Tags: doctors | healthcare | insurance

Sidelining Doctors for Politics in Healthcare

Sidelining Doctors for Politics in Healthcare
(Paulus Rusyanto/Dreamstime.com)

By Monday, 06 May 2019 03:31 PM Current | Bio | Archive

Politics is what’s wrong with health care.

With the advent of Medicare and Medicaid, critical care for patient decisions has been taken out of the hands of doctors and given to healthcare policy wonks. For example, many recoverable strokes require intense physical therapy, yet Medicaid only grants 3 visits and Medicare will allow many visits if supported by documentation.

State of the art equipment such as upright walkers for those with low back injuries are not approved by either agency though regular walkers which worsen many lower back aches are. Those without insurance and strokes are dependent on family and friends or community agencies which do not have the resources for the more than 700,000 annually who are stroke sufferers.

The debates over abortion, cancer care payments, and cost for critical injuries is unfortunate for these should be made on the basis of necessary medical interventions not politics. The 1974 Hill Burton Act notes that if one cannot afford the cost of healthcare, hospitals which received federal funds in their construction or take monies from the government for their services are required to provide such. One cannot get the service and decide such was too expensive; therefore not to pay. This legislation, contrary to popular opinion, guarantees access to healthcare.

Obamacare sounds great until the deductibles of $5,000 or more are appreciated. This means one has to pay for the first $5,000 before the insurance kicks in. As businesses examine their health cost, increasingly they too are increasing their deductibles and out of pocket cost to employees for other services. Medicaid will cover some dental cost; however those without it find crowns, fillings, and general care beyond their means. That could be covered with Part D of Medicare which would help the elderly immensely. A Health Savings Account sounds good if one is in good health with a job or no major medical problems which can easily drain these resources.

People from all walks of life just can’t afford the cost of health care and most are not putting the critical care issues on the line.

First, all citizens should demand that they have access to the same coverage that Congress, the Executive Branch and other federal employees are given which they pay for as well as that paid for by the government. This duality of care should not continue exclusively for those being supported by citizen tax dollars.

Secondly, elective procedures/costs such as Viagra, plastic surgery, abortions, c-sections for convenience, IVF, birth control pills, etc. should not be covered by insurance. These citizen choices should be paid for by the persons making them.

Third, prescriptions, medical devices, physical therapy, and home healthcare need reconsideration for reimbursement at a higher rate to help deliver standards of care with the health department being a vital partner in this.

Fourth, some type of catastrophic coverage is something that should be covered by all insurance for the Go Fund Me initiatives are most bothersome.

Doctors need to get their act together and quit being afraid to speak up and speak out at the infringements upon their rights to deliver standards of care because of time restraints, requirements to follow scheduled protocols which limit innovations of thought and care, medication itineraries which don’t have the most up-to-date or efficacious formularies, and demands to see more than 20 patients a day. Research hospitals and medical centers should receive a higher rate of imbursement given the critical nature of many patients that they see. Pharmacist and other care providers should be limited in their ability to override doctor's decisions on what medications are indicated unless contraindicated by side effects, recalls, or some other factors for which that physician should be notified. And doctors should not be the first source to be squeezed in controlling cost less we continue to farm out patients to midlevel and tertiary practitioners.

It is past time that we let doctors decide with patients on major health decisions to be made. Boards often are used to hide behind rather than doctors standing up for their right to determine procedures or medications they will receive. Patient care is poorly served in doctor hopping in search of finding someone to do as they say for which they must bear such costs.

Ada M. Fisher, MD, MPH is a licensed teacher, retired Corporate physician, former county school board member, speaker, author of "Common Sense Conservative Prescriptions Good for What Ails Us Book 1" (available through Amazon. com) and is the NC Republican National Committeewoman. Contact through DrAdaMFisher.org. To read more of Dr. Fisher's reports, Click Here Now.

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Politics is what’s wrong with health care.
doctors, healthcare, insurance
Monday, 06 May 2019 03:31 PM
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