Thank you, Zoe, for sharing your personal experience with UHC in France. I think it boils down to this: when do we Americans realize that we are responsible to one another? We are ultimately the ones who must look after the other, in the best way possible. HMOs and insurance companies get wealthier each day because they DENY care to those who need it.
Recently I changed physicians, because I was sick and tired of my pill-pushing, insurance subsidized doctor never listening to me. I have Type II Diabetes and all the alternative treatments that I am trying from Dr. Gabriel Cousens’ book “There is a Cure for Diabetes” were scoffed at; never mind that my numbers don’t lie. A1C went from a 10 to a 7.8 in three months…cholesterol, good, everything is great. All he could see was pushing me on insulin.
My new physician not only listens to me, but she is sharp in dealing with the AMA and all those insurance codes. Part of our conversation was NOT on the care I would receive with her, but on how to code our conversation so my insurance company would pay. This wasn’t my doctor’s fault, but doesn’t it make more sense to just leave healing and healthcare to the experts?
And thank you Zoe, for your points about teachers and doctors and their input on national policy. I, too, am a teacher. My agenda is to educate the children who are entrusted to my care. I see every day how NCLB legislation strips away my ability…and how the testing program fails in so many ways. Accountability used to be the report card. It used to rest equally on the child and the teacher, instead of how it is now: blaming teachers.
Well, I see how more and more of us Americans are waking up from our slumber and realizing that WE need to be in control. The lobbyists, pharmaceutical companies and insurance companies buy off politicians. They try to control our country and for NOW, do. For too long we have turned our heads and said, “not my problem.” Don’t wait for it to become your problem, help make our country better.
Doesn’t this sort of contradict itself? You say that healthcare decisions should be made by experts, yet you shopped around for someone to approve payment for treatments that are (to say the least) unproven?
Gabriel Cousens, for instance, seems to be pushing vegan foods and meditation as a cure for diabetes. Whether or not this works as well as insulin does not seem to have been demonstrated thru good, double-blinded studies. And Dr. Cousens seems to be basing his ideas, not necessarily on the scientific method, but on -
One might wonder if 59% of doctors, or even 59% of the general public, would be interested in paying for whatever treatments the local Essene spiritualist decide works better than insulin.
What it boils down to is that conservatives, or at least economic libertarians (not necessarily the social-religious conservatives nor the paleocons), reject that thesis, and as a matter of principle. No cite, but I read something about the struggle for UHC in the first Clinton Admin. Some leading RW – not a pol, but a funder like Richard Mellon Scaife or a pundit like William Kristol – posited that if Clinton succeeded, even with the incredibly corpo-friendly halfassed “managed care” plan proposed, it would be the worst disaster imaginable for everything the conservative movement stands for. Because it would irreversibly change the terms of American political culture; henceforth we would be like a European “social democracy” in terms of what role we expect government to play in our lives.
So much the better, I say. Things go better in Europe, even when conservatives are in power for the moment. Not even Thatcher dared dismantle National Health.
Perhaps it seems contradictory on the surface; let me explain my situation. For years I had been following my ADA approved diet and taking all the prescribed medications. I could not get my morning sugars below 170. When I started applying just a few suggestions found in Cousens book, my sugars began to normalize. My A1C now is 7.3. My morning sugars usually fall between 100-140. A huge difference from 170-260. The only thing I did differently was consume two products found in the healthfood store. I have not, for the record, picked up any Essene practices.
My current doctor and I had to figure out how to code my visit: well visit or diabetic care. That was our conversation on that topic. Not whether or not I should become vegan.
As for changing doctors, I found my former physician to be surly, unsupportive and very hard to deal with. He had the bedside manner of sandpaper, if you must know. He only spent on average ten minutes with me per visit. He didn’t care that my sugars were normalizing, all he talked about was how I should go on insulin. In other words, my condition is improving and he wants me to take yet another medicine?
I don’t expect my insurance to pay for what I purchase at the health food store. I just wanted a doctor who was WILLING to listen to me and give me her honest opinion of what I was doing. In fact, she recommended some things I have been doing anyway while informing me about some alternative treatments that aren’t so effective. Dr. G spends about thirty to forty five minutes with each patient. She has purchased the book and is reading it as well. My former physician just basically scoffed at me.
FWIW, I don’t think UHC should cover alternative treatments unless there have been double blind studies that prove what works. UHC should provide **allopathic ** healthcare to everyone.
I believe well visits and diabetic care visits are reimbursed at different rates. So I don’t doubt that Dr. G. is well-versed in finding ways to describe her methods that will result in higher reimbursement - in other words, to make them more expensive.
Again, that’s rather different from “health care decisions should be left up to the experts”. Your former doctor may be surly and unsupportive, but his expert opinion was the insulin was indicated and raw foods (or whatever Cousens wrote in his book) was not.
Isn’t that what your first doctor did - give you an honest opinion?
Were the alternative treatments she recommended double-blind tested? How about the ones that she recommended against? Were the suggestions in Cousens’ book double-blind tested? If not, why do you believe discussions of such suggestions should be reimbursed at the same rate as discussions of double-tested treatments such as insulin?
One of the many factors driving increased health care costs is that the demand for health care is essentially infinite, and people are shielded from the cost. People want (for example) to spend thirty minutes with the doctor discussing whatever they read in a crack pot book, and if they can’t do that, they shop around until they can. Then the new doctor is spending half an hour talking about raw foods and meditation instead of treating diseases.[SUP]*[/sup]
So we can implement UHC with rationing, in which case the doctor isn’t going to have time to talk about balancing your chakras. Or we can implement UHC without rationing, in which case one is likely to wait six months before getting a chance to talk ayuvedic medicine. Or we can implement what I would suggest, which is catastrophic insurance subsidized from the government and make the consumer pay for everything else.
I’ve said it before, but Americans want three things from their health care system -[ul][li]The best care in the world []Available to everyone []at a reasonable cost.[/ul]They can have any two of these three. [/li]
Regards,
Shodan
[sup]*[/sup]Although I will go out on a limb here and guess that the Dr. G. mentioned previously is not an MD. Probably a chiropractor or something like that. Maybe that is where the reference to “allopathic” medicine came from.
FYI, Shodan, my physician IS a Board certified physician. My point was that doctors shouldn’t have to spend their time coding your visits; they should spend time in examination and discussion with their patients. If Dr. G wanted to, I am sure she could do like many doctors I know: double code. For example, a gynecologist can code a visit a physical exam and “discussion of special issue,” which could mean anything. That is double coding on the bill that goes to the insurance company, resulting in double reimbursement.
And yes, my doctor did discuss medications/treatments that have been researched and studied. However, given the propensity for attack in this thread, I will divulge no details.
My point about my former physician was that he didn’t take into account the work and progress I had made evidenced by my bloodwork. When I wanted to ask him a question about a medication I was on, he didn’t answer my question. Ten minutes is not enough time to get a physical AND questions in. Are your medical exams ten minutes long? If so, for what condition? And who is your insurance company, Shodan?
I’m not sure I agree, but anyway, I don’t see how UHC would help this.
What’s going to happen when millions of Americans who are uninsured have the right to go to that same doctor? Seems to me that your 10 minutes is likely to turn into 8 minutes.
Excellent question. That is a distinct possibility. This point you bring up is something I would like for a doctor who practices in a country which has UHC to answer. Do they have severe time limits? Are their patient loads so burdensome that they can’t give quality care? All I know is that under the private system (which is run by the insurance companies and HMOs), most office visits are severely short. At least in my little town.
I am passingly familiar with medical coding, HCPCS, CPT coding, DRGs, and so forth, from several years writing and supporting the coding software in a local hospital system. Coding is not an issue that will necessarily be addressed by UHC - Medicare and Medicaid used the same coding systems as private insurance. Doctors learned to game the system under both payment options.
Well, if they were tested, then they weren’t “alternate treatments”. You must have misspoke. And Cousens’ stuff is not tested.
Again, this is not an issue that will be addressed by UHC. Quite the opposite - if a large number of the uninsured enter the system, the pressure will be to shorten the times doctors spend on each visit, since a greater volume of patients must be seen and treated.
There’s no ER fees in France as far as I know, and the ambulance was most probably the SAMU, a medical emergency service, hence free (It could have been the firemen instead, since your case doesn’t seem to have been life-threatening but you’d probably have noticed the uniforms if it were the case).
So you probably had to pay $20 for the doctor (seeing a doctor costs currently €21 if he doesn’t overcharge, and an hospital wouldn’t overcharge) and $10 for the shot.
Note that had you been a French citizen, you’d have been reimbursed (except for €1 of co-pay)
Apart from that I’m going to ask (that’s not the first time) why private but non-profit (ran by the insured people themselves, or more exactly their elected representatives) insurances don’t seem to exist in the USA and more importantly don’t seem to ever been mentioned as an alternative to either state-run insurance or private for-profit insurance companies.
They’re used over here by most people as complementary medical insurances (*) for expenses not covered by the “public” (actually not run by the government, either, but by representatives of the employers and employees) health care system, and if it were to be suppressed (not a snowball chance in hell), most people would probably rely on them rather than on for-profit companies for their insurance.
(*) Actually, it’s the same for car insurances, home insurances, liability insurances, etc… I never dealt with a for-profit insurance company in my life even though they exist.
Many of the big insurance companies in the U.S. are, indeed, nonprofits. You don’t hear about them because they don’t fit the script that the loud folks like Michael Moore want you to believe, namely that the profit motive is destroying U.S. health care. But since most of the funding for health care comes from either the government (almost half) or non-profit insurance companies, it’s hard to see any truth to this statement. Most Americans are fairly ignorant as to how exactly the U.S. health care system works, though, and they assume all insurance companies are for-profit and that these companies finance essentially all of U.S. health care spending. That assumption (and many other false ones) drive our debate, unfortunately.
