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Monday, May 03, 2010

Medical Care Thoughts

I worked in medicine for many years, when I was young and needed the money. I didn't like it. Too many whiners and liars. I was like House before it was cool to be like House. Even in the world of microbiology you have a lot of patient contact. Usually icky patient contact involving blood, urine, feces and phlegm. For that alone I can see being paid high dollar. To sit there and actually listen to them whine? Oh you bet I'd want mega-bucks.

I think doctors should be paid for their services. Whether or not I think the price for those services is something the market should rule, not the Government. Yet, this is something we've allowed since the inception of Medicare. Every quarter, every physician is mailed a MAC, which is a chart of the fees that doctors are allowed to charge for procedures, office visits and all things connected to patient care. Insurance companies use the MAC to set their fees and tie payments into things like global periods where they are not allowed to charge the patient anything and in which period Medicare will pay the doctor nothing for taking follow up care of a patient.

In 1991 Medicare decreed that all physicians would have to use the MAC fees and that Medicare patients were not allowed to pay anything over and above the MAC fee that the doctor was shorted. Back then a few specialists started to cut off Medicare patients. They accepted new patients and helped current patients find new doctors who still accepted Medicare. I worked for a dermatologist back then and the office manager and I attended several conferences and seminars put on by Medicare to justify to physicians how they came up with their fee structure. they were giddy when explaining that Ivy League mathematicians had come up with the formula they used to reduce any and all payments, when not outright denying them. I was asked to leave one meeting when I told the presenter that it sounded like they came up with what they felt was fair and hired the mathletes to come up with a formula so they could baffle us with bullshit.

It's lucky I'm really good at higher math and saw it for the steaming pile of crap it was.

Tomorrow morning I go in to have my frozen shoulder unfrozen. It's Arthroscopic surgery of the shoulder joint, cleaning up adhesions, then manipulating the arm into a full range of motion, then re-scoping the join to clean up everything that was worked loose as a result of the manipulation. It's pretty straightforward. However, I have dealt with the dumbed down version of medical support care as the worst of all possible situations.

First, they scheduled the surgery while I waited in the office. I specifically asked if I needed any blood work or x-rays done, as I had gone through that a few years back when I got my heart ablation done. It's a totally cool thing that you are awake throughout. Evidently, the Versed they give you to keep you from freaking out when they speed up your heart makes you come on to your surgeon from a foreign country and tell him that if the doctor thing doesn't work, he can always come be your personal cabana boy. Oh, and evidently the thigh area is actually the groin... Just in case you have any strategic shaving that needs to be done before any medical procedure. I was happily prepared, even in December.

Anyway, I am having the procedure done at an outpatient surgical center. The center called me to see if I had my bloodwork and x-rays done and what had my primary care physician said to do about my insulin? Hold the phone, there, Susan. I was specifically told I did not have to do that, after I had asked them TWICE. So, I panic, call my regular doc and pick up orders for all the stuff to be done and schedule the pre-op visit. Unfortunately, my blood sugar was too high and I needed to work for two weeks, get it down. I did that, and faxed the numbers to my doc on Friday, thinking that my doc and my surgeon would then talk and someone would call me to schedule the surgery. A few hours after I faxed the glucose results the surgery center called me to tell me that my surgery had been scheduled for 6:30 AM on Tuesday. Stellar, the surgeons office had scheduled it and not told me.

Today my primary care physician called to tell me they hadn't received the blood glucose results, I re-fax. At the time of this posting, the surgeons office has still not contacted me to even tell me the surgery is scheduled for tomorrow morning. Very early tomorrow morning.

I have half a mind to tell them that I'm out of town and that she should have called me to find out when it would be convenient to have this done. I'm a bitch that way.

The point is this, does anyone honestly think that Obamacare or Nationalized medicine will make situations such as this any better? When has the government handling anything made it any better? Shitwits will be making life and death decisions about things they know nothing about, ill prepared to make any sort of decision about their own lives much less the lives of others. Who wants that? No rational being does. Not me, that's for sure.

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