It's a Mad Mad World
Some things are so screwed up.
For one, healthcare and medicine are f*cking expensive. Doctors' visits ain't cheap (and no, I don't get to choose the dollar amount I charge. We just code according to 'complexity' of the case) and the amount that gets charged depends on the health insurance and bureaucratic BS that I don't fathom. Secondly, the medications themselves are overpriced, really. I understand the need to cover costs of R&D. But to be making billions seems wrong.
For one, healthcare and medicine are f*cking expensive. Doctors' visits ain't cheap (and no, I don't get to choose the dollar amount I charge. We just code according to 'complexity' of the case) and the amount that gets charged depends on the health insurance and bureaucratic BS that I don't fathom. Secondly, the medications themselves are overpriced, really. I understand the need to cover costs of R&D. But to be making billions seems wrong.
I guess I'm just irritated with things. I saw a patient the other day for poorly controlled diabetes. She has type 1, a condition that requires lifelong (until someone comes up with a cure) insulin and regular glucose testing to allow for safe adjustments of her insulins. Unfortunately her hemoglobin A1c was 14%, her control hampened by lack of compliance. Except I don't blame her.
Tearfully, she tells me she just cannot afford the glucose strips, and the insulins. She is one of the millions of uninsured Americans. And so, medical care costs a bomb, and she has had to decide what's more important, food/rental or medications.
And so, I squirrelled away whatever free samples I could find in the clinic. And referred her to the social worker. And, hoping the hospital director never finds out, bills her a level 2 (with the multiple issues and her high risk situation, this would have been a level 5). Essentially, something akin to a nursing visit. The last time I did this, I got a reprimand.
Elsewhere in the world, if a doctor, in good faith, decides to undercharge a patient, it's his perogative. Heck, in Malaysia I've had doctors who give courtesy 'free consults'. Here, in this overly civilized country, that may be perceived as a form of discrimination. Why would you give a discount to one patient, and not another?
And so, the hospital and it's lawyers go nuts with these things. And it is very frowned upon, as tragic as the case may be. The hospital does not wish to open itself to any lawsuits.
In my opinion, if we weren't afraid of being sued, healthcare in general would be much cheaper, and the world would be a better place. Without the threat of lawsuits, that may make some idiots be bigger idiots, but I'd like to trust that mankind generally, is good.
Tearfully, she tells me she just cannot afford the glucose strips, and the insulins. She is one of the millions of uninsured Americans. And so, medical care costs a bomb, and she has had to decide what's more important, food/rental or medications.
And so, I squirrelled away whatever free samples I could find in the clinic. And referred her to the social worker. And, hoping the hospital director never finds out, bills her a level 2 (with the multiple issues and her high risk situation, this would have been a level 5). Essentially, something akin to a nursing visit. The last time I did this, I got a reprimand.
Elsewhere in the world, if a doctor, in good faith, decides to undercharge a patient, it's his perogative. Heck, in Malaysia I've had doctors who give courtesy 'free consults'. Here, in this overly civilized country, that may be perceived as a form of discrimination. Why would you give a discount to one patient, and not another?
And so, the hospital and it's lawyers go nuts with these things. And it is very frowned upon, as tragic as the case may be. The hospital does not wish to open itself to any lawsuits.
In my opinion, if we weren't afraid of being sued, healthcare in general would be much cheaper, and the world would be a better place. Without the threat of lawsuits, that may make some idiots be bigger idiots, but I'd like to trust that mankind generally, is good.
If we weren't so careful and afraid of missing somethings, things would be so much simpler and cost effective. Ie, make a medical decision based on the history and the clinical findings and suspicion, and go with it. And not "run other tests to make sure I'm not missing something" defensive medicine that the malpractice lawyers have made American medicine to be, these days. I mean, come on, do all tummy pains require a CT abdomen?
And all that "If you've taken Pill X and have had an adverse effect of Y, call Lawyer Z as you may be entitled to a monetary compensation...". ALL medications have side effects. All of them. You take a pill if you and your physician agree that the benefit far exceeds that. I get pissed seeing the new TV ads for people who had a heart attack while taking a certain pill; chances are without that medication MORE patient would have died from their medical condition.
You tell me, is this not screwed up?
We'll see if I get a call from the director about this case. Frankly, I don't care.
posted by vagus at 8:57 AM
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