Frugal Healthcare

There are many blogs today about living frugally.  Do you ever hear anyone talk about spending healthcare dollars frugally?  Not a word.

At our house we have excellent health insurance and almost never have any healthcare expense.  It worries me when that happens to people because I'm of the old school that people don't value what costs them nothing.  Perhaps I am the exception.  I cringe at all the waste I see everytime I'm in a clinic or the hospital.

How about Medicare?  Spend those Medicare dollars you say.  Not me.  I have a chronic condition that lands me in an Urgent Care Clinic about every three to four months.  I don't know what that costs but I figured there had to be a cheaper way.  I set about to come up with a plan.

Why did Medicare and my insurance company need the expense of me visiting an Urgent Care Clinic when I knew, my doctor knew, and the Urgent Care Clinic knew what the problem was.  All I needed was a prescription.

I decided to approach my doctor about allowing me to keep on hand the prescription I needed, give me a limited number of refills and cut out the expense of the Urgent Care Clinic.  He agreed.

Have you noticed how wasteful hospitals and emergency rooms in particular are with supplies?

An elderly family member was recently prescribed a back brace that was terribly expensive.  She will never wear it.  It was a waste of Medicare dollars.  The doctor should have been smarter.

No wonder healthcare expense is out of control but if you said the word frugal in the same sentence with healthcare people would go all Sarah Palin on you.  Frugal doesn't mean cutting quality, it means cutting waste.

Let's hear it for frugal healthcare dollars!

Heroic Measures

The new year had barely begun when there was a death in our family.  He was 63, weighed 360 pounds, on oxygen 24/7, could walk only a few steps.  During the night he fell in the bathroom.

The ambulance and paramedics arrived.  Seeing the gravity of the situation they inquired if his wife wanted them to use heroic measures.  They could give her little hope.  She wanted them to do everything possible to save her husband's life.

He was care-flighted to a hospital with a trauma center.  After three days all machines were disconnected and he was gone.

I've thought a lot about this situation.  She said he had signed a "Do Not Resuscitate" order but later rescinded it because he said he wasn't ready to die.  She agreed with his decision.

It's hard not to appear harsh and cold hearted about this but what on earth went wrong to get to this point.  Who failed?

No wonder healthcare cost in America is out of control.  Who paid for all this?

We cannot afford to be a medically illiterate society. Regardless of Sarah Palin's talk about death panels, there needs to be education about end of life issues.

Concierge Medicine

I noticed our family practice doctor had become frustrated and angry with the financial side of medicine in this country.  At the time I didn't think too much about that but I should have stopped right there and changed physicians.

We liked this young man, or at least we had at one time.  It became apparent once he went into private practice he was not capable of managing an office.  He began to blame others for his problems.  He felt he had been misled into family practice medicine when specialists were making a lot more money than he was seeing in his practice.  He was angry about Medicare, and insurance companies in general.

In time I received a phone call from his office inquiring if we would be interested in retainer fee/membership medicine.  Next came the letter informing us our doctor was changing his practice to this kind of medicine.

The thing that quickly grabbed my attention was he would no longer accept any forms of insurance.  Medicare/Medicaid claims cannot be filed by the patient so even if we'd been inclined to stay with his practice that alone would have been a deal breaker.

For a retainer fee he would be offering some services each year but anything above that the patient would pay up front and file their own insurance.

Knowing this young doctor I knew he was all about a more lucrative practice for himself but I also knew he preferred to practice preventive medicine.  He did not enjoy treating chronic conditions.

While I have no doubt the frustration level among doctors is high over insurance and Medicare I did not see the masses rushing to concierge medicine.  Doctors in our medical community were puzzled over our doctor's decision.

At this point I lost respect for our doctor.  I also felt bad for him because I felt his choices were going to disappoint him and lead to more anger and frustration.

If his choice worked he would have set up the following things:

1) Set in motion a two-tiered system that favored the wealthy.
2) He would no longer see the elderly or the poor as he would not accept Medicare/Medicaid.
3) His practice would be smaller allowing the time needed to care for his retainer patients.
4) He would not see patients with chronic illnesses as they must rely on insurance.  Why go to him and have to file your own when doctors' offices all over town file insurance for you?

We're now some two years out from all this.  His practice has gone bankrupt and my understanding is he's left the area.

My next post will be about choosing a new doctor.