When Patients Own the System

A Progressively Financed, Single Standard of Care for All

The national legislative healthcare fix that may be
passed
by the 111th Congress and then signed by President Obama will
do little
to relieve the stresses felt by most patients in this country. The
steady
decline most of us have seen in the kind of quality medical services we
need is
not likely to be mitigated. Insurance companies will grow ever stronger
and more deeply ensconced, and the patient voice will fade more quickly
from
prominence than it has in recent years.

Patients have been props in this discussion.
Patients
are widgets in an economic system. Patients are an annoyance to
insurance
companies who worry about the medical losses (claims) as a loss of
profit and
often even to providers who must carefully screen patients to make sure
they
come with profit potential via their insurance coverage or very deep
pockets
full of cash for payment. Pesky patients.

And nothing - nothing - in the current
legislation disrupts this process from deepening.

The results are mind boggling and devoid of any
ethical
grounding which would lead anyone to believe that healthcare is a human
right
in America.

I know scores of patients - people who need medical
care - who tell me about their personal journeys. They are often
shuffled from provider to provider getting whatever medical tests or
procedures
are approved by their insurance companies while not receiving even one
stitch
of treatment or relief for the issue that brought them to seek care.
The
money flows; the patient is not treated. Maybe a pill. Maybe.

The practice of medicine has long ago shifted away
from
being a patient-centered art and science, from the perspective of most
patients
I know. Most providers spend very little hands on time with patients
and
even less listening time. Nothing about forcing the purchase of
private,
for-profit insurance will change that reality. And finding that one or
two providers who still care enough to try to provide kind and
compassionate
patient care is a daunting and long process for most patients I know.
Most give up and just get care when they have to and put up with being
treated
as an annoyance, an irritation in a system that just wants to take more
and
more profit with less and less contact with the patients who generate
that
profit.

The costs of that shift form the practice of
medicine to the
profit-taking of the medical business is enormous both in dollars and
cents and
in human decency. People spend long days and weeks and months seeking a
medical home - somewhere that they can trust to provide the right care
at
the right time with just a touch of kindness instead of the nasty,
condescending atmosphere so many patients endure just trying to make
appointments, get test results or God-forbid ask a question over the
phone.

I know a seriously ill person who has at least five
different providers. Yet this patient is slowly wasting away while
begging someone, anyone to take his symptoms seriously. Not one of the
providers has an appointment time in anything less than five or six
weeks
- and all have office staffs that grow angry if questioned about that
wait. No one on the other end of the phone wonders what is making the
patient feel bad or even suggests a way for some earlier treatment.
Not one provider who has made thousands of dollars on this patient's
behalf cares enough to want to find out how they can help. The
providers
simply have all the revenue streams they need coming through the door so
one
patient's life and one patient's suffering doesn't matter
much in the scheme of things.

Nothing in the reform bill will interrupt this
hideous and
relentless process for many patients. You simply cannot legislate a
system drunk on money and massive profits to care about patients. We,
the
people, need to control the system - our money, our system, our
lives. Nothing but a progressively financed, single standard of high
quality care should be allowed. It should be a crime to do less.

The U.S. healthcare system represents more than 16
percent
of the gross domestic product. That's a huge chunk of the economic
energy of this nation. That's going to get bigger and bigger in the
years going forward. And as the financial linkages and economic impact
of
the system grows, the patients' individual significance will continue to
lose ground. It's simply a numbers game.

My biggest worry is that the diminishment of caring
and
compassion will accelerate that has escalated in recent years with
managed care
and for-profit insurance driving medical decisions and therefore medical
profits and therefore how providers really treat patients.

We, the people, must own this system or it will own
us. Public, progressive financing of a single standard of high quality
care is the only way to protect patients from the abuses.

I remember days not so very long ago when patients
were
treated so very differently. We're never going back to those days
but we'd better stop the trending. Patients need to band together,
share information about provider practices and take a stand together -
it
must be our system. Or the profit-takers will make their fortunes ever
larger on our suffering and pain and never look back for an instant.