The so called "excessive" use of health care
The problem with HMO's
|Home||Fictions||Articles||Facts||Life Stories||Poems etc.||Herbs etc.||Links|
note that most links
presented, are off site links, save where noted.
One thing I find extremely annoying, is the habit of most medical articles to point out the financial and social burden that disabilities create. Now, I can understand it from one point of view, as for them to get the funding for their research for example, pointing out to the ones with the money that X disease is causing a financial hardship. From the standpoint of lost work hours, medical costs and outright support needed, for those no longer able to work, is quite reasonable. I would imagine it does tend to get the money holders attention a lot faster than appealing to them for humanitarian reasons. :)
This habit however, does not take into account that our society as a whole already has a negative mind set for any group that for whatever reason is unable to meet their own needs and must rely on the social systems we have in place to meet such needs.
Now, in the best of all worlds, this would be done without negativity and given freely by our society. However, we don't live in such a world, not yet at any rate. By and large the "healthy" part of our society, who has to foot the bill for this support, does so begrudgedly.
So, what we have is a dilemma when it comes to funding. The medical profession who needs vast amounts of funding to do the research to, one hopes, help those of us with diseases. But their manner of doing so has, by their very practices, created a focus of doom and gloom in the mind set of the rest of the world when it comes to lost man hours and over all costs.
I don't know about you, but I am sick and tired of seeing, article after article the focus on how much FM costs! This focus on cost of care, the so called "excessive" use of health care services and lost work hours etc., is needed information to be sure for funding. But does it need to be pointed out every dang time we turn around? I doubt very much if the ones who write such missives realize just how much damage they are doing to our already over stressed lives, by pointing out cost factors like this to the world at large.
So, how to counter this? Well, we cannot tell the research people that are pointing out the financial hardships to stop doing that, if that means that they will not get the funding they need. However, we can and should point out to them that putting such items in for the public articles, is out of place and uncalled for.
What needs to be countered the most is this idea that our need for health care, is "excessive." Understand, the main reason this is said is that your average person sees their doctor 2-3 times a year. An hour of the doctors time a year, spaced out over three visits, per person, is considered "normal." Use of testing facilities and lab work, is on average, 3 times a year as well.
Now, those of us with FM outright laugh at this idea. It can take seeing our doctor 5 to 10 times as often, just to get in everything we need to deal with said to them and or testing done, etc. Our issues are complex and time consuming. Which, given how many things can be wrong that need to be addressed is perfectly reasonable. So where does the idea of "excessive" come in?
It's a numbers game, doctors compute their average session with a client, based who are most of their clients which is your average person. Meaning, persons without a chronic problem. Insurance companies are the worst offenders. They are the ones generally paying for care, so anything that comes across their desk that is above and beyond "normal" usage, raises a huge red flag for them.
I have been told, to my face that I was "using up" a doctors entire funding for a dozen people. HMO's are mainly to blame for this idea. They have taken to paying doctors X amount of money per month, based on their client base.These payments are made even if the people on the list, never see the Doctor for the year. Now, this seems a perfectly reasonable idea, or at least it does from the doctors point of view, as it means the doctor gets a fairly standardized income. Even if the pay per person, is fairly low.
However, in comes someone with a major chronic illness ... and suddenly, that pay paradigm goes right out the window. This is so, for the fact that while Doctor's are get a promised income based on their client list, they don't get any more money if they actually have to SEE the person.
So we are, in point of fact, making them work for their money way above and beyond their normal clients. This can even cause them to lose money, just to see us. Or so I have been told, point blank.
So, what to do? Well for one, we need to inform the HMO's and other such medical backers that all of us with chronic disabilities need to have a completely different scale applied to us. So that our doctors are more willing to see us. This will take much effort on our part, to enforce change on the HMO's and the like as of course, they are not going to want to have to do that, as it will cost them more.
However, facts are facts, with the the aging of America the idea of more and more visits per person, will become the norm. This is inevitable, so it is not just we with FM who need to do what is needed to get rid of this concept in the medical mind of so the called "excessive use." It is everyone who needs to work for it, as one day, anyone who lives to see old age will be considered "excessive" in terms of their medical needs, as we with FM are seen now.
We need to write letters to the major insurance carriers, our government, our local association for the aged, etc. WE need to make this point perfectly clear that the "norms" in our current day health care system, no longer apply. It's time to stop considering us ( and the elderly ) a burden and just address our needs, without all the hype and hair pulling over what is "normal" usage.