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The so called "excessive" use of health care The problem with HMO's |
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One thing I find extremely annoying, is the habit of most medical articles to point out the financial and social burden, that disabilities create. Now, I can understand it from one point of view, as for them to get the funding for their research for example, by pointing out to the ones with the money, that X disease is causing a financial hardship, from the standpoint of lost work hours, medical costs, and outright support needed, for those no longer able to work, is quite reasonable. I would imagine it does tend to get the money holders attention a lot faster, than say, appealing to them for humanitarian reasons. :) This habit however, does not take into account that our society as a whole, already has a negative mind set for any group, that for whatever reason, is unable to meet their own needs, and must rely on the social system we have in place to meet such needs. Now, in the best of all worlds, this would be done, without negativity and given freely by our society. However, we don't live in such a world, not yet at any rate :). By and large the "healthy" part of our society, who has to foot the bill for this support, does so begrudgedly. So what we have, is a dilemma when it comes to funding. The medical profession, who needs vast amounts of funding to do the research to, one hopes, help those of us with diseases. But their manner of doing so has, by their very practices, created a focus of doom and gloom in the mind set of the rest of the world when it comes to lost man hours and over all costs. I don't know about you, but I am sick and tired of seeing, article after article the focus on, how much FM costs ! This focus on cost of care, the so called "excessive" use of health care services, and lost work hours etc., is needed information to be sure for funding, but does it need to be pointed out every dang time we turn around ? I doubt very much if the ones who write such missives realize, just how much damage they are doing, to our already over stressed lives, by pointing out cost factors like this, to the world at large. So, how to counter this ? Well, we can hardly tell the research people that are pointing out the financial hardships to stop doing that, if it means, if they stop doing it, they will not get the funding they need. However, we can and should point out to them, that putting such items in, for the public articles, is out of place and uncalled for. Insurance companies: What needs to be countered the most, is this idea that our need for health care, is "excessive." Understand, the main reason this is said, is your average person, sees their doctor, once, maybe twice a year, at most, three times. An hour of the doctors time a year, spaced out over three visits, per person, is considered "normal." Use of testing facilities and lab work, is on average, 3 times a year as well. Now, of course, those of us with FM laugh at this idea, as it can take seeing our doctor 5 to 10 times as often, just to get in everything we need to deal with said to them, and or testing done, etc. Our issues are complex and time consuming. Which, given how many things can be wrong, that need to be addressed, is perfectly reasonable. So where does the idea of "excessive" come in? It's a numbers game, doctors compute their average session with a client, based on what is most of their clients, your average person, without a chronic problem, requires. Insurance companies are the worst offenders really, as they are the ones generally paying for it, so anything that comes across their desk, that is above and beyond "normal" usage, raises a huge red flag for them. I have been told, to my face, by doctors, that I was "using up" their entire funding for a dozen people. HMO's are mainly to blame for this idea. The reason being, they have taken to paying doctors X amount of money, based on their client base, no matter if the clients really see the doctor or not. Now, this seems a perfectly reasonable idea, or at least it does from the doctors point of view, as it means the doctor gets a fairly standardized income. Even if the pay per person, is fairly small. However, in comes someone with a major chronic illness ... and suddenly, that pay paradigm goes out the window. This is so, for the fact, that while they get a promised income, based on their client list, they don't get any more money, if they actually have to SEE the person. So we are, in fact, making them work for their money, way above and beyond their normal clients. This can even cause them to lose money, just to see us. Or so I have been told, point blank. So, what to do ? Well for one, we need to counter the HMO's and other such medical backers, that all of us, with chronic disabilities, need to have a completely different scale applied to us. So that our doctors are more willing to see us. This will take much effort, to enforce change on the HMO's and the like, as of course, they are not going to want to have to do that, as it will cost them more.. However, facts are facts, with the the aging of America, the idea of more and more visits, per person, will become the norm. This is inevitable, so it is not just we, with FM` who need to work to get rid of this concept in the medical mind of so called "excessive use." It is everyone who needs to work for it, as one day, all who live to see old age, will be just as "excessive" in terms of their medical needs, as we with FM are now, and for the same reason, out of necessity. We need to write letters to the major insurance carriers, our government, our local association for the aged, etc. And make this point perfectly clear, that the "norms" in our current day health care system, no longer apply and it's time to stop considering us ( and the elderly ) a burden, and just address our needs, without all the hype and hair pulling over what is "normal" usage.
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