- - Monday, July 10, 2017

ANALYSIS/OPINION:

There’s an infection in our health care system and its name is greed.

Greed is seldom mentioned in the waterfall of words about the health care crisis. “Greed” would sound oddly out of place in a discussion of national policy. It is an old-fashioned word, and judgmental. Nevertheless, there it is; there is no way around it. Our nation’s health care is infected by greed.

Leaving aside, for the moment, the urgent challenge of providing adequate health care for the very poor and near-poor, the problem of greed impedes access to and quality of health care for all of us.  The best interest of the patient, or consumer if you prefer, is increasingly being sidelined in favor of corporate concerns.

What is your experience? How difficult is it for you to reach your doctor by phone? How long do you wait for an appointment? My therapy patients routinely report waiting weeks – and sometimes even months – to see a specialist.   One can turn to the Internet for advice on becoming a savvy patient/health care consumer; there you will find article after article on how to maneuver to get and hold your doctor’s attention, and how to get your medical needs met in a 15-minute-or-shorter visit. Welcome to health care in America.

This is not a column about bad doctors. People who choose to become physicians are usually sincere in their desire to care for patients. I don’t blame the doctors. The corporate health care system in which they practice is what drives the problem.  Here’s just one example.

My friend Kay is a cancer survivor. She depends on a monthly infusion of medication to stay that way.

Last month the system failed her; not because of any individual’s incompetence, malevolence or laziness. Simply put, the system failed because medical organizations are saving money in ways that end up blocking people from getting the care they need.

Here is Kay’s story.

“I was supposed to have my monthly infusion this afternoon.  Early this morning, when my infusion supplies hadn’t arrived, I called the company that supplies them. They told me that my prescription had expired (I would have no way to know that independently) and my doctor hadn’t called to re-order it. 
And you were planning to tell me this when?

“So I called the doctor, and left an urgent message with a message-taker. When he hadn’t called back in three hours, I called the medical center and tried to get connected with the clinic where he works, so that I could get the receptionists there to ask the doctor in person. I found out (and later verified) that this message-taker can only leave a message for the doctor — he can’t, nobody can, connect me with the clinic where the doctor works. I asked, what if it’s urgent, and what if the doctor is on vacation? Yes ma’am, I understand that’s unfortunate. I made at least twenty calls, both to the doctor’s group practice and to the hospital, and finally tricked somebody into connecting me with the clinic. The receptionist took a message and then when I asked, she confirmed that that message-taking guy is not permitted to give anybody the clinic’s phone number, ‘because the administration is trying to reduce phone traffic to the clinics.’ “ (Emphasis mine.)

Kay’s is a story of frustration and blocked access to vital care, which has nothing to do with insurance, but has everything to do with a system that prizes earnings over patients’ well-being.

We need a system of checks and balances, of pushback and oversight to counter the unbridled greed of the health care system. Health care is one-sixth of our economy, the price of drugs and insurance are making paupers of the sick, and we are still left asking

Is there a doctor in the house?  How can I reach her?

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