The most grievious to me are the patients with type II diabetes (insulin insensitive) diabetes. If they knew what was coming they would do much more to stop the diabetes before it took them to kidney failure. Who wants to sit in a clinic every other day for four or more hours?

As for your fourth confession, THANK YOU! I don’t get it either. To me this law is all about requiring personal responsibility. And I’m scared about what happens if the Court strikes down the individual mandate alone. The law will be a huge problem without it, I’m afraid. I’m hoping the fact that Congress did not include a severability clause will sway the court, but unfortunately sometimes they don’t pay as much attention as they should to such textual arguments.

I’d love to see a #11 tip added, however – and that involves personal responsibility for making lifestyle changes to improve your odds of recovery. For example, I’ve written frequently about the research of German cardiologist Dr. Rainer Hambrecht, who has been saying for years that regular exercise shows better outcomes for heart patients compared to implanting cardiac stents. Yet he concludes:

“Patients are not motivated to take responsibility for improving their own cardiovascular health – even if it means better event-free survival.”

Empowerment must extend to patients being accountable for doing what needs to be done to maintain and improve their own health.

You make some wonderfully astute points and, of the many health care sites supposedly geared to patients (a/k/a “consumers”) of health care, I would argue yours is among the best. I am one of those who works in the health insurance area and I could not agree with you more about the absence of REAL patient voices in discussions about “patient centeredness” or “consumer-driven health care” or whatever euphemism one wants to throw into the waters. Insurance is more complicated than ever (and it isn’t merely due to “gov’t [over]regulation”, or greedy health care providers or greedy Pharma et al). EVERYONE must be part of that discussion and empaneling experts only about patient involvement is akin to taking a patient history without a patient!

Another problem I think we see all too often is the PR spin by patient organizations who tout that they are “listening” or they “truly care” about their patients, etc. Yet, we almost never hear from these same organizations about WHAT they have done to reflect their concern and care for the patient population. Certainly, in the company where I work, I cannot recall any widely discussed instances where we, as a company, failed to address our patients’ interests and turned that failure into a teachable moment. Rather, we get the PR spin about the letters of PRAISE we receive from members or providers as “rah rah” moments. Certainly, some of the praise is deserved, but we really should also hear the other side so we better understand the patient experience in our interactions.

In addition to the PR spin above, the near vilification of regulatory agencies by many within health care / insurance organizations. Despite the fact that regulations were put in place not just to be a pain in the a** but rather, were implemented in response to abuses or neglect either in patient care OR in the commerce of patient care. It would do us ALL good to consider ALL of the working pieces and take ownership of our own failures and/or inadequacies in making the health care sector function more effectively, efficiently and AFFORDABLY. To do otherwise is automatically a disservice to and failure of service and care for patients at every level.

(Thanks for allowing my rant – I look forward to exploring more of this site and will certainly recommend it to others)