Thursday, September 24, 2020

Medical Practice Today


Medicine, according to Wikipedia, is "the science and practice of establishing diagnosis, prognosis, treatment  and  prevention of disease."  You feel bad, go to a doctor, obtain a diagnosis and  establish a treatment plan. That sounds relatively straightforward and it usually is - as long as you have insurance or a wad of cash to pay for it all. Speaking of cash, your healthcare provider likely acquired a mountain of debt while attending medical school. 

Over the years the USA has evolved into a country wherein most people count on their employers to provide health insurance, a standard employee benefit. That system left 10s of millions without coverage since insurance is a benefit too costly for most small businesses to offer. Our response to that was The Affordable Care Act aka Obamacare, and more than 8 million people are signed up for coverage. But about 27 million people are underinsured or uninsured, many with preexisting conditions that make insurance virtually unattainable.

Health Insurance

Health insurance is a product in our capitalist system. There are numerous exclusionary factors - aka the aformentioned preexisting conditions. Not fair you say? Many agree, but many also say it is a business. Profit is king. Healthy people should not have to pay increased premiums for insurance because of someone else's preexisting condition. Now healthcare has become weaponized in today's political debate. While the bickering continues, Trump is attempting to totally dismantle Obamacare, a death sentence to some people insured through the plan. 

I will go on  record as saying I think healthcare is a right, and we need some form of public option to keep as many people as possible insured. It is indeed interesting that only one western power does not offer a public healthcare option, something we have not yet given up our leadership role.

Quality Care is Available

Delivery aside, excellent healthcare is available here. There are specialists available for almost anything. Family doctors should harp on preventative medicine and show you how to stay healthy and my experience has been just that. Specialists are available for everything else - as long as you have insurance or a wad of cash. A huge wad. Doctors are small business owners and those businesses aren't cheap to run. Equipment, employees, office space and oh yeah - insurance. Doctor's malpractice rates are outrageous. Why? Check out the settlement figures for malpractice. Remember - just like any school, there are doctors who performed at the very bottom of the pack.

Dr. as a Small Business

Holes in our system? Of course there are holes. Many small, rural hospitals are closing. Areas of the deep south and Midwest have no or insufficient quantities of doctors and must rely on services provided at no charge by organizations.

Holes in the System

There is a glaring hole in medical care offered for mental health issues. The level of service we provide is embarrassingly insignificant. Simply look at the number of homeless veterans.

At times one wonders why anyone wants to be a doctor. I had an interesting conversation with my cardiac specialist about just that. She is a Physician's Assistant (PA). She just smiled and said "Chuck - I make excellent money and do not have to run a business. I get to help people but not deal with the rest of the headaches."

When you feel bad, you want to feel better so you go to a doctor and if it is a Dr. Feelgood you may come away with a script that gets you pills to numb you. Or, you go to a doctor that is interested enough in your well being to help you. We have them both here. Ultimately your healthcare is up to you. You decide what you will do - whose instructions to follow. Don't like your Doctor? Change to a new one, though the new Doc will need to be one approved by your insurance provider. We are fortunate to have some of the best healthcare in the world as long as you can pay for it. But, we have a long way to go on the delivery mechanism. I do not see us ever becoming a single payer nation - too many people fear the term socialism. You would think more would fear the notion of no insurance but that looks like a topic for another time. Until then people here must wait until retirement and eligibility for Medicare unless Trump decides to dismantle that as well.

Big Pharma in Control?

Lastly there is phenomenal control over our healthcare system exercised by the pharmaceutical industry. They get paid to sell medicine and like everything in this day and age that has been weaponized - politicized like never before. Clearly this deserves more than a scant paragraph in this blog - again that deserves its own weekly topic,

That ends my quick shack take on Padmum's topic. Be sure to visit the others of this little blogging group to see what they have to say.

ConradRamana,  SanjanaPadmum,  RajuMaria & Sriniva       




4 comments:

  1. Pithy and very pragmatic description of your system there. Our system here is multilayered and to a large extent dependent on free enterprise of the professionals. The Pharma industry does its bit too.

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  2. it's always all about the money isn't it. bottom line.
    great post Shack. as always. right on the money as they say.
    no pun intended! xo

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  3. It's difficult to think of a doctor as being a businessman. Or a business person. But that's very much how it is. In many cases.

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  4. I agree that health care should be a human right. Single payer is something I support. What it would do to overall health care quality I don't know, I just feel it would be more compassionate and fair.

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