(Or whomever is in charge),
Please, take a few
moments
from the
lugubrious task
of dumbing down
policies, quibbling
amongst yourselves,
and attempting
to remove any documentation
- on line - of the truth of
climate change, seepage of
fracking waste water and gas,
or the Affordable Care Act.
I would like to
begin by asking,
Question 1: "Why
are we using the 80/20 rule
for healthcare costs and
shared payments?"
Most often,
I hear this rule
bantered in marketing
meetings when the person
under the light
is asked for data he/she
has no possible way of
knowing (because of
lack of fact and data
in his/her reach).
Reaching deep into
his/her rectum,
out is pulled a plum
of a fact and it is
always something
to do with 80/20.
Silent pause
and listening.
Question 2: "Am I
allowed to know how
much I will pay for
"procedures" before
I am rendered unconscious
and "proceeded upon?"
If I walk
into McDonalds; or, let's
say Taco Bell. I can
look up -
to the GREAT BOARD OF
COST. I can
select the meal I want
and find out -
and, here is the KICKER -
how much it will
cost BEFORE I have
to place the final order
and pay.
I can then adjust
my order based on
what I know I am
able to afford.
"Please, let's take
off those extra fries."
Silent pause
and listening.
Question 3: "If not,
WHY not?"
Silent pause
and listening.
Question 4: "Do you
drop off your car for
repairs and just tell
them to fix it regardless
of the cost or procedure?"
Silent pause
and listening.
Question 5: "Don't
you want AN ESTIMATE?"
There had been a time,
when as a member of
the ex-MIDDLE CLASS,
I could take my car in
for repairs
one or two days after
hearing that
ping under the hood.
Get it fixed early -
before it fell apart.
Times have changed.
Now,
I take it in when it
no longer moves.
But, regardless,
I want a list
of parts, labor,
costs and a plan
for getting it done.
Silent pause
and listening.
Question 6: "Does anyone
remember that one of
the first aggressive act of
the ACA was to make
sure Insurance Companies
spent 80% of their revenue on
the actual cost of healthcare
the were insuring the
insured for? Killing overt
marketing and fat-cat bonuses!
And, making doctors
accountable for kick-backs
from BIG PHARMA? Making
that all disappear."
Silent pause
and listening.
Question 7: "Don't you
think that doctors, clinics,
hospitals, nursing homes
and healthcare providers
across the industry know
exactly what procedures they
will need to do for each
ailment or service (shouldn't
they have procedure manuals
and protocols for how to
remove a spleen - LET'S
SAY?)?
"And, if they
don't, don't you think
we should not allow them
to provide care?"
Most of them all have
computers so they can
bill Medicare or the
insurance company -
we KNOW THAT
for sure.
Can't that same hardware
be used to - LET'S SAY - deliver
stored data on procedures,
dependencies of those procedures,
and the said cost of all
of the above?
These are just
a few thoughts
I have had while
laying on my back,
staring at the ceiling,
trying to decide if I
could surgically remove
my kidney stone
myself. From my
garage.
Even if
I ran to the ACE
Hardware to get
that one tool I
don't have for
surgery, I could
know that cost
before I operate.
The overhead
on my garage
is fixed.
Silent pause
and listening.
Yes, I am aware
that I have reduced
this issue to COST -
at least 80% of
the conversation and
RESPONSIBILITY to
20 %, but I
figured those were
terms you could work
with and understand (can
you smell the plum?).
The last time I looked,
it was WE THE PEOPLE
who pay ALL of YOU
THE PEOPLE's salaries;
whether you are in
public office,
in CMS, in pharma, in
insurance or in
healthcare.
CAVEAT
EMPTOR needs some
change.
CAVEAT VENDITOR!
You see, here is the
thing, I am already
paying hundreds of dollars
each week for the
LUXURY (?) of a
health plan. So, when
my doctor says I need
a test, I wrongly assume
that that money ( the
hundreds paid weekly)
is going
to offset my repair
costs.
WRONGLY.
My monthly car
warranty extension plan
seems to be able
to pay for the items
LISTED IN THE POLICY
out of the monies I
pay monthly.
It's a car.
Silent pause
and listening.
Question 8: "How can
$1,184.00 be 20%
of a test and its
procedure? Does it
really cost $6,000.00
to drag that machine
up to the Poconos
and rotate it among
offices to take pictures
of my gut and tell me
I have STONES IN
MY KIDNEY?
Shouldn't someone
be able to regulate
THAT; I mean we
have been doing this
for some time?"
BELIEVE ME, I
KNOW I have stones
in my kidney!
The doctor wonders
why I won't go to
a specialist to review
the "work done".
Meanwhile, I know
there is only one bugger
left in there. I am headed
to ACE.
Also,
can I bill them
for my wasted time
waiting for services
or having to call them
to get results of
the tests I have
paid for?
Silent pause
and listening.
Question 9: "What have
CMS, the insurance companies,
and big pharma been doing
with the bazillion terabytes of
data they have collected from
us on the forms we fill out
and they themselves generate?
Couldn't our providers be
able to assemble a menu
of choices and costs and
estimates from all of that?
Or, is it in a landfill
somewhere with the red
plastic sharps containers;
or worse, yet,
off the west coast?"
Silent pause
and listening.
And, finally,
Question 10: "Does anyone
who is writing policy and speeches
recognize that every issue is
connected to every other issue
and, we cannot simply
tear one down and fix it.
Complexity and compromise
are sure signs of
an adult brain and
its ability to survive."
We cannot just say we
will solve diabetes, and
be done with it. We need to
pull on the string a bit
and find it is connected.
It is connected to poverty,
to diet, and to genomic patterns.
Intricate and varied is
ALL OF LIFE.
Liken it unto the neural
ganglia in your head or
the quasars and galaxies
above that head.
You don't just build a wall
and watch your conflict
turn back and retreat.
While you are dismantling
the complexity of the warp
and weft of what it means to
live TOGETHER on a
small planet with MANY
organisms, see if you can
use some of what we know
about our situation to
tighten up some of the
LOOSE BOLTS.
Silent pause
and listening.
How is it that
cave men can operate
a laptop; steering
through the panoply
and wonder of cellular
connectivity and
images of
hundreds of billions
of galaxies with untold
mystery and delight
and still use a rock
to fix the world.
Silent pause
and listening.
Darwin was clearly
WRONG,
not all species
evolve!
image from Fox 8
No comments:
Post a Comment