Some days you just have to write what I suppose is called a stream of consciousness. The intent is to enlighten--probably myself, and perhaps to clarify my own bleak intuitions.
The doctor for whom I do volunteer work at the hospital where he is a surgeon and oncologist is a human angel on earth. Trust me, he is a rare breed. His entire motivation for being in medicine is to render help. As he said to me the other day, "I saw three patients today who will probably die within a year, I need to be able to focus my time and efforts on comforting them."
Then, in the next breath, he said, "take a look at this." He showed me a computer printout. It was a tally of insurance company reimbursements. In almost every instance a service or surgical procedure was billed at one amount and this fine doctor was paid literally cents on the dollar.
Even more shocking, the printout was replete with open items from six, eight or ten months ago. All unpaid.
This is ground zero of the American healthcare system. And my fears should be your fears.
Not only are we being scammed by the insurance industry, good doctors like my friend, are being squeezed and fucked every step of the way too.
These doctors need to survive, we need to survive. This system is so rancid it is destroying everything and everyone it touches.
So what did this noble, may I call him a heroic doctor, say? He said, "how much longer can I give totally unreimbursed care?"
Then he told me about a patient who had a history of cancer that was, "screaming at me." When an oncologist says, something is "screaming" you better listen up.
He said this woman needed a digital mammogram. A digital mammogram is a state-of-the-art screening procedure. It is also somewhat more expensive than the more routine old-fashioned mammogram. This woman was unable to secure the digital mammogram. Then the doctor said, she has a terrible history, she needs a breast MRI--but the insurance company will not pay. They won't pay for a digital mammogram and they certainly won't pay for an MRI.
So what will happen to her I asked? "We'll fight, we'll appeal" he said. "Then she should file a criminal complaint, insurance companies are practicing medicine without a license."
I have written about being in his office on countless occasions, as some of you may recall, as he pleads with insurance companies on behalf of a critically ill patient who requires a specific medication.
This is how doctors across American are spending their very precious time. Is this acceptable?
I overhear clipped conversations among my friend and his colleagues, trading suggestions and horror stories about how to appeal or circumnavigate one insurance company denial or another. Is this how doctors should be spending their time? Discussing criminal insurance companies or complex treatments and surgical procedures?
I crawl home on days like these with a heavy heart and in absolute despair. I cannot for the life of me, understand why we allow such atrocities to go on and on and on. And why we allow the political class to remain so totally detached from the suffering and hardship this system inflicts on everyone?
And what about the newest generation of doctors. Why would anyone want to be involved with what is evolving into a Third World health care system. Yes for the rich it offers untold miracles, but for so many it is a like running a toxic, sewage-encrusted gauntlet.
Without a universal, single-payer system we'll eventually end up with a healthcare system where you can have anything you want if you're rich, and most of the rest of us can just go away and die.
If we lose doctors like my friend, we as a society will have failed as miserably as we have failed and lost in Iraq.