Stanley Feld M.D.,FACP,MACE
Many people have made the following comments about the healthcare system
“It is hopeless!”
“There will be no solution in our lifetime.”
“Good luck.”
“You are wasting your time.”
“We are too far down the road to be able to save this puppy.”
“The politics and economics are out of the control of physicians and patients.”
Only 20% of the people are sick at any one time. Therefore only 20% of the people think about the healthcare system and their healthcare insurance policy at any one time. The uninsured think about the potential cost of getting sick and fear not having health insurance.
When insured people get sick and navigate through the healthcare system is a nightmare for only about 40% of them. At any one point in time only 8 out of 100 people who have health insurance are having difficulty with the healthcare system. When all the people with healthcare insurance are forced to think about the healthcare system only 40% have experienced a horror of the situation. The other 60% that did not have a problem think the problems with the healthcare system are over exaggerated.
In August 2006 I received this comment from Cleve:
“Great post and keep it up. After 44 years of perfect health, my 45th was spent with doctors, labs and hospitals ...the system is beyond Kafka. I'm no expert but I have a feeling that doctors will have to be the spearhead of change(with patients the driving force maybe?). So keep at it...please!!
Cleve”
Last week I spoke to a friend who had neck surgery two years ago. He was hospitalized for 2 days. He had the opposite comment. He has health insurance with UnitedHealthcare. He thought my comments about UnitedHealthcare were exaggerated. His hospital bill was $17,500. The surgeon charged him $17,000. I remember his complaining about how atrocious these two bills were. I assured him the adjudication of the bill would look nothing like the retail charges. UnitedHealthcare paid both the hospital and the surgeon $3,500 each. He was responsible for nothing. He was relieved and pleased with the system. He said the hospital and surgeon seemed satisfied.
What about Denise? Remember her. She did not have health insurance. She was self employed with a preexisting condition. She did not qualify for health insurance. If she needed emergency neck surgery she would have been responsible for the entire $34,500. Both the hospital and doctor would have been unrelenting in the pursuit of payment. If the hospital and doctor would settle for $3,500 with the insurance company they should settle for the same with Denise. However, she would probably go to the collection agency and if she did not pay, her credit would be destroyed.
Denise could not get information for the price of a simple x-ray from the hospital. This precipitated her frustration and letter to then gubernatorial candidate Kinky Friedman the comedian cowboy running for governor.
Matthew Huebert wrote:
“There is something meaningful about blogs and RSS that I've only begun to understand recently, and this post describes and exemplifies it well: you are a thinking person, putting yourself 'out there', introducing outsiders into your own world and adding depth to a discussion that matters to you and matters to society. For me, it is writing like this that is an antidote to the superficial sound bytes that obscure possibilities for change by avoiding the "Why?" questions. I think what's finally hitting me is the fact that these conversations simply wouldn't be happening if RSS did not exist! What you're doing is inspiring. Thanks for the great post.
Matthew Huebert”
A huge barrier to real repair is the lack of awareness of 60% of the insured population. The 46.7 million uninsured are a mere abstraction to these people. The horror of the 40% insured is also an abstraction. If the trend continues the system will cave in all at once and everyone will be affected. People have to be stimulated to action now and demand the solutions I outlined in the last three blogs.
We are approaching a Presidential election year. We will hear all sorts of noise from “leaders” who in my opinion have little serious knowledge of the problem or the solution as seen in recent initiatives in California and Massachusetts. Our leaders are not stupid. The problem is the input of information is coming from the facilitator vested interest groups and not the people in the street.
Perhaps I can capture the imagination of all of the stakeholders. If we could all focus on the higher goal of excellent medical care at an affordable price rather than improving the financial results of facilitator vested interests, all of the stakeholders could all flourish with the minimum of pain and maximum creativity.
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