I went in to see my primary care physician today on a followup for a minor infection, and one of the first things she asked was, “Are you meditating twice a day?” She had recommended this when I had my physical last summer. I told her I was occasionally meditating twice a day, but most days I was lucky to meditate once, that some writing prodjects and my blog were keeping me up late nights.
“You really should try to meditate twice a day,” she said firmly.
“Okay, okay,” I said, feeling my blood pressure rise…and wondering if that was a productive feeling on the road to more meditation…
Seriously, it is good news that some individual physicians are becoming ever more sensitive to alternative approaches. I truly appreciate it that I can show this internist a bottle of special enzymes a nutritionist recommended I take—and have her read the ingredients carefully, and inquire into what benefits I might be experiencing. Same with her suggestion that I follow up with a doctor at Columbia doing a study involving use of a special herb to deal with prostate-related issues. I even told her I drink raw milk and she admitted she didn’t know much about it, but did ask me some questions about its benefits. (I suggested a while back that she read this blog, but not sure she has.)
For many years, I went through the experience that some readers have described, of withholding data from my physician because I knew that at best he wasn’t interested and, at worst, he would ridicule me with a little laugh or snide remark.
I’m fine with a doctor saying, “I don’t know a lot about that.” I actually welcome it, because I realize that no doctor can know everything about all the therapies and theories out there. Unfortunately, most M.D.s can’t bear to say they don’t know certain things, so they ridicule those things they are unfamiliar with.
This inability by the medical community to admit to ignorance or uncertainty is one of the reasons I see a power struggle emerging between providers of traditional and holistic approaches. Hopefully, it’s a struggle not decided by the main providers—physicians, insurance companies, drug companies, and government. Dave Milano suggests a scenario under which the actual customers could be the power brokers. It’s a nice concept, but I’m not sure the politicians and insurance companies will allow it a full trial. Most people don’t qualify for the HSA because they already have insurance of some sort. As a result, individuals with HSA who seek to buy medical services are at a serious disadvantage, since insurers get huge discounts, and individuals using HSA pay sky-high rates for the same services, discouraging legitimate usage of the system.
Still, the underlying message applies: the best way to send a message to any service provider is with our feet. To the extent individuals seek out providers who are open to so-called "integrative" approaches, the system will have to adjust.
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A few notes:
The segment Mary McGonigle-Martin alerted us to on Good Morning America aired this morning. It’s a nice plug for alternative medicine, but unfortunately, that message kind of gets lost in the midst of discussing fashion improvements for hospital gowns, based on the comments that follow.
Michael Moore has a new film coming out shortly about the health care system, “Sicko” (great title). The bureaucrats and politicians apparently aren’t looking forward to seeing it, since the U.S. Treasury Department has gone after Moore over a trip he took to Cuba in his filming to test out medical care there. They sure know how to help generate buzz.
Finally, I want to alert you to a wonderful new feature on this blog—a search mechanism. You’ll see it immediately under “Recent Updates”, in the left-hand column of each page. It does a very nice job of searching for articles or comments containing particular terms, though it’s not perfect–it looks as if it can’t search by authors of comments. Thanks to Jason Gumpert for dealing with the hosting company to figure out the instructions and making it happen.
David, you are almost certainly right about that. The insurance companies are actually helping HSAs go away by redfining what they are! Cleverly, they co-opted the name by offering tweaked, but still largely standard, insurance intruments, loaded with high fees and onerous restrictions, and called them Healthcare Savings Accounts. (This is, of course, with governments happy assistance.) My own hospital system offerred one. It drew all of four takers, out of approximately 1,300 employees. I was not one of them.
Of course what my employer offerred was not an HSA at all, but it did have the effect of creating the general opinion that HSAs are no good. That was more than a bit frustrating for me, especially when I discussed HSAs conceptually with our Human Resources Director. He patiently explained to me that, when developing an HSA, there are rules that must be followed. Sigh. And that leads me to this:
David wrote: Most people don’t qualify for the HSA because they already have insurance of some sort.
Rules, of course, are OURS! Made by us; for us to change! Or at least they should be. (Sigh again.)
And this: individuals using HSA pay sky-high rates for the same services [as those with standard insurance], discouraging legitimate usage of the system.
Yes. And with that my third and final sigh. The current third-party system is in fact responsible for much (though of course not all) healthcare cost inflation. I know about this because my own service deals operationally with forced losses from many corners: low Medicare and very low Medical Assistance payments, unreasonable denials, bad but (somewhat) necessary network deals, late payments, complex and often inscrutable third-party reimbursement rules, and the enormous human and technical costs of third party billing. We deal with all that by raising prices to rapist levels, and from that collect only reasonable rates. The only people that pay anywhere near list price for services are retail customers, including those with HSAs. Thats sick I know, but it’s not going anywhere soon.
That we have let our incredibly broken medical healthcare system get so incredibly large and so well-entrenched is a testament to how much we love our centralized systems. But there is a limit to how much artifical propping up we can apply to any system, and with healthcare cost inflation consistently way above the rest of our economy, and the health of our population gradually deteriorating, I do have hope that this particular system will eventually hit the dirt. The thud will be audible on Mars.