Our Pathetic Health Care System: Not as Good as They Tell Us

By: Teddy
Published On: 11/24/2006 3:44:49 PM

When I was in New Orleans a few weeks back at the convention of the National Association of Realtors, I suddenly developed a fiery sore throat, so I went to the concierge at the major hotel where I was staying, and asked for medical help.

GÇ£There are no doctors on this side of the River anymore. YouGÇÖll have to cross the River,GÇ¥ apparently to Algiers opposite New Orleans... assuming I had transportation to cross the River.

GÇ£IGÇÖve been to the French Quarter before, I know there are, or were, dozens of doctors and clinics in the heart of town. What about the hospitals?GÇ¥

GÇ£The doctors left after Katrina and never came back.GÇ¥ And of the three major hospitals only one wing of one hospital had re-opened, and that was not at what could be called full service.

I may be in my seventies but IGÇÖm reasonably strong and healthy, and I survived on my own. But what about all the residents, those who have returned? What about the 30,000 convention-goers in town for a few days? It is like a Third World, maybe a Fourth World country in the Katrina-stricken area, one year after the storm.

But New Orleans is not alone. The Washington Post on 23 November had an article about the complete lack of accessible health care services, not even a pharmacy, in the 7th Ward of the nationGÇÖs capital.

When I returned home I did get an appointment (not being allowed to GÇ£walk-in,GÇ¥ I had to wait a day or two) and had a 10-minute talk with a physician who prescribed a mild antibiotic, but could offer nothing for a new problem which had developed: a swollen, sore foot. So I wrangled a begrudging fill-in appointment with my podiatrist. It had been a few years since IGÇÖd seen the podiatrist and how organized and corporate he has become! Exactly 15 minutes per patient, office closed two to two-and-a-half hours midday while everyone in the office takes off for lunch, and a $25 penalty fee if you are more than 15 minutes late for your appointment (this does not apply the other way around, though, the doctor does as he pleases without penalty). Oh, and the patient signs statements which serve to notify the poor sod that anything the doctor prescribes may not be covered by insurance, and the patient will be billed directly.

When did this new generation of doctors acquire the radio talk show host manner of talking right over the patient?  I once interrupted a doctor and asked, GÇ£Do you want to hear from the patient?GÇ¥ It stopped the self-important little guy dead in his tracks, and made the nurse standing behind him give me a beaming thumbs up. The fact is, though, one seldom gets to complete a sentence before the doctor is off on his or her own tangent. I realize they have to put patients on a rapidly moving assembly line in order to make enough money to pay off their school loans, but this is counterproductive.

I grew up with military medicine (my father was Army) and it served us very well indeed, especially when there was something seriously wrongGÇö as when my husband clobbered in on a combat airborne jump and shattered his thigh, and a certified orthopedic surgeon did an open reduction with a bone graft from the hip and a steel plate.  The operation was so successful that my husband jumped again (to my dismay).

Notwithstanding the formidable lobbying might of Big Pharma and scare tactics by the American Medical Association, it occurs to me that we need to re-vamp the delivery of health care services in this country from the ground up. Of all the major industrialized countries, we have the poorest delivery system, and the most expensive. What I believe would serve the public best is a system of walk-in clinics open 24/7 and 365 days a year, available everywhere, not just in white, wealthy suburbs or as non-profit social services in a few places in the inner cities. Let the government pay for the medical school costs, and let the doctors owe equivalent years back as salaried employees, just as so many of the military doctors paid back the military for picking up their medical school costs.

I have had military doctors confess that the experience they got in Army clinics was invaluable, far broader and more enlightening than anything they would have received in twice the years of private practice. We could even put the young doctors into uniform and on a government pay scale if it would make the authoritarian-minded Republicans happier. What happens up the line from the clinics (which would not, of course, be totally free but would care for everyone who walked in regardless of ability to pay)? Some could be linked to teaching hospitals, some could develop a sophisticated referral system within a health insurance plan redesigned to take into account what we need as patients, not what the medical industry needs.

Comments



Health Care an issue in the election (Teddy - 11/24/2006 4:01:01 PM)
When phone banking for Webb, especially in Southside and Southwest, the problem of expensive health care came up a suprising number of times, and it went beyond the infamous donut hole. People are hurting, especially in rural areas where the economy is depressed to begin with. Will new businesses locate where there are inadquate schools and inadquate health care facilities? One of Webb's statements was that he believed we should provide accessible health care at a reaonable cost for every American.


Thanks for the New Orleans Update (d'moore - 11/25/2006 9:12:42 AM)
Wow that is dreadful.

Friday I watched the NOW program on WETA about the  schools in New Orleans 1 yr later.  Since the public school system had collapsed even before Katrina, they have gone to Charter Schools to provide education for  most of the kids who previously were part of the public school system.  Aside from the fact that most of the public schools have not been rebuilt and that the featured charter school had no textbooks for the first 2 months of school, the people interviewed were trying to put a brave face on how they were taking positive action, I guess that is the first step to getting rid of what we know as public education. Soon Republicans will be siting New Orleans as the model system for educating kids. No one will really know if it's working or not because the various Charter schools won't have the same measurements as public schools. Some will work and others will not. Some people will get very little for their money and some schools will have lousy teachers and equipment. But no one will be able to measure  one school against the other because they will each be acting as a separate entitity reinventing the wheel for curriculum and administration. It will just be a total crap shoot as  to whether  your  child gets anything resembling a decent education or not.

In the classrooms featured in the story I did not see one white child anywhere altho they did show white people helping to build the playground, so I guess that's something. I know from people who have lived there that anybody with any money sends their kids to private school and the Catholic school system there educates about as many students as the public schools.

I  like your ideas about healthcare. If only the American Medical Association and the drug companies didn't write all the health-related legislation in Congress, maybe we could enact some things that made sense. It doesn't hurt to keep thinking of ways to improve things, however, maybe someone in the state legislature would listen.



please, do NOT get me started... (CommonSense - 11/25/2006 9:13:55 AM)
after going to Richmond and doing the family turkey day thing, my 80 year old mother presented me with her 107 page "Medicare and You" 2007 official government handbook that I am still trying to decipher two days later.

"What do I do about this?" was her question.

The first thing I find is that because she was unable to figure out what to do about prescription drug coverage she will now be paying a penalty premium IF she manages to choose one of the many programs available to her before December 31. Her mailbox is stuffed with offers from multiple insurance providers offering coverage and 
confusing her even more, most offering a "double premium" option which (I think) will keep her from falling into the now infamous "donut hole".

Now granted, at 80, she is remarkably healthy and only has one prescription that she takes on a regular basis. Her mind isn't gone yet, and she figured out on her own that it was cheaper for her to just pay for her one medicine rather than get on any whoop-de-do (her words) prescription drug "plan".

However my question to her was, what happens when you are 85 or 90 and you might possibly need more drugs to keep things moving along?  Will you be SOL if you don't sign up now?

I am sure there will be more comments to follow as I wade thru this prime example of gibberish being sent out to our senior citizens......

Oh, and did I mention she is STILL a freaking Republican?  Go figure....



Same problem with my 85 year old mother (Catzmaw - 11/25/2006 10:16:32 AM)
We didn't speak for a week after I told her I was working on the Webb campaign.  She'd "heard" he was "against the soldiers" and he wants to "socialize" medicine and "raise taxes".  What the hell are they discussing at the senior centers in this state?  And who the hell is putting this crap out there?  It's awful trying to figure out her coverages and prescription benefits. 


We need to bug all places seniors congregate! (CommonSense - 11/25/2006 11:09:08 AM)
My 80 Mom said Webb shouldn't pick on Allen for "problems" with his first wife because he (Webb) was on his third.
This is called Nana logic.
When I tried to explain to her that Webb didn't say anything of the kind, her response was, "well, his people did...." (I guess she meant me) and that was that. We did not even get to the macaca thing, didn't see any point.

Tried to explain that the 2007 "Medicare and You" was a direct result of Republican rule and you KNOW how far I got with that.

Thanks Catzmaw, it helps restore my sanity to know I am not alone here.



Nana logic -- that makes sense to me (Catzmaw - 11/25/2006 12:58:48 PM)
My mother complains constantly about the government and her convoluted medicare benefits, but she refuses to make the connection between the Republicans and her situation.  She goes on and on about not being able to pay for her meds, but rails against anyone suggesting something like Teddy's very sensible suggestion down below.  I have a steadily growing list of things I can't talk about.  Then there are my conservative sibs.  Can't talk to them, either.  Up until recently two of my sisters had no health insurance and no hopes of getting it on their own.  But try getting them to make a connection between their insurance problems and the current admin.  Sheesh.


We must keep trying (Teddy - 11/25/2006 1:53:03 PM)
Early in the campaign, when doing phone banking to Souithside and Southwest, I often ran into that obdurate blindness--- my Northern Grandmother used to say, "there are none so blind as those who will NOT see"--- but when they complained, and ran on and on about their medical problems, apparently relieved to find someone, anyone, who would listen, I would tell them I was 75 myself. From there it was a short step to ask if they are dissatisfied with the way things are, and they usually were. And I would say, then why reward bad behavior? Why vote to keep in office the people who created this mess? Isn't it time to throw the bums out? If that brought up the question of Democrats (God forbid) I'd remind them when all good Southerners were Democrats, and when that political party failed to remember who they represented, we all became Republicans--- well, Republicans have had their turn and they really, reall screwed up across the board, so that's why I changed my coat and now vote for Democrats. Set them back on their heels, and actually converted several. I think because I am "one of them."


A revised health care from BOTTOM up (Teddy - 11/25/2006 11:15:36 AM)
is my idea: give the country a walk-in clinic everywhere, even in the inner city and in remote rural areas, staffed with doctors trained at taxpayer exepnse, like a public health officer corps; rotate 'em out to their own private practice (if they choose) after their payback tour of duty. Prescriptions? Govt. negotiate with all its power, just like VA. Kind of like TVA was built to bring electricity to the depressed rural Appalachian areas, providing a standard cost that showed up profiteering by power companies (who did not find the free market supported their running electric lines into the sparsely populated hill region), and this  reined in the greed of private power companies--- at first, anyway.

As for the Medicare prescription drug program, I took one look (I use Medicare and AARP medigap) and said No, Thanks. Mainly because I do not trust the government. They will make me give up my current coverage, and, once I am helpless in their hands, they will start restricting and otherwise monkeying with the coverage, and whine about it's costing too much, so I'll have ever-growing co-payments for ever-shrinking coverage.

By any definition, the  entire system is an odious scandal.



Military brat and military myself (relawson - 11/26/2006 1:57:17 PM)
I grew up visiting military hospitals.  I never thought I would say this, but military medicine is much better.

Hmm, isn't military healthcare "socialized" healthcare?  The only difference is that the "socialism" is reserved for one group.

I am a believer in a mix of both capitalism and socialism.  Things like public health, roads, water supplies, education, and law enforcement SHOULD be socialized.  Doctors could still have private practice (we shouldn't socialize boob jobs, for example), but I believe that the government needs to get into general medicine and emergency care.  We could then get out of medicare if there was a free source of healthcare. 



Retail Medicine (Teddy - 11/27/2006 2:11:43 PM)
I agree, military medicine, on the whole, performed exceedingly well. What I am peddling in this article is to ask: absent ANY health care system, where should we start? And it seems obvious to me that entry-level individual care on an as-needed, walk-in basis is the answer. It does no good for the average schmuck to have fancy specialty operations and careavailable if they never get that far, and can't afford it even if they need it.

As a public health matter, I say start at the retail level. Whole swatches of our population have no ready access to affordable care, especially for everyday knocks of life, and doctors cannot afford to practice in those areas to serve these needs, so we need to pay for their medial education and demand reciprocal time back in service clinics scattered across the landscape.

Seems to me a state could do this as a pilot program, and it would have many benefits economically as well as socially.