The HC Fubar

HC in this country is a disaster. 

• Question: How much does it cost to stay one day in a hospital for a gallbladder operation?
• Question: Do you, the patient, get ALL of your records in context and sequence including imaging/lab, the doctor's note and the chart, along with billing, prescriptions and all related documents keyed to each and every patient visit and ... are they free?
• Question: Can a hospital or practice calculate the REAL P&L keyed to patient and/or practice as needs warrant?
• Question: Do medical bills make sense, are the written in english keyed to the product or service rendered at the time of the patient visit?
• Last Question: Can HC be considered a viable business when an accurate P&L keyed to patient and/or practice cannot be generated in real time or any other time frame as far as one can tell, something nearly every other industry can do without issue if the organization & software environment in question is properly designed to do this.

There is no other industry that operates this way. None. Billing is separate from services rendered. This is why the bill comes in, ad hoc, with no organic connect to said service, something totally different from buying a car where the invoice states exactly what's being purchased without question. This is why records get lost, this is why records are almost never in context and sequence and, last but not least, this is why records are almost never complete unless one happens to strike gold by being in a system that actually does a fairly decent job of doing all of this. In effect, you and I ALMOST NEVER GET what we pay for, our complete records keyed to each and every visit in context and in sequence.

Scenario: You get into a bad car accident far away from home and you need your records NOW when the ER is treating you as they must know about the rare blood condition you have prior to treating you because if they don't, you're dead. This lack of timely access to patient records kills approximately 250.000 Americans a year. - The Journal of Public Safety

In many institutions, you pay for your records and they are, in most cases, incomplete, hard copy documents made available two weeks after requesting for YOUR information. 

Question: Why do us rubes put up with this crap?

Answer: Insurance companies, hospitals, IT, big pharma & medical hardware vendors because of the enormous amount of money being made at our expense while maintaining a failed system that's falling apart as we speak.

What do people want? All of the above and more. 

To whit:

They spoke anxiously about rising premiums, deductibles, copays and drug costs. They were especially upset by surprise bills for services they believed were covered. They said their coverage was hopelessly complex. Those with marketplace insurance — for which they were eligible for subsidies — saw Medicaid as a much better deal than their insurance and were resentful that people with incomes lower than theirs could get it. They expressed animosity for drug and insurance companies, and sounded as much like Bernie Sanders supporters as Trump voters. One man in Pennsylvania with Type 1 diabetes reported making frequent trips to Eastern Europe to purchase insulin at one-tenth the cost he paid here.

Surveys show that most enrollees in the Affordable Care Act marketplaces are happy with their plans. The Trump voters in our focus groups were representative of people who had not fared as well. Several described their frustration with being forced to change plans annually to keep premiums down, losing their doctors in the process. But asked about policies found in several Republican plans to replace the Affordable Care Act — including a tax credit to help defray the cost of premiums, a tax-preferred savings account and a large deductible typical of catastrophic coverage — several of these Trump voters recoiled, calling such proposals “not insurance at all.” One of those plans has been proposed by Representative Tom Price, Mr. Trump’s nominee to be secretary of Health and Human Services. These voters said they did not understand health savings accounts and displayed skepticism about the concept.

What we're going to get.

This week, President-elect Donald Trump and congressional Republicans began to dismantle Obamacare, and here are the details of their replacement plan:

—— —- —- —- - —— —- —— —- - —- —- — —— —- —— —- —- —- — — - - - - —— —- —- —— —- —- —- - —— —- —— —- - —- —- — —— —- - —- —- — - —- —- — —— —- - —- —- — - —- —-

That captures the nonexistent Republican plan to replace Obamacare. They’re telling Americans who feel trapped by health care problems: “Jump! Maybe we’ll catch you.”

This G.O.P. fraud is called “repeal and delay.” That means repealing the Affordable Care Act, effective in a few years without specifying what will replace it.

If the Republicans ran a home renovation business, they would start tearing down your roof this month and promise to return in 2019 with some options for a new one — if you survived.

Obama care is a weak but important first step. The repugs approach is, If your young, healthy and wealthy, it's all good. If you're middle class, old and sick, die.

It makes sense don't you think, especially when these incompetent and mendacious fools making the decisions on our health are covered to the max with OUR MONEY.

End of rant, for now.