Our devolving medical care system is a threat to people who do not know how to navigate it. Let me share with you what I am personally doing to secure and manage superior care. You desperately need your own advocate in today’s medical world as much as you need an excellent lawyer to
navigate an unwanted encounter with the U.S. legal system.
I love the holiday season, and hate to intrude with something unpretty. But what I’ve experienced has been a wakeup call for me. As such, I accept it as a meaningful gift and hope you feel the same once I’ve explained myself.
Before I get into that, let’s address the hope about Obamacare being repealed. It’s just not going to happen. Even Rand Paul, the Republicanlibertarian front runner for president, has said so.
I really do believe that observing and learning from others’ misfortunes respects their memories. For example, almost no one dies in a plane crash in vain. The families see to that – that’s why pretty much every time an air disaster happens, the result is improved air safety for millions of travelers. Learning from air crashes and acting on that knowledge is one thing America does pretty well.
Medical System No Longer Works
Unless You Take Key Steps Now
But not so much in government-directed medicine. Lots of people are dying due to growing medical dysfunction spawned by intrusive government. That dysfunction is spreading fast as freeloaders clog up the system and doctors flee from lousy working conditions, stupid paperwork, and hard to collect substandard pay.
There’s not enough money left for doctors in a government-driven system. Medicine is packed to the gills with officious make-work jobs throughout the insurance bureaucracy and all the regulatory compliance channels. There are just so many infuriating hoops to jump through with absolutely no benefit or added value. Everyone comes out worse by allowing the people who run DMVs to control the administration of medical science.
I have mentioned before that one of my neighbors, a well-respected and financially well off guy, got inoperable lung cancer. Which is a horror in and of itself. But in the last four days of his life, his medical facility “temporarily” ran out of morphine. The system let him down. He was financially successful but did not understand “the system” until it was too late for him.
Don’t Make Much News So Far
Why? Because of what amounts to price controls on basic medicines. I’ve been writing about this problem for years. You need to understand this medicine shortage business and have a plan to deal with it down the road. It’s going to get much worse before the public catches on.
So let me go into something that’s very, very basic to your well-being and survival. Until Obamacare passed, there were about six different “levels” of medical care in this country. Now, we are rapidly approaching two levels of care. These categories are deadly simple: Category one is already becoming clear – politically managed medicine. Doled out by bureaucrats working in cahoots with hospitals that are little more than publicly controlled DMVs.
Insurance companies are also consolidating to fewer and fewer and bigger and bigger entities. They are increasingly packed with make-work oversight jobs, wasteful and inefficient green-energy compliance, and endless piddly rules and procedures.
Much of this doesn’t even bother the folks who take a passive approach to their medical care. These are the same people who don’t really mind being groped by TSA bullies, and seem willing to accept almost any bureaucratic abusiveness without question.
Growing Medical Horror Stories
Don’t Make the News They Should
Maybe it’s because an airplane crash is more dramatic, and touches on primordial fears of falling. In those cases, the public demands answers and solutions. Bad medicine involves science and unique individual failures that are not dramatic, so public learning and correction are almost nonexistent.
I wish Obamacare dependents well but have no plans to be part of a fatally flawed system. Obamacare’s architects lied to the public about what the new system would entail, so perhaps a full dose of Obamacare is what’s needed to wake up the masses who were duped. I do not intend to be one of the casualties in the public’s slow learning curve.
So back to my escape route from the spreading consequences of Obamacare:
Here’s the very first on-ramp to superior medical care: To get the proactive medical care you should, you must bypass insurance companies as they exist today. Most people know this deep down but don’t act like it. Insurance was never intended to be anything more than for catastrophic situations. Getting everything for “free” is a fatal concept because it traps you in cookie cutter medicine and insurance-approved tests.
Often Fall Short of Your Needs
Why are insurance-approved tests bad? Because the extent of testing is governed by actuarial tables. Put another way, the system accepts that X-number of people will die earlier if tests A, B and C are not made, and then decides how many deaths are acceptable for the greater financial good of the system.
Not such great news if you have a health condition that requires lots of proactive testing, monitoring and basic attention. My first piece of advice: Decide right here and now that you will pay for the tests that your condition requires. Don’t make insurance reimbursement your primary concern.
Which brings me to my second piece of advice: Get someone to customize your tests to your unique medical weaknesses. To do this, you must recruit your personal advocate in the medical system as you would an attorney for a legal problem. Put another way, you need a doctor with an efficient staff who is outside the government-run system, and who knows how to get things done on your behalf when it is needed.
My most important recommendation to you is to sign up for what the media refer to as a concierge doctor. They exist now in almost all communities. This is a medical practice that charges anywhere from $3,000-5,000 for your annual medical needs. Most doctors under the collapsing public systems deal with 2,000 or more patients annually. A concierge doctor limits himself to 200-300 patients.
My doctor knows all about me. He is just an email or a phone call away. His vendors know that for the most part I am private pay, so they cut me much better deals than with padded insurance payments.
You Can Negotiate Medical Fees and Services
I had a friend who had to spend five days in a hospital due to an unexpected medical emergency. He was able to negotiate a pennies-on-the-dollar deal for his care due to the fact his situation was not covered by insurance. Negotiation really does work when you understand the limits of insurance.
It is important to pick a concierge doctor who is part of a larger practice and demonstrates strong administrative skills. A call from a doctor’s office on your behalf to specialists, pharmacists, and medical supply companies is invaluable. Ideally, seek out a concierge medical practice that is more than five years old and operates in an affluent area of your community.
Recently, I was diagnosed with sleep apnea, a condition in which your breathing actually stops numerous times during the night. In my case, the home test I was able to get on short notice (yes, thanks to calls from my doctor to the sleep diagnostic center) registered that my breathing stops 29 times per hour. When the result came back, I knew immediately that a “CPAP” breathing assist machine would instantly make my life so much better. Imagine, no clean REM sleep for probably many years. Lack of healthy sleep can take a huge toll on your overall wellness.
When You Need Your Doctor’s Office to Cut
Through “Compliance Channels”
To make a long story short, I decided to get my medical device immediately and opted to pay for it privately and without insurance. To go through insurance, there was a lengthy process that would have taken more than a month.
I negotiated a significant discount on my CPAP machine and arranged to receive it after a mandatory consultation, which my doctor provided on very short notice. However, the sleep diagnostic center and the medical supply people got into a behind the scenes dispute over who was going to get a $100 “set-up” fee. These parties had never heard of anyone side-stepping the insurance protocols, so both dug in for almost a week.
I finally figured out through endless rounds of phone tag and email that the sleep diagnostics people and the medical supply people could not coordinate their efforts to release my damn machine. All I wanted was a good night’s sleep. So I called my doctor’s office and they forced a bureaucratic resolution. Within two days I had my machine.
And what a difference it has made. If you suspect you have sleep apnea, get this checked off your list.
When Your Pharmacy Fouls Up,
Your Doctor Can Step In and Fix It Fast
On more than one occasion, my doctor’s office has intervened with the “no-soup-for-you” dimwits that populate so many pharmacies these days. Getting your meds on short notice when there is a foul up at the pharmacy is hugely helpful if you are on the road or about to travel.
I finally relented two years ago and got my first colonoscopy. What a relief! My doctor cut through all the non-mandatory pre-procedure nonsense and I was able to get it done with a minimum of hassle. By the way, the whole thing is a breeze – don’t put this off because of people who tell you how horrible the prep is.
It’s just not so if you are properly advised by a physician who carefully tells you the best way to time it.
Recruit Your Medical Advocate Now
I know that $3,000 per year for a concierge physician is a lot of money. But the improvement to your treatment is so great that I strongly suggest going out to dinner less or finding some other way to cut back.
Fundamentally, if you are ever caught in an extremely serious medical situation, you will have an advocate in the system looking out for your interests. The system is increasingly treating people like a number. And that means you might not be able to get access to critical medicines you need if you are stuck in a cookie cutter system.
Remember, doctors are quitting at record numbers right now. Getting a medical advocate working for you is in my view essential. Get set up with a private doctor now because getting one later will be like trying to make the last lifeboat on the Titanic.
Sorry for such a grim take on the subject. But in the end if what I have learned helps even one reader, that totally makes sharing some of my personal medical history here worthwhile. I owe it to you.
Please have a very Merry Christmas and Prosperous New Year and thank you for being an Independent Living subscriber.