According to the NAHU (National Association of Health Underwriters), mandated benefits on health insurance policies can raise premium costs up to 25%. That means that I should only be paying $150 every two weeks for my insurance, instead of $200, because I’m required to pay for the cost of them requiring prostate exams on my insurance policy even though neither me or my daughters have a prostate, and my husband is 29.
Mandated benefits are laws that require insurance companies to cover certain services, which in this day and age are fast becoming every service. There are states that mandate care for morbid obesity and port wine stain removal….under insurance. Port wine stain (a birthmark) removal and acupuncture are required to be covered by insurance in some states. For the complete state mandates listing, as of 2004, check it out, here. I don’t have the federal lists as of this moment. I think that mandated benefit laws are a drain on the system, and should be abolished.
I have two separate insurance policies other than my health insurance and that is my homeowners and car insurance. With homeowners insurance, a la carte is less the case, but still pertinent. I have a value assessed based on information I have given the insurance company. This means I’m not going to pay for a large custom kitchen or bathroom, because I have neither. I do not live in a flood zone, and therefore do not possess flood insurance. It is required for me to purchase if I did live in a flood zone, but that is the insurance company protecting their investment. I am able to purchase flood insurance if I live outside a flood zone, but it is my choice to do so.
My car insurance is a much better example of a la carte services. My vehicle is financed, so I am required by the insurance company to maintain collision/comprehensive insurance on my car. Aside from that, I’m not required anything else. I choose to have towing, rental car, and additional benefits above state minimum coverage required. I could hit an Escalade, that then hits a BMW, and I wouldn’t owe a dime (except in increased insurance premiums), but again, that is my choice.
What I propose we do is offer a la carte medical insurance. Like those Progressive commercials. A single man shouldn’t have to pay for a plan that includes mammograms and pelvic exams, just as a single woman shouldn’t have to pay for a plan that includes care for erectile dysfunction.
If you had to pay full price for every single doctor’s appointment you will truly only go to the doctor when you need to. Here is what happens then…..demand decreases. When demand decreases, prices fall to counter it. When prices for doctor’s visits fall, more people will go, but prices will only go up so much. The market will find the balance of price it can bear, unencumbered by government regulation.
Offer things like emergency care, hospital visits, children milestone visits/immunizations, women’s health packages, labs/diagnostic, etc. There are so many ways that this could be broken down, but the best part is, no one is going to make you pay for something that you don’t need.
I would even support insurance companies offering benefit packages for specific diseases, cancer, AIDS, hepatitis…or for certain age groups, the over 50 plans, which includes coverage for colonoscopies and mammograms…..whatever.
The fact remains that I should not have to pay for someone else to see the doctor every single time their nose runs. I don’t have to pay for other drivers on the road to get oil changes, and health insurance shouldn’t cover simple preventative care.
Tuesday, August 18, 2009
Saturday, August 15, 2009
I am a survivor of socialized medicine - Part II
The second part of my article about socialized medicine involves my first pregnancy, and the medical care I received. It’s not nearly as bad as the series of events that occurred surrounding my ankle surgery, but it’s still fairly indicative of what is going to happen if this monstrosity of a bill gets passed.
When I found out I was pregnant with my daughter, I immediately went to the clinic (on sick call, see first article for an explanation of how that goes) and received a blood test, over the complaints of the lab tech, who told me that it wasn’t necessary right now, because at the point I found out, I was only about two weeks along. I was in a special situation as I was getting ready to be stationed overseas in Holland, and I wanted the results to take and maybe get a quicker doctor’s appointment.
I received the positive test and went on my overseas assignment. It took about a week to get an appointment (not bad, all things considered) and was given a prescription for prenatal vitamins and informed that there was not a maternity center at my current assignment, and that I would have to be “detached” for medical services and see a doctor on the Dutch economy.
When this happened, in 2004, there was alot of force protection issues with that, as the Netherlands are very relaxed, much like the United Kingdom, with the Muslim population. When I went to my first doctor’s appointment in Holland, I had to change my clothes prior to my appointment, and be very careful to not allow my being American to show. I saw the doctor, who spoke spotty English, was given an ultrasound and a due date and had my next appointment scheduled for four weeks later. I was relatively satisfied with the quality of care I received by the Dutch doctors.
Given the circumstances of my situation, I decided that getting out of the Army would be in my best interests, so I started the paperwork, and eventually got out. I returned to North Carolina at the end of October, with paperwork allowing me to have the baby on post at government expense. I didn’t have a job at the time, so I thought this my best option.
I was 18 weeks pregnant, give or take at this time, and I was unable to get an appointment for three weeks, and that wasn’t even to see a doctor, that was to go to “orientation” which is required for giving birth in a military medical facility. I was 21 weeks at this time, and it was still another two weeks before I could see a midwife. I see the midwife, and she was unable to find my child’s heartbeat, so I was given an emergency ultrasound. To this point I had been developing normally, and nothing had changed.
I went to make my next appointment, and was informed that I couldn’t get another one for six weeks, putting me at almost 30 weeks, the point at which a doctor normally wants to see the patient every other week, which I was informed was also not the policy at Womack, due to their patient load being so high. I was made three appointments and told to make my next two (and last two) appointments at the next appointment.
All of these appointments went normally, except that I never saw the same midwife twice, since they didn’t assign an OB, so you had to explain everything over and over again. It was extremely irritating seeing a stranger every single time I had to go to the doctor.
At 36 weeks, there was some concern about the size of my child, so I was given a “growth scan” ultrasound to determine if a scheduled C-section was needed. I was measured at something like 200 grams (7 ounces) short of a scheduled C-section. They estimated the baby at being 9 pounds, 7 ounces. Remember this difference, it comes in handy later.
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I go on as I have been, and my due date of 3 March comes…and goes. At my appointment the day after my due date, I was nearly begging to have this baby taken out of me, and was told that due to space confinements (not enough beds) the soonest they could schedule an induction was five days from now on 8 March. Of course I thought to myself if there was so much space confinement, what would happen if I went into labor earlier….hmmm, but I kept my mouth shut.
I showed up at the hospital on Tuesday morning, at seven am, and was promptly taken to the waiting area and hooked up to an IV. There were no beds for me at the time, and I stayed there for many hours. When I was finally hooked up to the Pitocin, I was on and off with contractions and they kept dying off. Two or three times I was taken off the medicine completely and taken to other rooms due to the lack of space/staff. I was finally forced to dilate to 4cm, which is supposed to trigger labor, and nothing happened. It’s now noonish on Wednesday, and my water was broken.
Nothing happened since, except seeing seven different midwives in that time and I finally dilated enough (through actions of the doctors) to be given an epidural, which I appreciated, but didn’t really need. The pain wasn’t that bad. That to me signalled that something was wrong. I was having contractions every 30 seconds to 1 minute and the monitor never got above 90ish, something I was later told was very unusual.
The epidural made me sick, and I had been vomiting for about seven hours (it’s about 8 at night on Wednesday at this point) and I got a fever, which signalled an infection known as chorioamnionitis….which is often the case in prolonged labor, and I was working on 36 hours at this point. Since I had been throwing up for seven hours, I was given Tylenol, in pill form. Think about that. Not five minutes later, they were back out. Then the baby went into distress….her heart rate was high and there was some concern.
The furthest I dilated after 44 hours was to seven centimeters, and bear in mind, I was forced to dilate to four. At 3am, 43 hours after this debacle started I was taken into an emergency C-section and had my daughter at 3:55am on 10 March.
Understanding that even the private sector is not perfect when it comes to obstetrics care, this was totally unacceptable. Due to non-reform of tort law, many doctors are dropping the OB of the OB/GYN practice, especially in my state of PA due to the rates of OB doctors getting sued. This being the case, even if they have kept the OB, they perform C-sections at a much higher rate than they did 30 years ago. Today in America, the most commonly performed operation in America is a C-section.
All that being said, my case was a clear case where a C-section should have been performed when it became clear that my labor was not progressing, even with the aid of drugs.
My daughter was born at 9 pounds, 14 ounces. I was also informed by the doctor that my pelvic bone was too small to pass her head through and I would have broken my pelvic bone if forced to give birth vaginally. He also told me that the reason I wouldn’t dialate was due to the size of her head and her inability to engage on the cervix.
If I had seen the same doctor for my entire pregnancy, I firmly believe that some of this would have been caught. My pregnancy with my second child was much more smooth, and I was informed that I was not allowed to VBAC (vaginal birth after cesaerean) due to the infection I had during my first labor and it’s possibility to increase my risk of uterine rupture and death.
Reform tort law, deregulate the industry. This is the ”change” the health care industry needs. Get the government out of my medical decisions, that’s the best way to fix this problem. I don’t deny that there is a problem, but ramming government mandated care down our throats is not the way to solve this problem.
When I found out I was pregnant with my daughter, I immediately went to the clinic (on sick call, see first article for an explanation of how that goes) and received a blood test, over the complaints of the lab tech, who told me that it wasn’t necessary right now, because at the point I found out, I was only about two weeks along. I was in a special situation as I was getting ready to be stationed overseas in Holland, and I wanted the results to take and maybe get a quicker doctor’s appointment.
I received the positive test and went on my overseas assignment. It took about a week to get an appointment (not bad, all things considered) and was given a prescription for prenatal vitamins and informed that there was not a maternity center at my current assignment, and that I would have to be “detached” for medical services and see a doctor on the Dutch economy.
When this happened, in 2004, there was alot of force protection issues with that, as the Netherlands are very relaxed, much like the United Kingdom, with the Muslim population. When I went to my first doctor’s appointment in Holland, I had to change my clothes prior to my appointment, and be very careful to not allow my being American to show. I saw the doctor, who spoke spotty English, was given an ultrasound and a due date and had my next appointment scheduled for four weeks later. I was relatively satisfied with the quality of care I received by the Dutch doctors.
Given the circumstances of my situation, I decided that getting out of the Army would be in my best interests, so I started the paperwork, and eventually got out. I returned to North Carolina at the end of October, with paperwork allowing me to have the baby on post at government expense. I didn’t have a job at the time, so I thought this my best option.
I was 18 weeks pregnant, give or take at this time, and I was unable to get an appointment for three weeks, and that wasn’t even to see a doctor, that was to go to “orientation” which is required for giving birth in a military medical facility. I was 21 weeks at this time, and it was still another two weeks before I could see a midwife. I see the midwife, and she was unable to find my child’s heartbeat, so I was given an emergency ultrasound. To this point I had been developing normally, and nothing had changed.
I went to make my next appointment, and was informed that I couldn’t get another one for six weeks, putting me at almost 30 weeks, the point at which a doctor normally wants to see the patient every other week, which I was informed was also not the policy at Womack, due to their patient load being so high. I was made three appointments and told to make my next two (and last two) appointments at the next appointment.
All of these appointments went normally, except that I never saw the same midwife twice, since they didn’t assign an OB, so you had to explain everything over and over again. It was extremely irritating seeing a stranger every single time I had to go to the doctor.
At 36 weeks, there was some concern about the size of my child, so I was given a “growth scan” ultrasound to determine if a scheduled C-section was needed. I was measured at something like 200 grams (7 ounces) short of a scheduled C-section. They estimated the baby at being 9 pounds, 7 ounces. Remember this difference, it comes in handy later.
google_protectAndRun("ads_core.google_render_ad", google_handleError, google_render_ad);
I go on as I have been, and my due date of 3 March comes…and goes. At my appointment the day after my due date, I was nearly begging to have this baby taken out of me, and was told that due to space confinements (not enough beds) the soonest they could schedule an induction was five days from now on 8 March. Of course I thought to myself if there was so much space confinement, what would happen if I went into labor earlier….hmmm, but I kept my mouth shut.
I showed up at the hospital on Tuesday morning, at seven am, and was promptly taken to the waiting area and hooked up to an IV. There were no beds for me at the time, and I stayed there for many hours. When I was finally hooked up to the Pitocin, I was on and off with contractions and they kept dying off. Two or three times I was taken off the medicine completely and taken to other rooms due to the lack of space/staff. I was finally forced to dilate to 4cm, which is supposed to trigger labor, and nothing happened. It’s now noonish on Wednesday, and my water was broken.
Nothing happened since, except seeing seven different midwives in that time and I finally dilated enough (through actions of the doctors) to be given an epidural, which I appreciated, but didn’t really need. The pain wasn’t that bad. That to me signalled that something was wrong. I was having contractions every 30 seconds to 1 minute and the monitor never got above 90ish, something I was later told was very unusual.
The epidural made me sick, and I had been vomiting for about seven hours (it’s about 8 at night on Wednesday at this point) and I got a fever, which signalled an infection known as chorioamnionitis….which is often the case in prolonged labor, and I was working on 36 hours at this point. Since I had been throwing up for seven hours, I was given Tylenol, in pill form. Think about that. Not five minutes later, they were back out. Then the baby went into distress….her heart rate was high and there was some concern.
The furthest I dilated after 44 hours was to seven centimeters, and bear in mind, I was forced to dilate to four. At 3am, 43 hours after this debacle started I was taken into an emergency C-section and had my daughter at 3:55am on 10 March.
Understanding that even the private sector is not perfect when it comes to obstetrics care, this was totally unacceptable. Due to non-reform of tort law, many doctors are dropping the OB of the OB/GYN practice, especially in my state of PA due to the rates of OB doctors getting sued. This being the case, even if they have kept the OB, they perform C-sections at a much higher rate than they did 30 years ago. Today in America, the most commonly performed operation in America is a C-section.
All that being said, my case was a clear case where a C-section should have been performed when it became clear that my labor was not progressing, even with the aid of drugs.
My daughter was born at 9 pounds, 14 ounces. I was also informed by the doctor that my pelvic bone was too small to pass her head through and I would have broken my pelvic bone if forced to give birth vaginally. He also told me that the reason I wouldn’t dialate was due to the size of her head and her inability to engage on the cervix.
If I had seen the same doctor for my entire pregnancy, I firmly believe that some of this would have been caught. My pregnancy with my second child was much more smooth, and I was informed that I was not allowed to VBAC (vaginal birth after cesaerean) due to the infection I had during my first labor and it’s possibility to increase my risk of uterine rupture and death.
Reform tort law, deregulate the industry. This is the ”change” the health care industry needs. Get the government out of my medical decisions, that’s the best way to fix this problem. I don’t deny that there is a problem, but ramming government mandated care down our throats is not the way to solve this problem.
Monday, August 10, 2009
I am a survivor of socialized medicine - Part I
I have two pointed examples of how and why socialized medicine can be harmful to you. This is the story of the first. If you have served on active duty in the military, you are already aware of the lines and general difficulty in getting anything done. Every time you are sick, you are required to go to the hospital and get a doctor's note. Why not, it's free, right? So you go to the doctor at 6am, and wait in line to get seen until 9am or 10am, because everyone else on post has to do the same thing.
When I was 19 years old, I was stationed in Germany. Like a lot of folks stationed in Germany, I enjoyed my fair share of "adult beverages". At a festival in Februaryish (it's been ten years now) I hurt my ankle going into a funhouse, believe me, this was not my finest hour. It hurt quite a bit, and rather than go to the emergency room (your only choice on a weekend), I waited until Monday to go to sick call in the morning.
I finally get in to see the doctor, and I'm told that this is a really bad sprain (it was swollen and turning all kinds of colors, but I knew it wasn't broken) and that I should rest off of it as much as possible. I left with a note not to run for two weeks and some Motrin. With the sheer amount of Motrin I was given in my time in the Army, I could start my own drug store.
Two weeks go by, and the pain is still not getting better. What's even worse is that now, when I walk around, my ankle will occasionally turn in on itself. So I make a doctor's appointment, which takes me a solid week to get. I go to the doctor, ankle still swollen, and am told that I pulled a ligament or tendon (this doctor had X-ray vision, because I wasn't given an MRI) and that I would need some physical therapy. I'm given another note about running, and sent on my way. I have to wait three days for the referral to get into the computer, and then it take 3 weeks to get in to see the physical therapist. It's now the middle of March. I go through two months of strengthening exercises, and ultrasonic massages, and still I'm having pain and instability in the joint.
In May, I go back to my regular doctor, and he refers me to podiatry. I can't get into see the podiatrist until almost July. He then looks at my ankle, and tells me I need an MRI to confirm, but chances were that I had some fairly severe tendon/ligament damage. I don't get the MRI until August, but I've gotten smarter, I make the appointment for the podiatrist when I've get the MRI appointment. About two weeks after my MRI, I go back in to see the podiatrist, who tells me that I have torn the peroneus brevis and peroneus longus and the band of tissue that hold them together, and I will need surgery to correct this. I ask when surgery can be scheduled; he tells me I will have to see another doctor, because he is getting ready to get out of the Army.
I'm now referred to an orthopedic surgeon, as there is only one podiatrist position at the military hospital. It takes me until October to see the orthopedic surgeon, who I dub Dr. F***** Useless. Dr. FU then decides that tendons that are ripped apart might magically fuse themselves back together if I am casted for five weeks. I can't even get a second opinion, because it would take me longer than five weeks to get an appointment, even if there were another independent orthopedic surgeon in the hospital, which at the time, there wasn't.
I get my cast off around Thanksgiving, where he then tells me he will do surgery on me, in two weeks. I was due to start clearing to go to North Carolina in two weeks, so I ask for a referral because the surgery was going to be fairly extensive, and I wouldn't be able to drive around doing all that was necessary to leave Germany with a cast, nevermind get my cast off before I left.
I get to Fort Bragg, NC at the end of January and go to sick call with my MRI, X-ray, and referral from Dr. FU. I immediately get a referral to podiatry on Bragg and see the doctor in March. He tells me he can perform surgery, but not until May. By the time I've had the surgery, it's been 15 months since the original injury and in post op recovery, the doctor tells me he has had to extend my incision further than my MRI (that at that point was nine months old) indicated due to the length of time between MRI and injury.
This is a small example of what socialized medicine can do for you.
I would have had this problem taken care of before my MRI had taken place with private insurance.
It makes sense that there would be socialized medicine within the military, I'm not arguing for that at all. But try and imagine competing against the number of people that live in Philadelphia for an appointment with a limited number of podiatrists or orthopedic surgeons, and the two months can easily turn into four or six, or even twelve.
When I was 19 years old, I was stationed in Germany. Like a lot of folks stationed in Germany, I enjoyed my fair share of "adult beverages". At a festival in Februaryish (it's been ten years now) I hurt my ankle going into a funhouse, believe me, this was not my finest hour. It hurt quite a bit, and rather than go to the emergency room (your only choice on a weekend), I waited until Monday to go to sick call in the morning.
I finally get in to see the doctor, and I'm told that this is a really bad sprain (it was swollen and turning all kinds of colors, but I knew it wasn't broken) and that I should rest off of it as much as possible. I left with a note not to run for two weeks and some Motrin. With the sheer amount of Motrin I was given in my time in the Army, I could start my own drug store.
Two weeks go by, and the pain is still not getting better. What's even worse is that now, when I walk around, my ankle will occasionally turn in on itself. So I make a doctor's appointment, which takes me a solid week to get. I go to the doctor, ankle still swollen, and am told that I pulled a ligament or tendon (this doctor had X-ray vision, because I wasn't given an MRI) and that I would need some physical therapy. I'm given another note about running, and sent on my way. I have to wait three days for the referral to get into the computer, and then it take 3 weeks to get in to see the physical therapist. It's now the middle of March. I go through two months of strengthening exercises, and ultrasonic massages, and still I'm having pain and instability in the joint.
In May, I go back to my regular doctor, and he refers me to podiatry. I can't get into see the podiatrist until almost July. He then looks at my ankle, and tells me I need an MRI to confirm, but chances were that I had some fairly severe tendon/ligament damage. I don't get the MRI until August, but I've gotten smarter, I make the appointment for the podiatrist when I've get the MRI appointment. About two weeks after my MRI, I go back in to see the podiatrist, who tells me that I have torn the peroneus brevis and peroneus longus and the band of tissue that hold them together, and I will need surgery to correct this. I ask when surgery can be scheduled; he tells me I will have to see another doctor, because he is getting ready to get out of the Army.
I'm now referred to an orthopedic surgeon, as there is only one podiatrist position at the military hospital. It takes me until October to see the orthopedic surgeon, who I dub Dr. F***** Useless. Dr. FU then decides that tendons that are ripped apart might magically fuse themselves back together if I am casted for five weeks. I can't even get a second opinion, because it would take me longer than five weeks to get an appointment, even if there were another independent orthopedic surgeon in the hospital, which at the time, there wasn't.
I get my cast off around Thanksgiving, where he then tells me he will do surgery on me, in two weeks. I was due to start clearing to go to North Carolina in two weeks, so I ask for a referral because the surgery was going to be fairly extensive, and I wouldn't be able to drive around doing all that was necessary to leave Germany with a cast, nevermind get my cast off before I left.
I get to Fort Bragg, NC at the end of January and go to sick call with my MRI, X-ray, and referral from Dr. FU. I immediately get a referral to podiatry on Bragg and see the doctor in March. He tells me he can perform surgery, but not until May. By the time I've had the surgery, it's been 15 months since the original injury and in post op recovery, the doctor tells me he has had to extend my incision further than my MRI (that at that point was nine months old) indicated due to the length of time between MRI and injury.
This is a small example of what socialized medicine can do for you.
I would have had this problem taken care of before my MRI had taken place with private insurance.
It makes sense that there would be socialized medicine within the military, I'm not arguing for that at all. But try and imagine competing against the number of people that live in Philadelphia for an appointment with a limited number of podiatrists or orthopedic surgeons, and the two months can easily turn into four or six, or even twelve.
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