Down the rabbit hole

Thru the looking glass went Alice and so have I... today a beloved patient lost their insurance. Well, I should not be surprised that happens every day here in rural working class America, but this patient - patient X - cannot work... matter of fact this patient has a terminal illness and may die without access to medicine and medical support. When I called the insurance company I was informed that the patient had failed to turn in a form for review to be able to keep the insurance and so had been terminated from the plan due to sweeping state sponsored cuts. This form had not been completed because the patient was admitted in another hospital miles away from home fighting for survival. Oh, it did not matter, insurance still gone.

So, angry, I called a state senators office. No, the senator was not in. No, they could not be reached, but please send us the information and we will forward it to the insurance company and try to help.

I am really getting frustrated at this point. Our president is on the TV telling everyone how he is going to force health care reform and his plan looks awful to me as a practicing MD - more cuts and more forms and more "Mother may I please..." and a board to decide if my patients lives are worth enough to treat... So then, I have to go treat my next patient after being torn up over my patients loss of access to care and medicine. Wouldn't you believe that my very next patient is a 20's year old, who has been previously convicted insurance fraud, who needs something for pain.

I think that we have gone down the rabbit hole. When did we as a society forget how to work, when did young people want to be on disability and let the state and nation pay for them instead of having pride in themselves?

Health care reform needs to occur - I am not disagreeing with anyone on that. Less than 10% of a medical schools class goes into primary care now and of those less than 4% will go into a rural area to practice. In 7-10 years we will be facing a shortage of primary care (family medicine, general internist, general peds) doctors because everyone wants to be a specialist in America... Why it pays better... and when you come out of school on average $140,000 in debt you need to get paid. Now with physicians facing a 21% cut in pay looks like I should have been a specialist too. Every other civilized country pays for prevention and primary care first and as a result has better health care than the USA does. Yes that is right, among our peers - we always rank in the bottom for health care outcomes. Maybe the lawyers should consider that health care reform cannot occur without TORT reform. You cannot practice good medicine without being able to tell the fakers and drug seekers to get out. I spend 50% of my time on 30% of my patients and it is the same 30%. These are the patients that take their children to the ED in the middle of the night for a runny nose just because they can - Why not they have no co-pay like the rest of us do...

See the many problems you can get into with health care reform... I want the system fixed. I love my job and my patients. Why else would I have stopped in the middle of my day, gotten behind, and beaten my head against a wall for one person...