Fri, Sep 19, 2014 ●
BathHarpswellTopshamBrunswickCumberlandNorth YarmouthFalmouthFreeportPortlandCape ElizabethScarboroughSouth PortlandChebeague IslandYarmouth

The Universal Notebook: My contribution to health-care reform

Opinion

The Universal Notebook: My contribution to health-care reform

With the health-care reform bandwagon rolling to a halt as Congress goes into its August recess, I thought I might take advantage of this breather to offer a few modest reform proposals of my own.

Not long ago I ran across a poll that found that 68 percent of Republicans believe that the United States has the best health-care system in the world, while only 32 percent of Democrats believe that. No surprise there. Republicans like things to stay the same. Democrats like things to get better.

Being a liberal Democrat, I support a single-payer universal health-care system. Yes, my good conservative friends, I am all in favor of "socialized medicine." I find it unconscionable that the U.S. is the only industrialized nation that does not have a universal health-care system. And according to the World Health Organization, though we spend more on health care than any other country, we don't get what we're paying for. Our health-care system ranks right between Slovenia and Costa Rica in terms of quality.

In general, however, I have been more than happy with the health care I have received from my family physician, my unrivaled urologist, and the good folks at Maine Medical Center. That said, there are few minor amendments I would like to add to the Obama health-care reform package based on my own experience and that of several family members who have been hospitalized recently.

First, major medical centers are extremely confusing places for those not accustomed to navigating the corridors of healing. To help easily confused old folks like myself figure out who's who and what's what, I would respectfully submit that health-care professionals and workers be required to wear appropriate uniforms. In the casual atmosphere of today's hospitals, it's difficult to tell the doctors from the nurses from the custodial staff. White lab coats seem right for physicians. I don't care what the nurses wear as long they all wear the same thing. Green or purple scrubs will do.

Second, continuity of care is a real concern. Since few if any family doctors make hospital visits anymore (remember when doctors actually made house calls?), it's hard for a patient to know who exactly is in charge of their care. Is it the absent primary care physician? The ubiquitous hospitalist? The drop-in specialist? Two of my family members were discharged after four- and five-day stays in the hospital without a clear diagnosis, prognosis or treatment plan. "Take two Oxycodine and call me in a week."

To rectify this oversight, I suggest taking a page from our local veterinary practice. When I take the dog or cat to the vet, I get a statement that says what the diagnosis was, what tests and treatments were performed, and what to do once we get home. I figure my mother and father deserve nothing less. A discharge document detailing the health-care regimen should be part of any meaningful health-care reform.

Finally, we need to get insurers out of the business of managing health care. Not only does it interfere with the doctor-patient relationship, it ends up costing more. When I had my annual physical, for example, I was charged a $20 co-pay, even though there is not supposed to be a co-pay for physicals under our health insurance plan. When Carolyn called about this, she discovered that because I had my blood pressure medication adjusted, we were charged for a separate office visit as well as for the annual physical.

I naively figured anything health-related that came up during a physical was covered. ("Hey, Doc, can you take a look at this freckle on my fanny?") How anyone would know what might trigger a separate office visit charge is unknown and unknowable, so until Congress passes sweeping health-care reform Carolyn has forbidden me from asking any further questions of my doctor.