State of our Healthcare System

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  • #101261
    myimd_dup1myimd_dup1
    Participant

    What should be done about the state of healthcare in our country? Depending on our individual experiences, we’ll (of course) feel differently. And because of different levels of training, our different fields, and our different degrees of involvment in healthcare, we can (together) probably solve the healthcare problem. (joke)

    But seriously, here in California, it’s a huge problem. I work at the County Hospital here (I don’t know what it’s like anywhere but here) and it’s horrific!! I’m almost willing to argue that *no* healthcare is better than the current county system. I’m here in the battle zone, experiencing firsthand the inefficient way things are done. For instance, to “save money” our hospital has decided to do away with bedside pregnancy tests. Do you know how long our lab takes to run specimens? 2-4 hours. Can you imagine having under your care in the ER a young woman, and witholding all drugs, radiographs (and essentially) treatment because you don’t know her pregnancy status? Can you imagine not being able to rule out (even the possiblity) of ectopic pregnancy in a young woman c/o abd pain…for 2 hours!! So frustrating!!

    Was just wondering if perhaps others have an opinion as to the solution. Universal healthcare? Vouchers? Boutique medicine?

    What about immigration and the “burden” of caring for them, the working poor, the addicted, prisoners, etc. We as physicians have a responsibility to society, but with the average medical school debt over $150,000 and rising…we can’t work for free. Malpractice insurance, etc. Perhaps “society” should pay for the education of physicians?

    There are many docs who see no Medi-cal/-care patients because of the shitty reimbursement? What about that? Only poor people and physicians suffer.

    HMO’s dictating healthcare with our medical lisences? Unsatisfied patients…and docs? What if doctors just *refused* to work under these “rules.” Would that help the situation any?

    #101262
    MinaMina
    Participant

    Interesting topic.

    Healthcare is in a transition state, and I think it’s headed for a universal-type system. If you think about it, we provide “universal” health care now, with our tax dollars. The problem with our current system the people who use these facilities are not (typically) paying into the system. What I mean is, like Kaiser, for instance, takes money from all of the healthy people month after month, and with it pays for the relatively small number of sick people (who have also been paying into the system prior to their illness).

    If we as a country could somehow have everyone “pay into” the system, there would be enough funds to cover the sick people. I don’t know how this could be done, however. :confused:

    I understand why doctors are not seeing a many poor MediCal and MediCare patients if the reimbursement continues to decline. You can’t expect people to work for nothing. No one works for nothing. It is expensive to become a doctor. It costs lots of time, lots of money, and sometimes even valuable personal relationships. To do it for no compensation is not an option. Espcially when the thanks you get is a fat lawsuit. No, free medicine is not something physicians are typically willing to provide. So that’s not the answer. :twocents: Just thoughts that this topic evoked in my mind.

    #101264
    PremedRNPremedRN
    Participant

    I dont know any good solution to this problem. Certainly, it is true the poor and physicians dont benefit from the way it is run.

    I can tell you this, the elderly should be provided with better coverage than they have. I think it is ridiculous for them to have worked and got us to where we are now, and retire to spend more than half their monthly income on scripts. It is heartbreaking. Because the government refuses to improve benefits, they now keep increasing the retirement age, and have changed rules to where retiree’s can work a little more and still get benefits, sure, this may work for a healthy retiree to afford prescriptions, and healthcare cost but what about those who are less fortunate healthwise? What is their solution?

    Because the US system tends not to reimburse adequately, the cost of med schools should decrease, after all, I dont see the government increasing pay or benefits for anyone or anything.
    Sorry this is sooo negative, its the way I feel.

    #101266
    CaliMDCaliMD
    Participant

    I am going to offer my 2 cents here of practice experience. All of the issues previously mentioned by the other posters on this thread are significant with respect to the crisis in medicine. However, the largest problem I see with health care in America is the fact that medicine has been run into the ground by insurance companies whose primary goal is to make a profit significant enough to satisfy shareholders and executives. An obscene amount of health care dollars being spent in this country does not go toward direct medical care (which includes paying physicians). Even the historical blue cross and blue shield non profits have been merging into various FOR profit entities (Wellpoint, for example). Anyway, it’s late and I’ll end for now with my two cents.

    #101267
    efex101efex101
    Participant

    I will tell you right now that socialized medicine is not the way to go. If you are in doubt go visit any European country and ask and look around. My father was left to die because he was 60 and liver cancer so nothing was done for him period. I went and I saw and I lived there. Most people that can afford private insurance have it. The hospitals are understaffed and overburdened if not look into what happened in France this summer. So before you wish for something take a real close look at it, the grass is not greener. I do have to agree that our litigous society has done more damage than good to healthcare. If we had caps it would help. But there is no easy way of fixing anything, I do believe that we here in the US provide the best healthcare available but at a very high cost. Having the government subsidize anything will mean that the government will say who and what can be done just as HMO’s do. In my father’s case he was NEVER asked about chemo or radiation, the doctor thought there was no need for it hence he never ever saw an oncologist for 8 months. So buyer beware.

    #101269
    DONOTDELETE ****DONOTDELETE**
    Participant

    I think helping to curb lawsuits will be a huge step in the right direction. Now, if you offend someone by breathing the wrong way you get sued. If your name is in the chart, doesn’t matter what your role or capacity, you are sued. If you happened to be born and have MD behind your name you get sued. Now I’m not saying that people that have legitimate malpractice cases shouldn’t have the right to their day in court, just that bringing a lawsuit should be made a whole lot harder so that people think before they do it and think about WHO actually they want to sue (not just everyone in the chart). Besides how many times have you ordered something not because it is necessarily indicated, but because you want to CYA. And insurance companies…well, don’t get me started!

    #101271
    MTaylorMTaylor
    Participant

    So what can we do as physicians to change things? My husband is constantly telling me that the physicians are their own worse enemy. We’re the ones sitting around and letting this happen. Without us there would be no “healthcare” so why aren’t we more vocal?! Why do we accept things as they are? :confused:

    We’ve concluded (my husband and I) that the AMA isn’t really looking out for us *young* physicians. Do you know how much political clout these professional medical organizations have, and they are not helping young docs very much. Consider resident work hours, the NRMP (matching) process….

    Malpractice is a big issue, tort reform is very necessary…but there are more issues to fight for. Old docs are worried about their private practices and making half a mil per year. We are worried about limitations on our (medical) decision making ability by HMO’s and government.

    I’m not sure universal health care is the answer. It seems to me that it’s much easier to argue (and potentially sue) Blue Cross or Kaiser (as both a MD and as a patient) than to have to deal with the government. Can you imagine having an issue with the government, and trying to get things changed? 😡 Impossible!! We just need more accountability on the part of the HMOs, or, we need a government system where (all of the medical) decisions are made between the physician and the patient (as if).

    The military seems to do it…or maybe they don’t.

    #101273
    efex101efex101
    Participant

    Well you cannot sue the military (I know folks who tried to no avail) so the military healthcare is good but, if they do make a mistake (like with a friend of ours amputated the wrong leg) there is nobody to run to. Physicians do need to take a stand and stop complaining and do something about this whole lawsuit ordeal. Now what to do I do not know. I am planning as a future physician to get my MPH during medical school and go from there. Maybe one day I will be lobbying I don’t know. But I do tell you this, I will be a voice in some fashion or form. If physicians unite things can change a little at a time. But it is easy to sit there and gripe and do nothing while physician autonomy gets clipped more and more…Of course I say this as I am yet to practice maybe my tune will change but I hope not.

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