Common Sense Ain’t

What do 19 year olds, little teapots, & doctors have in common? The ability to make me go *headdesk* ALL DAY.

Sorry, that was redundant. Many 19 year olds and doctors ARE little teapots. “When I get all steamed up, hear me shout!”

New Rule: You don’t get to argue with me about ANYthing unless you A. think and B. know what the fuck you’re talking about. Also, if you suspect for even 3 seconds that I do not know what I am talking about, you need to call me on it. Deal?

By “call me on it”, I do not mean “You’re mean!” and “I like you better when you’re cute & girly!” I mean you have to say something constructive, like, “My dear, I believe you are mistaken, because…” You don’t even have to put in the “my dear”, it’s just what I tend to get from some of you of whom I’m more fond.

Recent knock down drag out with an MD boiled down to: “My claims must not be getting paid because of something you’ve done wrong,” and then “I have to explain why a patient is having a repeat procedure done every time they’re having it done?! But I mentioned why the first time they came in!”

ARE YOU FUCKING KIDDING ME?!! *headdesk* *headdesk* *headdesk*

Thanks to Medicare, every time you visit a doctor, you’ve bought a product that gets its own ICN (individual claim number). That ICN represents one encounter note out of your medical record. To Medicare, & hence to all private insurance, that’s the product it’s buying on your behalf. So yeah, you might be coming in for treatment of the same thing over & over, but Medicare doesn’t care about that. They want to know what they’re buying today. So yes, doctor, you have to take an extra seven seconds to say, “Patient returns for continued treatment of her whateverosis.” Which, DUH, is good record keeping.

The next person who comes to an argument with a machete & sweeps it across the necks of all participating with a giant emotional, hand wringing accusation of “The world is unfair!” gets shot down. Never bring a machete to a gun fight, babes.

I love yall, but some of you really want the the world to be fair. I have news for you. It ain’t. It will never be, so you have to make the most with what you’ve got. Also, your version of fair & right is not everybody’s, so forcing it upon other people is NOT cool.

People get very emotional & hand wringy about health care. I do, in a more “clubbing baby seals over the head” way. I’m sick of it. I’ve been doing this for 19 years and I’m over it. No matter what the government does, they make it worse as is evidenced by how poorly they are handling “new” (10 year old) procedures we are now doing for patients. Baby seals are cute & cuddlesome, but not if you flood the waters with them so that they are choking out the ecosystem. The health care plan I was excited about, the change I tried to believe in, is a 2000 page partisan document of redundancy document that makes the Federal Register look positively brief by comparison (the Federal Register, for those who won’t google it, is NOT brief). But I’m not just bitching. I have alternate ideas.

Scrap it all; let charity sort it out!

I have an idea, and like most of my ideas, I have the name before I have it fully fleshed out (as I’m good at brainstorming, but not planning). It’s called Passport, and anybody better than me at planning is free to steal it. Passport would be a nationwide health care charity, but it would not be applied for by patients. Herein lies disaster, because patients do not have the time, energy, or knowledge to take care of this crap (yet Medicare & Medicaid expect them to, sometimes with the help of underpaid, overloaded social workers).

Passport would be very simple. If a doctor had a patient that wasn’t paying their bills, for ANY reason, they would just submit the HCFA (CMS1500 to you newbies) to Passport. The doctor would determine if the patient was truly unable to take care of the claim, because the doctor & his/her staff see the patient every day, & have access to the patient’s information. The doctor’s staff can smell that the patient is homeless. That way, nobody is working the system. Doctors who erroneously or falsely submit claims to Passport would get in trouble, NOT the patient. The onus would be on the professional, not the sick person.

AND because there’d be no federal fee schedule, RVUs would stop being so ridiculously low & doctors could universally lower their charges, even out the rates, & actually cover their costs! My God, common sense! (Assuming the private plans followed suit, that is.)

Peeps donating to Passport would get fatty tax breaks. Super fatty.

Hmm? Hmm?

Also, those of you clamouring for free health care, let me let you in on a little secret: it already exists.

Exhibit A: If you show up to the ER, you cannot be turned away if you are truly sick. Most ERs won’t turn you away even if you are kinda sick.

Exhibit B: If you can’t pay your bill, no law enforcement officer is going to come after you. Your hospital or doctor will try to get you state or federal aid. If you don’t qualify, & you still can’t pay, your doctor will have to jump through hoops to get your bill written off if he/she participates with Medicare, because if you take Medicare patients, IT IS AGAINST THE LAW TO GIVE FREE CARE. What?! Yes, THE FEDERAL GOVERNMENT DOESN’T LET US GIVE FREE CARE because of kick back laws. Because it’s caring like that. Innerestin’, huh? Hospitals also have to prove it with tons of paperwork, but unlike doctors, they have armies of staff to do this paperwork.

Exhibit C: If you still can’t be written off for some reason, you will just be sent to collections. Sure, your credit score will go down, but you can always file for medical bankruptcy and be good as gold in 7 years. If you think a person cannot live or function in collections AND get continuous, uninterrupted, high quality health care, boy do I have proof to the contrary (that I can’t share because of HIPAA).

America already HAS free health care. It is not perfect, it is not equally applied, but that is due to misinterpretation of confusing laws. It is not due to cruelty or greed.

You can watch all the soppy TV & listen to all the politicians you like. You won’t know the truth until you talk to human beings in the field, read things your government publishes. Or, y’know, just listen to crazy bitches rant.


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