A Perfect Storm - the third ingredient

The third ingredient is the lack of universal health care coverage for all Americans.  Again, I've harped about this in my blog.  Although the direct effect on me is less obvious, the effect on my patients is tremendous.  I've lost patients, not because they did not value my care or feel that I was an incompetent physician, but because they lost a job, can't find a job to pay for insurance, don't have money to pay for their deductibles, or their employer is struggling to pay for health care coverage and have to switch to new insurances every year.  Sometimes they switch to an insurance that puts my patient on a different network so I can't see my patient anymore.

Why does my relationship with my patient need to depend on whether they have a job, have money, or what kind of insurance they have?

Some advocates of this current system and those that say no to universal health care or "socialized medicine" say that patients have unlimited choices as to which doctor they want to have a relationship with, so why rock the boat?  My response is that all of my patients, at some time or another, unlucky or otherwise, do not and may not have a choice.  It's an illusion of choice because that choice can be taken away by circumstances beyond their control, no matter how prepared, rich, successful, or educated you are.

I know, because, I too have been a victim of this system.  Being a business owner, you're on your own regarding health insurance for yourself and your family.  Thankfully, I made enough to pay for insurance, but only the kind that is catastrophic (high-deductible).  When my wife was pregnant with my son, we consistently paid our dues on time and then on the day that my son was born, we found out after we came home from the hospital that our insurance company dropped us from the plan for not paying the previous month's dues.  We found out later, that even though we sent our payment on time, our insurance company already decided to send us a letter warning us that they would drop our insurance for failure to pay (while my wife was in labor, mind you), even though the due date hasn't even happened yet.  Subsequently, we were given a nasty surprise by the hospital that we weren't covered even though we thought we were.  Although the insurance company acknowledged later that they sent the letter in error, we had to undo the damage in reconciling the immense hospital bills that were sent to us because of that error.  And although we knew how to get ourselves out and knew the system and the games that insurances play, we were able to minimize the damage.  But mentally and psychologically, the damage was draining for our family...adding more stress where we could have spent quality time with our children.  I can imagine that our example happens quite often and how many people fall victim to the system and can't get their way out.  Obviously, being a doctor did not keep me from being immune to the system.  It was very humbling for me to experience what some of my patients had to deal with.

All the more that this system has to change.  Simply, for me, health care coverage is a right for all of us; whether you have a job or not, whether you are a child or retired, whether you are male or female, whether you've been ill before or not.  Everybody in, nobody out.

From a solo physician perspective, there are benefits to a single payer system; it would be much easier to work with one payer than hundreds, one set of rules versus a hundred set of different rules, etc.  With Medicare going to Medicare Advantage Plans several years ago, it went from one payer to many payers and it got so crazy for me that I had to drop Medicare altogether.  Not only did the change made it crazy for me, my patients had to re-apply every year and they couldn't tell heads or tails which plan was best for them (actually, none of them, in my opinion).  I think we all have better things to do than deal with our insurance.  No wonder most of our young adults don't even bother getting insurance.  Until something happens to them...