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True Confessions – My Take on Health Care Reform

Last week we watched (or more likely heard summaries during newscasts of) the Supreme Court’s (SCOTUS Supreme Court of the United States) hearings on American healthcare reform (AKA The ACA, Affordable Care Act.)  For those of us engaged in health-related issues every day, it was fascinating to watch the transition, and the voices of pundits, from “they will” or “they won’t” or whatever that day’s interpretation was.

Watching this culmination of many years of reform efforts has been fascinating to me. And in the midst of it, I realized that many of my regular readers have probably made assumptions about my take on healthcare reform that may not be true.  So yes, today it is time for some true confessions.

First Confession:  I am a registered Republican and, for many aspects of politics, (economy, defense) a conservative. I am, after all, a small business owner. It would seem, then, that I would be against reform of the system.  However…

As someone who has been personally buffeted by the system, during a time when I was insured (meaning responsible), the conversation held special interest to me.  Because, despite the fact that I was insured, and even though my diagnosis was wrong, I still lost my life savings (all except my house and my retirement).   So as you might imagine, beginning when the 2008 presidential elections began to play out in the media, I was immersed in the questions and arguments about healthcare reform. It was highly personal.

As a result of my conservative business nature, combined with my in-the-trenches understanding of how the healthcare system works in the United States, I was truly conflicted!

In those days, I did a lot of speaking on the subject of healthcare reform.  I believe so many invitations came along because I established a reputation of being able to see and argue all sides of the argument.  Perhaps because I was so conflicted, I could switch sides at the drop of a hat, and plays devil’s advocate no matter what the argument.  I would challenge my audiences to see if they could determine whether I supported reform or not – and rarely could they tell.

Second Confession:  Even though I could intellectually understand and argue why big business “had to do what it had to do,” I never could reconcile in my heart that the current non-reformed system is geared to only the “haves.”  The current system is very much about making sure the have-nots (or choose-nots) cannot access care except through emergency rooms, or by going bankrupt. Period. It’s very elitist – all about controlling those who can’t afford care and making sure they get sicker and die, while reserving decent care for those who can afford it.  And THAT is not me.

And that is not me MORE than the capitalist conservative IS me. And so yes, despite the fact that the ACA is highly flawed, and despite the fact that it requires many changes to make it work well, and fairly, I believe that we must start somewhere and so, yes, I am in favor of the ACA and hope it remains the law of the land.

Fast forward to today – two years post passage of the ACA, and a week past Supreme Court arguments, and…

Third Confession: I am less conflicted than I was then.  Why?  Because in these five years after the arguments have begun, I have seen Americans pay attention to aspects of healthcare they have never paid attention to before. Even if I still heartily disagree with those who are against reform, I know that they are seeing the fruits of what has taken place so far.  Maybe they had pre-existing conditions and, for the first time, have been able to find insurance again. Maybe they have a 23-year-old college graduate who still can’t find a job, but could stay on their family health insurance policy. Maybe they are seniors who have found the donut hole shrinking.  Whatever the reason, at least we as American citizens are engaging in the decision-making process – even if some are on opposite sides from my own thinking.

Fourth Confession:  I am totally confused (and hope someone can enlighten me) on why on earth conservatives want to shoot down the individual mandate.  Their arguments against it just don’t make sense!  Republican conservatives are all about personal responsibility, and so many of the arguments against reform have been aimed at problems that have occurred before now because people don’t take responsibility for making sure they have health coverage.  The individual mandate is what makes “lazy” people (the ones who are working six jobs, none of which offer health coverage), and “poor” people (the ones who have been laid off because of Wall Street greed), and young people (the ones who are bulletproof and won’t ever get sick, so would rather buy stuff than invest in health coverage) get coverage.  The individual mandate is what prevents those who run up their costs beyond what can ever be repaid (today) not have to file bankruptcy because – well – they had coverage. The individual mandate is what controls costs for the rest of us who HAVE been responsible.  So – WTH?  I just don’t get that.

And finally, my

Fifth Confession:  (I have confided THIS confession only to my closest friends before today.) Personally, and in a selfish way, it doesn’t matter to me what the Supreme Court decides.  Because no matter what the Supreme Court decides, I and my loved ones, will be just fine. Whatever their decision – it’s job security for me.

The Supreme Court’s decision won’t affect my ability to be insured because my husband is retired from the military, so we have decent coverage for our lifetimes. Our children are all well-employed in jobs that won’t go away, so they are in good shape, too.

No matter what SCOTUS decides, Americans will continue having trouble getting what they need.  I predict that if the ACA is blessed by SCOTUS, then there will be more confusion in the short term, but less confusion in the long term.  And if they strike it down?  Well then, my fortunes will multiply because my career is all focused on either helping individuals get what they need from the system, or helping them find a health advocate to guide them.

Which, of course, goes back to my original statement…. that is…. I’m a business owner and a Republican.  I’ll just continue to grow my business.  And that creates one heckuva circular argument – don’t you think?

So there you go – my five confessions about healthcare reform.  They say confession is good for the soul.  While I’m not sure this has done much for my soul (because it certainly doesn’t resolve any of my personal conflict!), I do hope it has given you some food for thought.

…MORE…

•  Where Does Rationing Fit Into Healthcare Reform?

•  What Is Socialized Medicine?

•  What is Universal Healthcare?

•  Where Does Rationing Fit Into Healthcare Reform?

•  Follow the Money: How Money Affects American Healthcare

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Want more Patient Empowerment?
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Every Patient’s Advocate

About.com Patient Empowerment

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full of Patient Empowerment Tips.

A Tutor Who Tooted the Flute…

In a conversation with a friend the other day, I was explaining the need for patient advocates (which she got immediately) – and the “tutor tongue-twister” came to mind.  Do you know it?

A tutor who tooted the flute,

Tried to tutor two tooters to toot,

Said the two to the tutor, “It’s tougher to toot, than to tutor two tooters to toot!”

Now – you may wonder what tooting tutors have to do with patient advocacy.  And yes, I’m going to tell you….

When I explain the role and benefits of having a private patient advocate help you when you’re sick (or a loved one is sick), sometimes people don’t understand why they would want to reach into their pockets to pay for someone to help them get the healthcare they deserve.  After all – healthcare has always been free, right?  (Well – free PLUS the cost of premiums PLUS the cost of co-pays PLUS the cost of services not covered, etc….  )

So – my new metaphor is that of a tutor.  If your child is struggling to pass trigonometry, and you know his ability to go to the college he wants to go to (or you want him to go to!) is dependent on whether he will pass trig, then you have the sense that it’s not just about trig – it’s about the quality of the rest of his life.

He goes to public school, which is free, just as healthcare is free. (We pay for schools in our taxes like we, or our employers, pay for healthcare with our policies.)

He has stayed after school for extra help (still doesn’t get it), your sister-in-law the math teacher can’t seem to help him (like many hospital advocates or websites might provide some help), he won’t let you help (caregivers find it so difficult to manage their loved one’s healthcare) – but he still doesn’t understand trigonometry.

So now what?  With his future so dependent on getting past this one, very difficult hurdle…. what are you supposed to do?

You hire a private tutor.  Someone who can work one-on-one with him. Someone who knows some of the inside information needed to get him past the final exam.  Someone whose sole purpose is to make sure your son passes trig – because if his work with your son is successful, then his tutoring business will continue to grow, too…

Someone who will make sure your son has the quality future he deserves, despite the fact that the “system” (meaning, in this case, the school system) just isn’t providing the way your son needs it.  And for that, you will happily pay from your pocket – because it’s that important.

Which is exactly what a private advocate does – provides you or a loved one with the quality future you deserve, making sure you get what you need from a system that is too dysfunctional to provide it.  A private patient advocate is only interested in making sure YOUR interface with the system works well, that you get exactly what you need, whether what you need is the right diagnosis, the right tests, the right treatment – or even medical bills that are no more than they should be, or must be.

… A patient or health advocate will help you navigate the health care system to get the quality future you deserve, despite the fact that the “system” (meaning, in this care, the healthcare system) just doesn’t provide you with the real help you need.

And more…. there are dozens of ways a patient advocate can assist you.

This week is Private Professional Patient Advocate’s Week.  Whether or not you are struggling with your medical care, you will benefit from having a private health or patient advocate to lean on, and to bring you through it.

…making sure you get the quality and quantity of future you or your loved one deserves.

(Now – say that three times fast!)

…MORE…

Find a Patient Advocate to Help You

How to Interview and Choose a Patient Advocate

Why a Private Patient Advocate May Be the Answer for You

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Want more Patient Empowerment?
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About.com Patient Empowerment

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A Dose of Reality – Today’s Doctor Appointment

Please note that this column first appeared in the Syracuse Post Standard
October 11, 2011

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In the “old” days, we could phone for a primary care doctor’s appointment in the morning, be seen right away, spend enough time with the doctor, leave with a treatment plan, and usually feel better within a day or two.

But no longer! Today it’s difficult to get an appointment, even within a few days. We sit in waiting rooms far longer than we expect. Then when we finally see the doctor, we often feel like we’re being rushed out the door.

We patients tend to blame our doctors and the way they run their practices. Why should we have to wait so long? Why won’t they spend more time with us?  What’s the big hurry?

The truth is, your doctor doesn’t like today’s limited time system either.  He would love nothing more than to be able to make immediate appointments, see you the moment you arrive in his office, and spend plenty of time with you, too.  But the insurance reimbursement system doesn’t make that possible.

Last week I had the opportunity to work with personnel at North and Northeast Medical Centers.  I was asked to help them help us patients manage this time-constrained reality we are all stuck with to improve patient satisfaction. I suggested some steps they can take to help their patients get the most from their appointments.

But the patient-provider relationship is two sided. We patients need to take our responsibilities in that relationship more seriously, too.

We can do so by preparing ahead of our appointments:

First – Write down anything that is new since your last appointment. New symptoms, new aches or pains, new supplements you’re talking, drugs another doctor has prescribed, or new triggers you’ve discovered that create problems for you. Record them along with the dates they started.

Second – Take a list of every drug and supplement you take, including brand names and dosages.  Note any that will need renewal within the next 90 days.  Or, instead of listing them, throw the containers into a bag and take them with you.

Third – Write down your questions. Prioritize them since you’ll only have time to ask two or three.  If you have more than one medical problem, and therefore extra questions, then make an additional appointment.

Being a prepared patient will make every interface with your doctor more effective and efficient. You’ll be more likely to get what you need – a collaboration that’s beneficial to you and your doctor.

……………… ADDITIONAL RESOURCES ON THIS TOPIC ………………

 Effective Patient-Doctor Communications

Why Do I Wait So Long for my Doctor Appointment?

Are You Prepared for Your Doctor Appointment?

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About.com Patient Empowerment

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Choosing a Safer Hospital

Please note that this column first appeared in the Syracuse Post Standard on September 27, 2011

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In my last column I shared an open letter to our local hospitals which resulted from my review of their most recent “report cards.”  These report cards score hospitals on their quality of service and safety records. Despite a few improvements, problems were exposed at all of them – problems that continue to put us patients in danger or simply make us miserable.

Think about that. Danger! Too many of us patients enter the hospital with an expectation that, whatever our medical problem is, it will be improved because we have been hospitalized.  Instead we find ourselves the victims of deadly infections, drug errors, falls, surgical mistakes, even crimes.

And think about the second part.  Misery!  When we are at our most vulnerable, perhaps unable to walk on our own, or even stay conscious, we may be at the mercy of staff who ignore our complaints about everything from intense pain, to the need to use the bathroom.

The potential for even more danger and distress is growing, too.  The numbers of hospitalized patients are growing as baby boomers age, and as healthcare reform provides more patients with access to healthcare. As time goes on, the ability of hospital personnel to keep us safe and relatively comfortable will be taxed even further.

So how can we patients ensure our own safety and comfort?  We’ve previously looked at important safety precautions to take during a hospital stay. But the best approach is to begin with safety and satisfaction in mind.  That means reviewing hospitals’ track records before we ever need hospitalization, and making our best choice based on what a hospital has already demonstrated it can do.

Which is why those report cards mentioned in my last column are important.  They are tools we patients can use to help us choose the best hospital.

Let’s use them!

The latest New York Hospital Report Cards can be found at  http://www.myhealthfinder.com/newyork11/ .  Medicare’s website, http://www.hospitalcompare.hhs.gov also offers information about hospital safety and satisfaction levels.

Finally, if you’ve been hospitalized, there’s something you can do to help future patients make hospital decisions.  After a hospital stay, some patients are surveyed about the safety, communications and quality of their care.  By answering and returning the survey, you’ll be contributing to hospital ratings of the future, and providing valuable feedback to help our local hospitals improve their service, too.

……………… ADDITIONAL RESOURCES ON THIS TOPIC ………………

More Hospital Report Cards (more states)

How to Choose the Best Hospital for You

A Patient’s Guide to Hospital Infections

How to Prevent Hospital Infections

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Want More Patient Empowerment?
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Every Patient’s Advocate

About.com Patient Empowerment

…and…
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Patient Empowerment Tips