Dr. Steve's Doc Blog

My succinct view on government health care

Our government cannot afford to do what it has already committed to do.  It cannot afford Medicare which is unsustainable and is doomed.  We (the government) cannot afford to take over care for everyone else without robbing and plundering our future as a nation.  To continue on this course of overspending and overpromising will bring our nation to certain ruin.

Life can be brutal, and there are many who suffer and many who may die who could be spare for a while if someone else could bail them out...but this should be via free will charity and not the  pillaged goods of others taken by force in the name of taxes, penalties and fees.  Such is basically armed robbery.  It is also unconstitutional because it is not in the spriit of the general welfare to do for others what they should do for themselves.

The role of government must be limited to doing what individuals cannot do for themselves such as delivering the mail and defending the shores.  Providing and managing and controlling how, where, when and at what price health care is obtained should be left in the hands of private individuals.  If it is out of control it is because the government has already entered into the arena by way of Medicare. Medicare was a mistake from the beginning and should be eliminated.  We either have to go back to living true principles or we will fall of our own accord.

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Who says the government should be in health care?

It seems like such a simple principle to me that the government should not be in the health care business.  It is such a clear example of the socialistic philosophy that the government should take care of people.

The government can try, but they cannot do it.  The government should not have started down this road with Medicare.

Is Medicare a wonderful thing?  Well, millions of "elderly" have gotten very good care through this program, and still do.  But it is bankrupt and is taking our country down with it.

What is worse?  To have some people suffer by not being able to afford doctors and hospitals and the latest in scientific progress or to have the nation brought to its knees and lower because we did not have the foresight to know that people have to take responsibility for themselves.

In the old days, those who were down and out might be shown charity by their fellow men.  Charity is voluntary.  What we now have is socialism:  The government takes from others and distributes it to the poor by force.  Goodbye Charity.  Hello Entitlement Mentality.

Getting back into blogging

The landscape in the medical profession is changing at a very fast rate.  Just as technology has been speeding up the world so have the changes and inovations in the health care field led to such changes that I can scarcely recognize it.

The thing that has not changed for me is the feeling I get when I sit down with a patient and, on a one on one basis, go into the most important issues in their lives.  That is the part of medicine that I  love and do not want to live without.

I will be posting on this blog many of my earnest feelings about being a family doctor and dealing with the current issues.

The Hospital Will Rape and Plunder the Uninsured in Emergencies

My best friend, Jim went to the ER by ambulance the other day.  He fainted at home and his 13 yr old son called 911.  The perimedics and the ambulance came, and they convinced Jim that he should go with them to the hospital.  He should have called me.

He has been going to see me in my office for over a year, but he has not gotten around to it.  That is partially becaue he knows that I will recommend some tests, and he has only "Catostrophic" health insurance.  Or rather I should say that he had catostrophic insurance.  He has neglected to check on something so vital, and his company somehow dropped that insurance.  At any rate, I surely could have saved him a lot of money.

He was in the hospital for two days.  Between the ER physician, the hospitalist, and the specialists, they ordered tests and procedures to the tune of well over $20,000.  They found nothing.  I have reviewed all of the tests and they were all negative.  He had had a simple fainting spell.

Patients in hospitals are like captives.  It they have insurance or Medicare it is just a whirlwind of activity and confusion.  If they do not, it is a financial disaster.  After they get out, the hospital comes down on them like a hard hearted business.

Why does this happen?  Because the doctors do not want to sit down with the patient and explain the options and costs versus benefits.  The doctor  wants mainly to leave no stone unturned and face no possible chance of being sued for negligence.  The doctors do not care one whit about the cost and he or she does not get paid one dime more for taking the time or exposing himself to the risk of doing anything less than 100% of every possible test.

Jim had a CT scan of his brain.  That is plenty to tell if he has a brain tumor or a stroke.  But his doctors went on to order an MRI and an MRA as well as a carotid doppler and an echo cardiogram and even a nuclear heart image.  This is ridiculous.  Jim was alert and feeling fine from the moment that the ambulance arrived at the ER.

When a patient does not lie quietly and allow the tests to be done, he is labeled as uncooperative.  The doctor gets upset and wants the patient out of his way.  Actually, all the doctor really has to do is to document in the record that a patient elected not to have a certain test done due to the cost.

By the way, Jim does not know it, but the hospital charges do not include the fees for the doctors.  He will be receiving a lot more bills in the mail.

More later on what all this implies for "universal health care".  How can a society afford it?

Long Term Care Insurance and my wife

I still cannot believe that my wife has Alzheimers disease.   But she does.  It has been and is a horrible experience. 

My beloved has to have someone with her all of the time.  Her dementia has robbed her of the ability to take care of herself.  She cannot turn on the TV by herself.  She tries to open doors by pulling on the hinges. She cries a lot.  She knows enough to know that she cannot do anything on her own.

When I am with her I do all I can to make her feel like she is doing something worthwhile.  I know how to do that.  So does Darlene.

Darlene is the main caregiver.  She comes for 8 hours during the weekdays.  I can tell that she really cares about Mardi.  Mardi is very dependent on her.

Mardi is only 56.  She has had AD for many years, but I did not know it until 2005.  I just thought she was not interested in many of the things that I loved to do.  I thought she just chose not to care about our business ventures and our bank accounts.  Now I know that she just could not grasp it.

My long term care insurance pays for 80% of Darlene's cost.  Darlene has to work for a home health company in order for my insurance to pay.  That is their rule.  If Mardi required skilled care they would pay 100% up to my max which is $150 per day.

How did I get this long term care insurance?  I think the Lord inspired my to get it.  At any rate, I read in a book that it was a very important part of estate planning so I brought it up with my insurance agent and bought it.  I elected the life time benefit with inflation increases.

If I did not have it I would already be in trouble.  I would not be able to work, and my family and I would be burning out.

More later.

SCF

US Healthcare Issues

As I practice medicine every week I encounter over and over again the issues that confront doctors and patients alike in the US health care system.  I see these issues while working "in the trenches" while I simultaneously keep up with the news and editorials.

True stories seem to drive  home the issues.  Today I saw Don.  He sees me often, but he has specialists that will not let go of him.  He sees a cardiologist that goes ahead and takes care of his diabetes as well.  Why does Don need to see me?  He doesn't, really. I can take care of him or the cardiologist can.  I resent the cardiologist.  He thinks that he can do everything better than me.

He prescribed a prescription fish oil pill that costs $400 per month.  Don wants to know if he has to take it.  Don is in the "doughnut hole" of his Medicare Part D prescription plan.  That means that he has to pay cash for his medicines that rest of the year.  His expensive branded medicines have used up his yearly allotment.

Why didn't he call the cardiologist who prescribed it?  Because he knows he will not listen to him.  I know he won't either.  The cardiologist is on the pharmaceutical companys' speaker circuit.  He likes to be known as the doctor who is the expert and only does the latest thing.

Do we have to use the latest branded medicine for everything?  Where is the common sense and the voice of reason?

I told Don that he can use the over-the-counter fish oil supplement.  I am not convinced that either one will make a bit of difference in Don's cardiac risk profile.

More later.

Doc