As Congress moves ever so slowly towards barely changing a health care system where doctors are unable to care properly for patients, and where people cannot even access a physician but end up in emergency rooms with conditions far more advanced than appropriate, all I can do is write from the front lines.
Many people think access to insurance is what they need. That is a beginning and necessary but hardly sufficient.
For five months I have been trying to get one of my little patients her ordinary immunizations. She has health insurance. She has “good insurance,” meaning it pays for many things she needs from the health care system. But this is what it is like out here. For me to give her the shot I must buy it, and fill out complex paper work, that is routinely delayed and rejected – for trivialities like a comma in the wrong place – then I get reimbursed for the vaccine months later.
To buy the immunization Prevnar from the company Wyeth, one must buy ten doses. No less. No exceptions. Ten doses costs about $1,000. I need one dose, and have no idea when I would need a second. Wyeth refuses to sell me a dose. Drugstores refuse to carry them because they cannot afford to buy ten doses and let nine go to waste either, and other practices will not work together for a variety of reasons, citing “risk.”
I have called many people in many agencies trying to solve this. I meet obstructions everywhere. This is typical of primary care. People want our time but we spend hours and hours of unseen unpaid time chasing down the toxic bureaucracy that blocks us from taking care of people.
I have succeeded in getting the child immunized by a complex arrangement with another office, having asked the parents drive to this other site to get basic care.
Every doc has many stories. We cannot provide care in the current system. Major change in the way we deliver care in this country is needed.
Making health insurance affordable will not fix many of the problems we face (see Massachusetts) and currently most of what Congress is doing is figuring out how to make insurance affordable. Access to health insurance is not access to care. It is a start but it is not remotely enough.
Jean Antonucci MD
Farmington
Good for Dr. Antonucci, for going to so much trouble to get one of her patients what she needs. I wish all the doctors around here were so caring. There are indeed problems at just about every level, and one gets the impression that the medical/pharmaceutical industry has lost touch with its humanity and is operating like a tangle of heartless computers. Examples could fill many pages.
I would just like to suggest, however, that “insurance” is part of the problem. We would all be better off if there were no such thing. Doctors’ bills would be lower. Catastrophic cases could be dealt with by community support, as we now (hopefully) rally to help a homeowner who has had a catastrophic fire (though we could stand to do more of that, too).
Thank you Doctor A. for speaking out and giving us some insight as to what a doctor might prescribe for a solution. Unfortunately the legislators are writing the law and not the doctors. I think you have pointed out the problem, to much red tape and lack of communication, the current legislation does nothing to address these issues, it is sure only to make it worse (I believe I should you a flow chart once).
It’s really too bad that the Maine Representatives and Senators were too cowardly to hold public town hall meetings, instead of invitation only events from there campaign donors list, so they could have heard from the patients and the doctors in Maine.
An interesting description of just ONE of the frustrations routinely encountered by health care providers practicing on the front lines of primary care.
As a provider of health care in our community, concerned citizen, and concerned parent of young children I have followed the most recent iteration of the health care discussion with interest.
The vast majority of the discussion has centered around how to pay for insurance, how to regulate insurance coverage, how to further micro-manage the delivery of care to our citizens; there has been scant discussion about what we citizens can do for ourselves (and how our government might support this) to improve our own health status, the health status of our own families, and by extension our own communities, and our country.
In a society in which well over HALF of our annual expenditures on health care are spent on the diagnosis and treatment of lifestyle driven illness (read – preventable), I consider it to be nothing less than an astounding, glaring, mind-boggling omission in the ongoing discussion.
Surely expanding the health education curriculum in our schools, resurrecting mandatory physical education in our school systems, supporting access to regular physical activity for all ages, educating children and adults about healthy eating, making eating healthy foods financially accessible for all members of society, supporting sustainable agricultural practices, just to mention a few ideas, would reduce our health care expenditures by a factor of at least a third to a half – not to mention ameliorate the MANY other social costs associated with premature disease, disability, and death.
I do hope that there are some common-sense folks involved in the higher levels of this discussion who might consider a similar perspective.
In the meantime, hats off to our local health care providers working on the front-lines treating illness and disease in the context of the current system while keeping an eye on and some hope for – a better way.
David Huish