. This is usually a keying error that can be remedied fairly quickly. For the doctor, it is an excuse to deny treatment or demand payment upfront.
Excuse me if I am being unduly harsh on doctors. The name matches, the birth date matches, the social security number matches. Can there be any doubt that this is an error that can be fixed? Why does the inconvenience of the doctor trump any inconvenience to the patient?
It’s stand at the gate until you can pay the freight.
Mrs. Chambers called our office. Her doctor told her that he would not see her until she paid a bill that the insurance had not paid. Mrs. Chambers had an Explanation of Benefits that said she had no liability for this bill. It seems the doctor filed the claim after the one-year timely filing limitation.
Further inquiry revealed that the doctor had never updated the insurance information he had on file, and had submitted the claim under an old ID number. Our office prevailed upon the insurance carrier to waive the timely filing limitation and pay the bill.
When the patient showed up for her next appointment, the doctor had not received the money yet. He insisted that the patient either pay the bill or reschedule the appointment. A telephone call from the insurance company to the doctor’s office offered assurance that the bill was being reprocessed and they would receive payment.
That was not enough to convince Doctor Greedy. Mrs. Chambers rescheduled her appointment.
The son of a member died while one of the providers argued with the insurance company about how much they were going to get paid – not whether, but how much. This was apparently not responsible for the death. But does a parent need that additional aggravation while their son is dieing?
To be clear
In case I am not making myself clear, I have absolutely zero sympathy with the 200 doctors who showed up on Thursday as part of the Million Med March and their leader Dr. Richard Chudacoff.
Doctors have lots of very valid complaints. And you can include these examples among them. But going back to an old model that never worked is not the solution.
Several groups of doctors have offered constructive solutions including Physicians for a National Health Plan who rallied on Capitol Hill the day before to advocate for a single payer health system. Healthcare Professionals for Health Care Reform has offered another sensible alternative that has been endorsed by several physician groups.
But the Million Med March reinforces the stereotype that doctors are only concerned about money and are only concerned about the health of those who have it.
We have a health care system that is bankrupting private companies and public budgets. And we have some doctors who still only think about themselves while pretending to think of patients?
That is why we need at least a strong public plan option as part of health care reform.
