Monday, February 9, 2009

You want a change? YOU make the change!

I was reading a news article the other day about president Obama asking for support to get the new stimulus package pushed through. In his speech he used the phrase "America voted for a change and this is the change America voted for." I thought about that and also about his ideas of "change" he has for our health care system. He was also quoted in another article saying that "only the government can shake the country out of a recession." Basically what this administration is running with is that more government involvement is what is needed to get us out of this hole (for my views on the capability of our government to enact such changes read my previous entry). So let me make a few simple suggestions about how if we want a change, WE need to make it. Let's look at health care for example.
As a nation we spend more money on health care than the rest of the world. Yet, there are more people in our nation that have little or no insurance and do not receive the proper health care that they need. Now some of the other nations on this chart have adopted a universal health care system and so this allows all of their citizens to receive a standard of care. Granted it might take 6 months for grandma to get that new hip she wants/needs, but at least under universal care grandma, regardless of her income, can get it. In America however, it's different...and that's why people believe that there needs to be a change. And in certain areas I agree with them, but I believe that there are a lot of misconceptions and beliefs about the system and how it needs to go about being changed. Also I would like to present some ideas at how it can be changed.

1- In this country health care is a business. That's the simple truth. Granted, most of us in health care went into it with some altruism in our hearts, but we still have bills to pay and this is our job. Before starting PA school I put in forty hours a week of work at the hospital because I needed money. I had a mortgage, bills, need for insurance, need for food, school tuition, etc that I had to pay for. After school I will still put in those same forty hours (if not more) as a PA for the exact same reason. Doctors, PAs, NPs, RNs, LPNs, and everyone else in healthcare also have those same expenses and this is how they make their money. If more of our nation understood that fact I think they would see health care differently. People will go out and buy expensive cars, entertainment centers, houses, etc and not complain about the people/business that sold it to them, but when it comes to going to the doctors..."are you going to charge me extra for cleaning my ears out because I don't want to?" Do you go to work as a "______" because of your innate desire to serve others, or because of money? And if you say that it's not about the money then you're full of crap!
2-"Doctors really just try to keep people sick because if they cured everybody then they wouldn't have a job." Let me tackle that statement for you. America, health care providers will always have job security not because we try to keep you sick because you do that just fine on your own. Keep on smoking 2 packs a day, keep drinking yourself to death every night, keep eating at places like McDonald's everyday, oh and one more thing...please, please don’t get off the couch and exercise because if you did that you might just lose weight. You might just start eating healthier and maybe you might stop smoking. That would lead to a decrease in heart disease, diabetes, lung cancer and all those other wonderful diseases that keep us in business, and we don't want that. Cure for cancer...why? Honestly people get over yourselves! You are the one making yourself sick, not me. Do I put the cigarette in your mouth and light it for you? Do I chain you down to the couch and force you to watch reality shows like "The Biggest Loser"? Do I convince you to spend money on alcohol instead of medication? NO! YOU! YOU do that on your own! If you're an overweight, smoking diabetic these are the things I'm going to tell you: Stop smoking, Exercise 30 mins a day at least, Eat healthier (and I might just even give you a diet plan and refer you to a diabetic educator to teach you about eating better), take these medications that have been proven to treat diabetes and heart disease. If after current follow up appointments and more suggestions you continue to not do those things then it's not my fault you're still sick.
3-YOU MAKE YOURSELF SICK (one more time for emphasis). Now there are plenty of people out there that have illnesses and diseases that they have no control over. Trust me I know this. If you're a Type I Diabetic I'm pretty sure you didn't tell your body to attack your pancreas. If you have a genetic disease then it's not your fault (you can blame your parents for this one). There are diseases that we can't stop from happening, but we can hinder their progression and in some instance cure them. But it's still up to YOU to manage this thing on a daily basis. Diabetics, take your insulin as prescribed. Hypertensives, reduce stress in your life and take your blood pressure medicine. Infected, take your antibiotics as prescribed. If it says take twice a day for ten days then do it! Don't stop taking them on the third day simply because you feel better, the infection still exists within you and will only grow back stronger and more resistant.
4-Rising Costs: Now how can we manage the rising cost in healthcare? Simple, learn how to use health care appropriately. The emergency room is not a family clinic. "Is it the EMERGENCY or the ROOM part that you don't understand?" When your kid has the sniffles go to your family doctor. Don't have one? Get one. Can't afford one? There are thousands of community clinics around our nation that base their fees on a sliding income schedule, and most of these clinics also have payment plans as well. Again, health care is not free and we too have bills to pay. I digress back to the emergency room. I remember working many days when there was a two hour or more wait in the emergency room. 75% of the cases could have, and should have been taken care of by a family practice doctor. People, the emergency room isn't free, even if you don't have insurance. While suturing up a young child I overheard the patient in the next room say to a friend while she was talking on the phone "Well does she have insurance? No? Then just tell her to come to the emergency room." Again, it's not free and if you come with the idea that it is then you are in for a big surprise. When we constantly use emergency rooms as family practice offices then of course costs of health care are going to increase. Again, the increasing cost is partly because of OUR actions. It's not all the insurance companies, or those greedy doctors faults that health care cost are outrageous...it's OUR fault. It's a simple example of supply and demand. If WE continue to abuse health care the way we due then prices are still going to climb.
5-Staying Healthy=WORK: You want to lower your health care costs? Then stay healthy. You do that by choosing healthy lifestyle choices....remember the ones they taught you in 8th grade health class? We don't teach these concepts to our children because it wastes another hour of their precious time. There is truth behind it all. Here's the hard part, it requires effort on our part. It requires that, instead of snacking on a bag of potato chips and a regular soda while watching "Dancing with the Stars", I turn off the T.V. and go for a walk/run/bike/insert your choice of physical activity. Instead of getting that super value meal super sized I stick with just the regular sized meal and a water, or even better, I cook something for myself instead. It requires that when I start to get sick with the sniffles I do all that I can to get better right away (proper use of available health care) so that I don't lose a day of work or pass it along to others. It requires that when my medications are running out and I need a refill I let my doctor know in advance instead of seeing him two weeks after they've run or calling his office on a Saturday, when it's closed. Yes people, it's easier and cheaper to avoid problems then to have to fix them. But it requires effort on OUR part. There are no magic pills!
6-Children follow Parent's Example: Today I saw a woman who was suffering from multiple ailments, while taking at least a half dozen different medications, who was no taller than 5'4'' and weighed over 300 pounds. That's a BMI of over 72! 25-30 is overweight, 30-35 obese, 35+ MORBIDLY obese. MORBID: "Suggesting the horror of death or decay." She could barely walk, barely breath, in constant pain, and many more complications. Next to her sat her daughter with the exact same build, except a little taller, but still MORBIDLY obese. And then there was the granddaughter, while still only less than 2 years old, probably fell above the 95th percentile in weight for her age. Parents it's up to you to keep your kids healthy while they're are under your care. Turn off the video games, make them go outside, give them fruits and vegetables as snacks, help them with their 8th grade health class homework on healthy life choices (who knows, you might learn something as well.) You want to make the world a better place for your children to live in? Maybe you can't change the world but you can at least help it so that they live to see that world by helping them stay healthy. Again, it requires YOU to take action.
7-You Do Not Know More Than the Provider: You don't. This isn't your specialty. You didn't go to countless years of school focusing on human anatomy/physiology, infectious diseases, or pharmacology. You do not spend your entire day at work diagnosing and treating others. You do not spend your free time reading new drug studies, researching new treatment modalities, or studying to recertify your credentials in medicine. If he/she says you don't need an antibiotic than you don't need one. It's not that he/she wants you to continue to suffer but years of schooling has taught that person when and where to use antibiotics. You want to know why we have drug resistant bacteria out there? Because of the huge overuse of antibiotics for illnesses that usually clear up on their own and also becuase people only take antibiotics until they feel better, not for the recommended time. You might not like your provider, but that doesn't mean you know more than he/she does. And don't go doctor shopping for one that will give you everything you ask for. You'd be better off finding one who knows what he or she is doing and has the guts to stand up to you and say "You don't need that." Maybe you want to try a natural alternative. That's fine, but where do you think we got most of our medications from? The majority of them were inspired by naturally occurring agents: penicillin, digoxin, Botox, insulin just to name a few. For a good read about natural products go here.
8-Stop Suing! Why does your provider all of a sudden want to order these expensive tests to rule out some rare disease? Because if he didn't, and by some incredible chance that you did, YOU would slap a lawsuit on him for all he's worth and for all his children's worth. Not only would you sue for any financial costs that this would incur but also the "emotional damage" it put you through. It's called practicing medicine people. We're not perfect at it and mistakes will be made. I now find that many providers are practicing CYA (cover you a..) medicine. This includes ordering more tests and prescribing unnecessary medications because they're afraid of the unforeseen possibility that their patient might just have some 0.0000000000000000001% chance of some fatal or debilitating problem. Let me put this in simpler terms for those of you that still might not get it: more lawsuits=increased medical malpractice insurance=increased CYA medicine=increase health care cost. Now if there was a provider out there that deliberately made a mistake putting someone’s life at risk I can understand a reasonable lawsuit. But because the doctor told you your cancer gave you maybe only 6 months to live, and for some reason you've made it a whole year since then, you think it's prudent to sue for "emotional damage" saying "I was ready to die and now I haven't" or "I sold my house and blew my life savings in Vegas." Get rid of the frivolous lawsuits! (See point 5 on doing YOUR part by putting forth an effort)

Now there are those companies and organizations (insurance/pharmaceuticals/Medicare/Medicaid) that can change their organization to help lower the cost of health care but we can't make them. They will have to do it on their own. But if WE work at changing what WE can then I imagine it would make a significant impact.

These are just some examples that I can think of that will help to reduce the cost of health care and "change" the system. Isn't "change" what the American people voted for anyway? Remember that our government is a government "of the people, by the people, and for the people." If the PEOPLE (YOU and I) can't/won't make these changes then the government won't be able to make them either. WE are the government.

Again, for emphasis, YOU/WE have to make the change. YOU/WE have to be responsible.

P.S.
If you've been sick for the past four days with severe vomiting, cramps, and diarrhea don't wait to go to the ER at 3:00 a.m.! Seriously, you're just asking to be called an idiot.


P.S.S

In the immortal words of Dwight Schrute: "In the wild, there is no health care. In the wild, health care is, 'Ow, I hurt my leg. I can't run. A lion eats me. I'm dead.' Well, I'm not dead. I'm the lion. You're dead."

Wednesday, February 4, 2009

Governmental Digital TV

So today while watching NBC nightly news I saw a report stating that the upcoming change to digital TV, originally scheduled for Feb 17th 2009, will be pushed back to early June because "the country just isn't quite ready yet." They expounded upon that by saying that there are over 6.5 million Americans who use analog reception and still don't have a digital converter box that would allow them to continue to watch TV. Now most of these people still using analog receivers do it not because they are stubborn and don't want to change but rather can't afford to by a converter box (average price $40.00). That's just the ones that are left, there are still plenty more people out there who can't afford a converter box but have received one, and sometimes even two, for free because when this proposed change was announced over 2 years ago the government started giving out coupons to receive free boxes, thus allowing everyone to make the switch. We've all seen the ads on TV about the upcoming switch and most of us either got prepared for the switch, or already have cable and so we don't have to worry. Today, 2 years later, in the Senate there was a heated debate about moving the switch date back to June. Democrats argued that the country just wasn't ready yet, because of the stated 6.5 million who still didn't have boxes and that the government ran out of coupons. Republicans argued that this switch needs to go forward as scheduled because this will free up the airways allowing the government to sell these newly freed airways. The verdict was passed and the date was moved back to early June. Now that I've caught you up on current digital affairs let me express my opinion and reasoning behind it, along with a couple of solutions.

Problem: Government giving out free coupons (sometimes even two per household) to ease the transition and now have run out. What's wrong with the government helping people out some might ask? Well, if the government is handing out coupons worth $40 dollars towards a new box that means the government spent $40.00 per coupon, couple that with over 13 million Americans who have received these coupons and that's a hefty chunk of change. Where did that money come from? Taxpayer pockets. Now there are a couple sub-problems within this problem.
Sub-Problem: We were already in a financial crisis two years ago when this proposal came out and now we have an even larger debt. Why is the government spending money on something that is not a necessity? Some might argue that TV is a line of mass communication during an emergency and that people will need these boxes to be able to continue to receive those emergency instructions. Here's where I find fault in that argument. In most home emergency kits it is recommended to have a three day supply of food and water, a flashlight, extra clothing, battery/hand crank operated radio (with extra batteries), etc. Your TV won't work when the power goes out so that's not included in the emergency kit. Any emergency information broadcasted over the TV will also be broadcasted over the radio. If a digital converter box is necessary for everyone to stay well informed then technically the government should have been giving out free TVs years ago so that everyone could have stayed well informed back then. But they didn't. Why?
Sub-Problem Two: The government would give out two coupons per household. Why? If someone can't afford a converter box my guess is that they probably don't have more than one TV in there house. If they do then their priorities are misplaced and maybe they shouldn't be getting a converter box in the first place. But alas, two coupons per household. Now the government has run out of coupons and there are still 6.5 million households left without boxes. Keep in mind that over 13.5 million have already received their coupons. So let's do that math...13.5 million at two coupons equates to 27 million coupons. Now 13.5 million plus 6.5 million adds up to 20 million. So we should have had an excess of 7 million coupons. Yet we ran out with 6.5 million left without their precious TV.

Solution: TV is a luxury, it's not a right. If you can't afford a one time purchase of $40.00 for a converter box then I'm pretty sure you're struggling to pay rent, buy food, afford health care, etc. TV for you is not a necessity. It's not needed in cases of emergencies, to stay informed (I have a TV and there are still things in world news that I don't know about. Why? Because I don't watch those channels and most people don't either), or is something that the government should regulate.

Problem: This project has been in the making for years and in the public eye for at least two years and now with the conversion date approaching the government is not ready.

Solution: It's too late to take back that extra coupon we gave to each household so now it's time to just cut your losses and go ahead with the switch. Americans are resourceful, if they want their TV their going to get it. You'd be surprised how fast a desperate person can muster up $40.00 for something they really want (not necessarily need).

As Glenn Beck would say let's take an ADD moment. The government isn't even able to handle the switch form analog to digital cable on time for those people who can't afford to. Remember there are plenty out there who already have cable or satellite so the government isn't helping them out. What makes us think that they will be able to handle health care for the ENTIRE nation? It's a one time switch that should only cost $40.00 per household that they weren't even able to take care of. Now they want to socialize our health care system and try and manage that for us? If you really think they can pull it off then more power to you.

Problem: TV IS NOT A NECESSITY!

Solution: I've already said it but I'm saying it again. If you can't afford this one time cost then you have bigger problems on your hand than not being able to watch TV. Get your life in order! Again you will see that people will be resourceful enough to find $40.00 somewhere so that they can get their precious television but when they're prescribed an expensive (because it hasn't gone generic), live-saving medication they think twice about it. What's more important in the future my health or my entertainment?

Now you might think this critical of me (along with my other prior blogs) and you know what...you're right. I am being critical. I think that this was a stupid idea to begin with and I continue to believe it. At least I've come up with solutions. I think that priorities are being misplaced in this nation. So if I think something is stupid, idiotic, ridiculous then I'm going to say it.

Addendum:
I just found this article online. My favorite quote is the very last statement.