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Let the buyer beware

Currently our government is in a mad rush to revolutionize the health care system in the United States.  As a physician, I agree that something needs to be done.  However, after listening to the current administration’s grandiose planning,  I’m left feeling uneasy and concerned.

I have been in practice since 1988. In that time period, I have witnessed a continual rise in deductibles with a simultaneous reduction in allowed services.  During this same time frame, my patients tell me that their premiums have gone through the roof.  Yes, policyholders are paying more and getting less. This appears to be the model of change in the insurance industry since the creation of HMO’s.

Health Maintenance Organizations

hmo-contractPromises… Promises… Promises… I remember when HMO’s were being advertised to the public and to physicians, as the next best thing since sliced bread.  The so called experts were touting all the “amazing benefits” that would come from people joining HMO’s.  Well, what has transpired since then has been quite a different story.

By far, the majority of people that have HMO’s are not happy with them.  Physicians that got hoodwinked into joining them are tearing up their contracts; they’re tired of being over-burdened with redundant paperwork, having bureaucrats defining their treatment protocols and having their fees cut by 50% or more.

Unfortunately… Common sense is not so common

Here is my concern, the people that are in charge of changing our health care system, don’t even understand it. If you don’t understand it, how can you possibly fix it?

The Government Health Care Plan will use HMO’s as their template.  Imagine a marriage between an HMO and Medicare, and then add layers-and-layers of Governmental Bureaucracy.

Put on your running shoes, the information age is chasing you.  The government wants all patient records to be available via Electronic Health Records.   By doing this, massive data bases will be created.  Data mining will allow diseases and syndromes to be pigeonholed and quantified.  On the surface, this sounds like a great idea; however this information will create a double edged sword. On the plus side it will give researchers and physicians a better understanding of diseases. On the minus side, both treatments and cost allowances will ultimately be determined by these numbers.  This will ultimately lead to denials of care, if you or your loved one’s disease requires care that is outside the allowed calculated amount or time frame.

Herein lies the rub,  physically, physiologically and psychologically we are all different.  When treating someone’s disease or illness you quickly find that there are many variables that will impact the patient’s outcome.  Many of these variables are beyond both the patient and the doctor’s control.  We all know of two people that have had the same disease yet had totally different outcomes. This is a reality that on many occasions is unquantifiable.

I’m all for minimizing costs and maximizing outcomes, however, until we all have identical genes, eat the same foods, live in the same environment, think the same thoughts and get the same amount of physical activity this will-never-happen. It is simply not based in Reality!  I don’t care who writes the bill be it a Republican or Democrat.

Personal Responsibility

Helping HandOur government’s responsibility is to give us a helping hand, not a handout.  Personal responsibility has almost become an oxymoron in our country.  This is a sad fact, because that trait alone can not only change one’s life but also can transform a country.  Without it, both the individual and the country are destined to mediocrity.

Our dysfunctional government makes an easy target for our criticisms; however, we must begin to look at ourselves.  Especially when it comes to our health, irrefutably the most important possession we have.

Are you doing all you can do to be as healthy as possible? A few questions:  Do you smoke? Do you drink?  Do you eat a healthy diet? Are you overweight? Do you get regular exercise? Do you regularly wear your safety belt? The answers to these questions dramatically impact your health.

The Bottom Line

Change is on its way.  If the Government’s Health Care Plan goes through and personal responsibility in our country does not increase, we will only have ourselves to blame when the system collapses.   It’s time we turn our shoulds into musts!

Becoming healthier is a journey.  Begin your journey today!

Call today… 513-791-8110

Yours in Health, Naturally!

Dr. Gould