In the last entry I focused on how doctors have been effected by the changes in medicine in America. They have my empathy for obvious reasons. Today, I am donning my other hat, the one that makes me look like a suburban mother – it is more fashionable but I still have to wear it at an odd angle for it to suit me. With five kids, I too am trying to navigate the tumultuous health care system. Just this morning, I had to refrain from throwing the phone through the window after a particularly frustrating and long battle with an automated system at a radiology department – a fight from which I emerged the loser. Your health is of utmost importance. You can have good looks, gobs of money, a job you love, a family who loves you and a fully stocked wine cooler and still, if you don’t have your health, you have very little. The culture of medicine in this country is leaving everyone wanting, and worse, it is potentially making us sick.
1. How do the changes in the medical system affect your health? An overburdened system means not only longer wait times and higher deductibles, it is a set up for more mistakes by health care providers, longer delays in obtaining a diagnosis and a complete dismantling of the doctor-patient relationship. A healthy relationship with your physician will do wonders for your health – both physically and mentallly.
2. How are patients reacting? Consistently, the U.S. ranks low in patient satisfaction when compared to other developed countries. Patients are angry and frustrated, both by their out of pocket expenses and by their experiences. As more doctors drop some or all insurance plans, even patients who always thought they had excellent coverage are feeling the sting.
3. What are they doing about it? Other than complaining, patients are suing. I just read a story about patients suing their doctors because of long wait times. These same people likely have no problem waiting for their hair dresser (who may cost a whole lot more.) This is a glaring manifestation of all that is wrong with the system. Patients are demanding more time and doctors are being forced to give less.
4. What are the options for patients when their physicians drop their insurance? Option number one – an apple a day. Number two – continue to see this doctor and become more savvy in health care and insurance lingo. You can still submit your own claims. All kidding aside, it will be worth your while to have a fax machine and some relaxation techniques. Number three – Find a doctor who does take your insurance but be prepared for the same thing to happen again. Number four – You can take part in a concierge or boutique system of care. I can’t even believe I am typing this, but it is something to consider. There are doctors who will accept your insurance but will charge an annual retainer of about $1500 to $2000 a year to provide with with preferential treatment. Other doctors are offering a system where they take no insurance and for about $6,000 per person (family rates available) will be at your beck and on-call.
5. Tips if you choose to stay with a doctor who does not accept insurance. Negotiate prices. It is possible your MD will take less money than he or she is charging. If so, get it in writing. Become more informed about your insurance coverage and learn the best way to file a claim. If you choose a concierge doctor, make sure that you have a contract that explicitly lays out what you are entitled to.
In America, we no longer have the luxury of showing up at an appointment, forking over our co-payment and feeling confident we are getting excellent care. No longer are physicians able to hold your hand through every step of a diagnostic test or treatment. Get savvy. Don’t get your legs swept out from under you. Know going in who and what your insurance will pay. If you can’t afford special treatment, at least for the time being, you should be able to find a doctor who will take whatever pittance your insurance company offers. Just don’t get too comfortable or too sick. What a disaster! I am starting to rethink my stance on socialized medicine.