Since I'm a nurse I thought the first subject I would tackle would be healthcare. by Kimilee Parker Steinmiller
(libertarian)
Sunday, February 28, 2010
This is my first submission. Before I get into the meat of it, I thought I would take a paragraph or so to explain why I felt the internet would not be complete without my opinion.
I am currently home, disabled, because my 16 year old drove me into a van during a driving lesson. This left me home all day to watch the recent "Healthcare Summit". Unfortunately, my husband has just lost his job of 15 years. He too, was home all day. So, for more than seven hours, I screamed at the television. Frequently, I tackled my husband to rattle on why this person had a good point or that person was so out of touch. Hubby, was trying to make good use of his "time off" by doing odd jobs around the house. Many of them have needed done for a long time. My rants were impeding his efforts, and he was visibly impatient with my need to pull him off task. After a particularly long rant, my husband said, "You should write a blog."
I told him at the time, that no one cares about my opinion. The internet is already a big bathroom wall with a bunch of nonsense on it. That was before I found this site. It just seemed like a good place to put my two cents in. I like that it is an open forum. It is balanced by many different views. My feeling has always been, that if your opinions can not stand up against opposition, then they probably are not very good.
Let me focus this first article, on what I believe, is an overlooked point in the argument about health insurance. In my humble opinion, the biggest problem with health insurance, is that people think it should cover everything. We don't expect our car insurance to cover an oil change. We don't put in a claim on our home insurance when the furnace breaks, but we expect out health insurance to cover maintenance. If we did use car insurance or home insurance like this, their cost would skyrocket as well.
I think many people of my generation will remember the episode of Little House On The Prarie, where Mary needs surgery. The church community passes the plate, and the Ingalls are able to afford the surgery because of their donations. I remember watching the episode with my mother. She explained to me, that this is what happened before people had health insurance.
Not everyone has a church community like the Ingalls, that is why we need catastrophic health insurance. However, they, and all the rest of the residents of Walnut Grove, managed to afford their more mundane health needs by working it out with Doc Baker. According to the television show, he even accepted chickens as payment from time to time. We need to get back to a place where we cover our own daily health needs, and only use insurance for unforseen, expensive problems.
I can hear you yelling that it is too expensive for average people to afford their everyday healthcare at your computer screens. Under this current system, it is difficult for most people to cover their maintenance health cost, but not impossible. It just so happens that as a byproduct of my husband losing his job, we have also lost our health insurance.
At first, I saw this as an impossible situation. I am diabetic and have several other health problems. I am also, as I said, off work because of an accident. My husband is in his fifties, and therefore has a couple of medications that he takes as well. Most scary for me, we have a 12 year old that is a medical mess. He was born with a congenital heart defect. He has asthma, he is bipolar, and he has rheumatoid arthritis. Health insurance seems to be something we can not do without.
It so happens, that being a nurse, I was able to go through our medications and find cheaper alternatives. Our local chain stores have programs that allow you to purchase prescription drugs for $4/month or $10/3 months. At this point, you may be asking yourself what my husband asked me. How is it that the chain store can do this? Who is paying the rest of the cost? The truth is, they are not offering this service at much of a loss. The drugs on the list are inexpensive to begin with. Without the cost of filing a claim with your insurance, they can offer a discount. With some insurances, your copay is more than the cost of many drugs.
As luck would have it, my husband has already needed to see the doctor. He had a rash and the itching was driving him crazy. It was not doing much for my sanity either. I was pleasantly surprised, that without having to bill our insurance, he received a sizeable discount for her services. It brought it down to approximately the cost of our chiropractic visits, which we have long paid for out of pocket.
The surprises just kept coming. We have for some time had difficulty keeping up with the costs of our son's psychiatrist visits. Our insurance does not cover mental health services well. We went to the doctor's office to pick up a prescription for his most expensive medication. The thinking was that we need to fill that medication before my husband's drug benefits stop. While there, I asked the receptionist if this doctor gave a discount because we no longer have insurance. She replied with a surprising figure. It is actually CHEAPER for us to see this doctor without insurance!
Let me say at this point, that not all my son's medications are available through the chain store programs. Unfortunately, many of the drugs he takes are quite new and there are no viable alternatives for him. Without getting too technical, let me just say this. Once your bipolar child is stable on a drug regime, and bringing home straight B's, you don't want to rock the boat. This is still a problem for us, and I have not yet found a solution. It is also important that I admit that I came at this problem with a distinct advantage because I am a nurse.
Despite the above disclaimers, the realization I have come to, is that it is possible. If we brought the cost of healthcare down a little bit more, it would actually be quite plausible to expect that everyday health needs be covered by individuals and not insurance companies. I think it would actually improve people's view of the healthcare system. It would be empowering. Those of us that have had extended exposure to health insurance companies, would find it a positive to tell them where to go and handle it ourselves. I was once on hold for and entire eight hour day with a patient's insurance company. Thank goodness for bluetooth and cell phones. Talk about increasing the cost of medicine.
As a nurse, I can see possiblities for helping people make cost-cutting decisions on their healthcare. Many nurses and doctors do not even consider the cost of what we ask of patients, because they have insurance to cover it. It is not as though they are actually paying for it themselves. If people were paying for things themselves, they would demand that their doctor find them cheaper alternatives, believe me.
I have already done this for many people. I had a patient last year who was having trouble affording her medications. She had several people calling her and trying to sell her Medicare part D. That is the optional plan that passed under President Bush that "helps" cover drug expepnses for Medicare eligible people. It is managed by private insurance companies. It has a considerable out of pocket cost for monthly premiums and copays. There is also the infamous "donut hole". I looked at the four medications that she took, and advised her not to sign up for the plan. Instead, I told her that she could change a couple of her medications to something the chain stores had as part of their program. In the end, this is what she did. It turned out to be considerably less expensive than Medicare part D would be for her.
I can hear many of you still screaming at me that you think I must have more money than you do. I assure you, as a nurse and a mechanic, there has never been a time when money has flowed freely at our house. Our current circumstances have all but shut off the faucet. Are we making sacrifices, sure. Would I rather my money went to a new car. Yes. All I am saying is that even in the current mess of a system, it is possible for us. It just might be possible for you too. Consider it.
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The views expressed
in this article are those of Kimilee Parker Steinmiller only and
do not represent the views of Nolan Chart, LLC or its affiliates.
Kimilee Parker Steinmiller is solely responsible for the contents
of this article and is not an employee or otherwise affiliated
with Nolan Chart, LLC in his/her role as a columnist.
I have been uninsured for several years now and recently got severely ill and had no choice but to seek medical care, so I went to a Walgreens clinic and to my supprise the cost if the visit was only $75 and that included 2 doses of albuteral through a nebulizer for no extra charge, and I was given 4 prescriptions that each cost me $4 so for less than $100 I was able to recieve treatment that I thought I couldn't afford. I totally agree if patients had more control and took responsibility for their medical bills, that costs would drop drastically because when you're paying the answer is always "give me what I need", and when the insurance pays the answer is "give me the best stuff you got". That difference alone would bring prices under control.
Another thing that I would like to see is reform of the FDA approval process, it currently costs over $500,000,000 and up to 15 years to get a new drug approves and everyone wonders why they charge $3-$5 or more per pill that costs them about $0.05 to produce. If they allowed pre-approval sales, after the animal and short-term human trials were completed and risks were known, patients and doctors could decide if the risks are worth the benifits, and the cost of the new drug that is not yet FDA approved would be much closer to the generic cost, then the drug is closely monitored for 5 years and if the rate of severe complications becomes unacceptable the drug is immediatly banned(like Phen-Phan), and if it is used safely by a set minimum number of patients over those 5 years it gets FDA approval and the option to sell it OTC, if feasible. If you have an illness that is worth the risk of trying a new unapproved drug then you have that choice. If you want to be safe and only use FDA approved drugs, you're still able to get the drug about 10 years sooner than the current process allows. Of course the people useing the unapproved drugs would have to sign a waver aknowledging the risks and releasing the FDA, the producers, and distributers of the drug of any liability relating to the use of the unapproved drug. You wouldn't want to solve one problem by causing a new one(massive law suits). This would cut the new drug costs down drastically and the real world testing is free of cost, and actually has the drug earning money for the company that created it.
Wow! I was just asking my husband why is it that our homeowner's and auto insurance are so reasonable, but healthcare is so outrageous. I think Kimilee has hit it on the head!! We truly expect too much from our healthcare, which is unnecessary. We need to investigate our options - get bids on regular medical services without insurance, and reserve the insurance for catastrophic cases. Shop the big box stores for generics, etc.Â
Most people could do that; the savings would be huge, and it might even make the insurance companies more competitive if they lost some business!
