Tuesday, November 24, 2009

Health Vultures

Today's Saying

If minutes were kept of a family gathering, they would show that "Members not Present" and "Subjects Discussed" were one and the same. ~Robert Brault

I saw a bit of sixty minutes Sunday night and I learned one of the reasons Medicare is on the edge of going bankrupt. Believe it or not it wasn’t government inefficiency or regulation. It was plain old American greed.
This poor old lady was in a nursing home being fairly well taken care of. She was comfortable and she hjad friends. She was living out the last of her life the best that it could be lived. She had a bad heart and kidney problems and one day she passed out. To be on the safe side the Doctor associated with the nursing home admitted her to the hospital. Now that seems to be like a reasonable thing to do.
But once she was in the hospital the health vultures descended. She was visited by twenty five specialists including a psychiatrist. Each one billed Medicare separately. None of them in any way improved her condition. But these specialists ordered a whole barrage of tests to be made some of them painful. These were administered by and billed through the hospital helping to pay the bills of that vast institution and , of course, draining money out of Medicare.
Now , at most , she should have been seen by a kidney specialist and a heart specialist. After a horrible four days when she could have been enjoying tea with her friends in the home she was finally sent back weaker and in no way improved.
From us they took Medicare money, from her four days of life but they all got paid.
Now I don’t know if this is typical but I saw some of it in people I worked with as their Pastor. Greed pushes up the costs of the system and greed doesn’t really care about the patient.
It is so sad.

Well when the old lady/gypsy showed up yesterday they were only $57.78 short of the goal. The horses were ready , the cows were ready and the wagon was ready. They explained to her that they had tried their best to raise the full amount and hoped she would take what they had as a good faith gesture.
She explained to them that she would like to because she could use the money but this spell required the exact change. It was the nature of the spell and not an arbitrary number.
The people who had gathered looked crushed. People began to realize that they would be stuck here forever. They would never get back to 2009. The little girl who brought in her piggy bank began to cry.
Then they saw him.
He was walking all alone up the main street.
It was Eugene.
“ I have decided”, he announced, “ to stay with her. This is my decision made by my free will. I have thought about it since I got back. I have no family in 2009. I have no friends. No one will miss me except the bartender at the Fly Inn. For once in my life I can do a good thing. I can make up for a pretty worthless life. I had a great talk with Anna Belle the other day. I think I will enjoy being here with her. All I ask is that sometimes you remember me and that I cared a lot for this town.
Then he got up on the wagon and sat down holding the horse reigns.
The old lady smiled raised her hands and said
“That which never was is gone
That which should be is again. “
Then she said “the spell will work over night and tomorrow you will find yourself back in 2009.”
She got up on the wagon and gave directions to Eugene. As they moved into the woods it was as if it opened before them and closed after them and soon they were gone.
A strange quiet fell over the town.


Anonymous Anonymous said...

I saw that episode as well Dr. John. It disgusted me to think that all these doctors did all those separate tests and billed medicare. How dare they. They even tested her for something, like a pap smear or something, that should have only been done on a younger women. It was just outrageous. And 60 Minutes should have been ashamed of themselves filming that poor woman in bed with her friend and showing her dying on TV. Sad.

Well I'm shocked that the witch need exact change but was proud of Eugene for wanting to do something right. I hope he has made the right decision and that they do indeed get back to 2009. I still don't trust that witch :) Pigeon Falls wont be the same without him.

1:25 AM  
Anonymous quilly said...

I spent 3 days in hospital a few years back and saw 4 doctors -- only to be told I was suffering from heart burn. MAJOR heartburn, but heartburn nonetheless. It took both an MRI and a CAT scan to discover that. Oh, and a heart stress test. The good news is, I knew I was healthy when I left. :P

When I complained I was told not to worry about anything because I had great insurance and it wouldn't cost me a dime. Of course, what it cost me, and several thousand other people, was that great insurance.

1:41 AM  
Blogger Sometimes Saintly Nick said...

Unfortunately, capitalism = greed & capitalism is "the American Way." We must always remember "What's good for business (read "profit") is good for the U.S. of A." That includes our so-called system of "health care."

To all of which, I say "Humbug."

2:50 AM  
Blogger Sue said...

Today's saying is right on.

3:49 AM  
Blogger Dulce said...

Oh those doctors... I hate appointments to see the doctor who is going to give me an appointment to see the specialist who'll tell me in two months they'll call me to give me an appointment and see what's wrong...

5:25 AM  
Blogger PS (PSanafter-thought) said...

I recently had several appointments and three tests, plus blood tests. It was very expensive, especially considering that along the way, they discovered that I had one blood test component that was so low that they had to put me in the hospital overnight. My symptoms are the same as they've been for years, but I wanted another opinion; I got the same diagnosis. BUT NO TREATMENT OR INSTRUCTIONS from the doctors on what to do to help the situation. I'm finding help on the internet.

The doctors want to do two additional tests. I asked, "What practical outcome would you expect from these tests?" I asked more than once. They've never answered that. They have told me that my condition is not bad enough to warrant surgery, so what good would getting more information be??? I haven't had those tests because they haven't answered that question.

Doctors often equate DIAGNOSIS with TREATMENT.

You know, in the OT Bible, the people asked God what His name was. They thought if they knew His name, they would have some control over God, I think. And just because we know the name of our physical problems, the diagnosis, doesn't mean that we have control over the disease or condition.

5:59 AM  
Blogger Melli said...

I have to watch Mom's eye doctor like a hawk! That man is out to take every penny he feels HER medicare owes him! He is forever wanting to do test on her that she CAN'T DO!!! I allowed the first one - but when she couldn't do it, I told them we were NOT paying for it, and that Medicare was NOT paying for it, and that BC/BS was NOT paying for it! I had told them before hand I didn't think she could do it - he ordered it anyway - and then she COULDN'T do it! One time he billed them for removing a foreign object from her eye - $2000 for it! He NEVER removed anything from her eye! I let them know - but by then it was too late! He'd already been paid! They just swept it under the carpet! Grrrrrrrr..... GREED! yes... it happens all the time!

YAY Eugene! See? He really likes her! He has something to live for - and stay sober for! How cool! I sure HOPE they end up back in 2009 tomorrow!

6:29 AM  
Blogger Jill said...

I had a doctor friend who absolutely hated the way some doctors practiced. I clearly remember his frustration at one doctor who ordered many tests on an elderly woman who was near the end of her life. Unnecessary, money hog MD,of course the actual words have been cleaned up.

7:40 AM  
Anonymous Brighid said...

I didn't see the piece that you refer to, but another that showed that fraud in the Medicare system is rampant. And to treat the elderly in such a manner.Terrible. Thought that Eugene would come thru, and he did. Now will everything come right on the morrow?

8:07 AM  
Blogger Nessa said...

Love the quote.

Unfortunately, what you describe is commonplace and done in the name of being thorough and avoiding lawsuits.

Have a Happy Thanksgiving. Turkey Butt

8:28 AM  
Blogger Akelamalu said...

It's shameful that they all jump on the bandwaggon - so greedy. We are so luck to have our NHS, even with it's faults.

9:09 AM  
Blogger PS (PSanafter-thought) said...

Not all clinic financial situations are set up so that the clinic/doctors profit depending on how many tests are ordered. In some places, the doctors are on a salary independent of how many tests and procedures are ordered.

And people can question/refuse tests. WE ARE STILL IN CHARGE of our own health care.

Lets also remember that the "doctor's charges" also pay for all the secretaries, the nurses, the cleaning people, the facility, and supplies, and the emergency equipment that may just sit there until the rare time it is needed to revive somebody.

We questioned the charges for some office visits my son had. We had to get his permission to get his files, then when we questioned, they said that the doctor's records justified the charges. We questioned the records because it was clearly documented that he had been with my son less than 10 minutes, but charged for a complete history and physical, which wasn't justified anyway. We threatened to report the doctor to the state attorney general or state department of health, and they backed down, admitted that the doctor had done the records incorrectly, and rebilled correctly, also stating that they were going to review all his records.

The Medicare fraud that has been in the news has to do with fake doctors offices and fake medical supply places and fake billing, especially in Florida. This SHOULD NOT reflect on hard working doctors.

All that said, I do know that some clinic administrators pressure the doctors to see more patients during the day than makes for good care.

9:27 AM  
Blogger Jim said...

Well, Dr. John, I wished I had seen this episode.

Yes, there are many vultures out there.
If they do a good job they don't get paid very well for their efforts at all.
For my latest dealings (a morning in the cath lab and an overnight half room) with our St. Lukes Hospital Medicare was billed $43,316.50. Medicare paid $7,622.35 and my deductible and a non-covered charge was $1641.12.
That meant St. Lukes had to swallow about $34,000 because I was a medicare patient.

It looks good right now for the visitors in Pigeon Falls. Will your tale end at the 2009 return?
It sounds like Eugene is happy!
BTW, we are still squabbling about $151 that they didn't bill my secondary insurance.


9:29 AM  
Anonymous Alice Audrey said...

That was very noble of Eugene. Now make sure the little girl gets her piggy bank back.

9:33 AM  
Blogger aims said...

Remember when you reeled with my story about my doctor?

I'm reeling with your story of health care and its costs in the States.

I once had a very good doctor who moved to the States so he could make megabucks. They don't make megabucks here in Canada. I 'think' they make about 150K a year. The specialists used to be on an extra pay system but they have done away with that.

If you want to be a doctor and make money here - you have to be a dentist.

Now - wondering what will happen tomorrow in Pigeon Falls.

10:06 AM  
Blogger Gattina said...

This could happen here too, they make 1000 tests try out all machines available, just to justify that they use their equipment !
I only go to the doctor when I am half dead or rather ask him to come to my house. So far I can't complain about my health. Mr. G does, he has arthritis, backaches, and a lot more (but only since he is retired, lol)

12:28 PM  
Blogger Lone Grey Squirrel said...

It's not just in America. It's happening here in Malaysia too. When I had a prolapsed disc, the first three doctors I consulted all advised for me to have a costly and risky surgery. Two of them did so without even examining me or viewing an X-ray of my injury. Only the fourth doctor did a physical exam, an X-ray and a NMR scan and concluded that I had a 90% chance i did not need the risky surgery and instead he recommended physiotherapy. About 1.5 months later, I was okay. My treatment had in the end cost about USD 900/- as opposed to about USD 3,000 for the operation.

It seems some doctors just opt for the costliest and most profitable option instead of what is best in the patient's interest.

It is GREED. so please fight it.

6:32 PM  
Blogger Melissa B. said...

The health care crisis makes me so sad. And the debate makes me angry. I don't understand why these greedy politicians would block critical care for those who need it...

6:33 PM  

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