Thursday, February 5, 2009

Capping corporate greed and the Health Care Model

Firstly, I must share some of new finds in the blog world- real gems---
The Pink Cowboy -well written, funny at times , poignant at others,love that he shares his own experiences and not
 just his observations- the design is fab!




 - here is writer who has class, elegance and is consistently updating her blog

High Desert Diva-a spunky, creative diva who has charmed me with Americana and her photos

Thank you all for your sharing !
Secondly, I read an interesting blog post on MSN - Obama pay cap puts overdue squeeze on bank CEOs
Posted Feb 04 2009, 02:28 PM by Anthony Mirhaydari


I think it was well written and covered the issues succinctly! Right, this is something I can not seem to do  lately, my run on sentences and dangling participles are out of control, but, do troll on if you dare! These"wall street monkeys", as I call them, gambled away the American dreams of so many during the past 8 years !! Their outrageous risk taking with other people's money created  the Fleecing of America grace à Bush/Cheney's policies.
  
Right, you may detect a sour taste here at WDF, and you would indeed be right.  You see fellow bloggers, I witnessed, both as a physician and a patient ,the evisceration of the American health care system by the insurers who operated with the so called " business model of Wall Street" Here is how it worked:
- they answered first to their stockholders and paid board of directors ,
-then to their top-heavy administrators, who over a five year period from 2001 to 2005, received a 100% increase in salaries
- and somewhere after advertising, accounting manipulations,ie kiting ,they dealt with paying for health care!!!  After a little whose bill is it pingpong .....An upside down arrangement for sure!

 Meanwhile the small businesses and families of Rhode Island ( a microcosm of America, being the smallest state) sustained  20% increases each year for 5 years- thus a family plan originally costing 425USD per MONTH increased over this period to over 1000USD per MONTH-not including the costs of medications and supplemental fees. 

And we wonder why most Americans have no health insurance?( for those following this from other more civilized nations where health care is a right and not a privilege - this seems outrageous!!!) ps the doctors do not , I repeat, DO NOT see any of this profit because of the strict regulations set forth by the government to date by medicare and a complicated formula similar  to a derivative

For me, the corporate manipulations of the medical system was just the tip of the economic crash's iceberg! Shall we say foreshadowing? 

How could the medical world dedicated to caring for the sick and suffering have allowed these parasites, often masquerading in nonprofit status (ie BCBS), to bleed off the very best  medical system in the world to the point where it now stands at 27 by WHO standards. Luckily, France is #1 and still directed by physicians.
 
Why did so many of my colleagues leave practice early?  because among other things, they were in moral conflict with themselves to withhold care from patients to obtain, what I called, "kickbacks" but, the insurers called incentives, bonuses! sound familiar?

For me the demise of the American economic Wall Street driven system FIRST took its toll on the weakest of the weak; the sick and the naivest of the workforce ;the doctors and nurses. These third party players placed antitrust laws on doctors preventing them from gathering to discuss fees or collaborative platforms to address these issues to protect patients.  They placed gag rules preventing doctors from communicating to their patients about the insurer's incentives. They  passed the risks onto the physicians, hence the malpractice insurance costs went up as more and more patients experienced the fallout of this process wherein the almighty dollar came before the primary intention to heal.

Why do I say the doctors and nurses were naive? Because they thought that everyone was working toward the same goal on behalf of the patients. Rather, the objectives of the insurers could not have been more diametrically opposed to this goal. 

 The insurers used monies to create warm and fussy advertisements to seduce the businesses but, their modus operandie  sp? was to create a quagmire of ridiculous paperwork, billing procedures, audits, oversight subsidiaries who were  made up of  non clinicians  geared toward debating with the doctors about their choices of medications , treatments or services. Hence, more than 60-70% of clinicians'  time in the USA was spent tackling the paperwork and billing codes to JUSTIFY their clinical decisions. Talk about regulation and capping earnings!  Hellllooo!

Now ,you are no doubt wondering why I have linked my experience with managed care medicine to the financial collapse of the Wall Street....it is because the greedy fed on the weak or highly distracted medical world first before it went onto feed on the home buyers and credit markets in the USA and EU, China, Russia...
At least this is how I see it.



For me leaving my work as a pediatrician, trained at an Ivy League Medical Center, and who experienced the realities of being a patient at the mercy of care plans which were directed by the greed from those in control, the 3rd party payer corporations yes, who were bought and sold on Wall Street ,breath--- I can tell you frankly, I saw this financial downturn coming! Why so many experts have denied understanding this infection of the financial systems is beyond belief and borders on disillusionment.

Lastly, on a more positive note:
  • I am glad Daschle withdrew, he was as related in the NYT and THE NATION in bed with these 3rd Party Payers, United Health etc. earning millions from them-  this is much more of a detriment to avoiding taxes.
  •  I am confident in Obama to find the right fit for health care reform, I am rooting for a physician or nurse or someone with more experience with patients.
  • Those of you who know me personally, know I fought not just my cancer, to stay in practice, to keep food on the table for my children and good education in the picture for my children but, also,to stage protests in the dead of winter at an Insurer, to help my patients access their care,  to serve as an advocate for what is  a human right not a privilege of ONLY the wealthy, to gain media support from major networks, to question the editors of major newspapers about their conflict of interest taking big  advertising dollars from insurers and not featuring the real new of the abuses at RIBCBS, to write and lecture and teach about how to be proactive when disease or trauma strikes- and yes, I would say, I am tooting my own horn or as we used to say about my Sicilian Grandma, I am on my soap box. 



However,as is true to form, from my Grandma in the factories defending the rights of immigrant women during the depression, to my Father as he fought to bring pediatric surgical and intensive care up to the forefront in RI, Italy, Argentina, to my cousin who was one of the first to challenge (and win against) the Vatican regarding the Priest abuses - I hope I have been of service to a cause greater than myself.  I so miss practicing, I miss my patients, watching them grow, advising them, being there for them. I see it as the end of a love affair yet,  I know that the future hold  promise with the intention for HOPE and CHANGE.  Thanks for listening to me rant about a subject close to my heart.



8 comments:

  1. Gosh, well covered and indeed I think your right. We take our right to Healthcare in the UK for granted and moan about it at times to but you've higlighted how greed and money corrupts even good so I'll keep our imperfect but lovely NHS.

    On the perfume choice. Paul Smith created hi Rose perfume in honour of his wife, which I think is lovely and it is gorgeous. But the Jo Malone perfume is equally splendid so you can't go wrong with either.

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  2. Thanks for the shout out! And I'm in good company, too. I enjoy The Pink Cowbow, and I've visited Bee Drunken as well....must pop back in...

    I'm focusing on the change and hope with our new government. We need both...desperately.

    I like your new header!

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  3. MDS-
    oh, how right you are about having a health care system accessible to all in the UK!!! I have heard complaints about it too, in terms of specialist care however, it sure beats the USA where many children go without basic care for preventable diseases. All fingers crossed for then new reforms by Obama!! Enjoy your little one, they grow up too quickly- he is absolutely adorable!!! Thanks for stopping by.

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  4. Diva,
    Of, course you are in good company! I believe like you, we have to focus on the change and the hope on the horizon with the fresh vision of the Obama team. Unfortunately, my training has me looking for the signs and symptoms of the financial trauma so many folks in the USA are facing,for me understanding the natural history or evolution of the problems helps me to see, embrace,and assess creative solutions. It is exciting though to feel we are finally at a stage where the gov. is not sweeping the issues under the rug! Hooray for that! Have a great weekend.

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  5. First, I would like to thank you for your very kind "advocacy." (The word seemed appropriate in terms of the rest of the post.)

    Like Make Do Style, I am really grateful for the NHS. The English all complain about it, and apparently there are all sorts of abuses and wastages in the system, but it seems terribly civilized to me. Anyone (everyone) can get treated, and the most vulnerable don't even pay for the medicine. I still marvel at how I can just walk into a clinic . . . and that there are no forms to fill in. It seems very sensible to me.

    Picking up on your "signs and symptoms" theme, it seemed obvious to me that when the financial people played with debts and balances and numbers (scrunching them, and dividing them up, and moving them around) there were bound to be all sorts of black holes everywhere. After all, they weren't MAKING anything. All of this "wealth creation" was just a chimera. I've known a bit about the way health insurance "plays" the system, but your critique was eye-opening . . . and stomach-turning. I hope that the U.S. has reached the tipping point on this issue, and of necessity, sorts themselves out.

    word verification is dathos:

    dancer's pathos?

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  6. Bee-
    Thanks for the insightful feedback-for noting your gratitude for the NHS and your take on the Black holes within the financial house of cards- as well as the word verification thingy- I have wondered on other blogs where they come up with these because they often seem related to subject of the post??

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  7. Hope some bloggers who are not in the health care system are reading this article:). Because of reasons of my own I choose a decade ago not to get licensed (although I had all the required hours) as a psychologist, but a "benefit" of being poor, is that I don't have to deal with insurance who prescribe me what I can or cannot do with a patient/client - without any of the expertise that I'm having! Now many people are jobless, and the economy has a downturn, I'm spending more and more time with art (painting) - wish I could dance :).
    Glad I found you.

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  8. Jeanette,
    Thanks for visiting and for your feedback re: your experience and impressions of managed (s)care- I do hope that with Obama's genuine interest in health care for everyone that things will finally improve! This change should provoke people to pay more attention to and to be more appreciative of the efforts to retrieve medicine from the grips of corporate America and the trading of WallStreet.
    salut du Midi!

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