Monday, March 23, 2009
And while we are talking about YOU and your bad habits, let's discuss your laziness. Did you shop for the best doctor? Did you compare the prices at different clinics, pharmacies, or hospitals? Do we have to always take care of you?
I have a shocking statistic. 100% of all of the people alive today will eventually die. 100% We are not machines. Even the most responsible amongst us will, one day, succumb to the inevitable.
Now this is not to say that we couldn't all use a check up. Lot's of our behaviors lead to illness or injuries. We just learned last week how dangerous the bunny hill can be. I don't ski, but I try to go snorkeling in the ocean each year. Where is the line between recklessness and acceptable risk?
Lecturing Americans on the evils of their diet, lack of exercise, or habits may be correct, technically, but is it useful? Are the insurers credible? I went low carb six years ago. Finding healthy food at an insurance company meeting is like searching for moderation at AIG. Insurers seem to be self-serving on this issue, blaming the victim for the problem. There may be a certain amount of truth in their pronouncements, but a different messenger must be found.
The insurance companies, with their incredible data banks of health costs and outcomes, have a place at the table. Real change, however, is cultural and starts in the home. Only a campaign of doctors, hospitals, schools and the government, unified in a common goal of healthier Americans, has a chance to succeed.
I touched earlier on Consumerism. Insurance companies want you to ask more questions, challenge the quick answer and to shop for the best value for your health care dollar. There is, of course, one exception. The insurers aren't too anxious for you to shop for the best insurance premiums, but I digress.
Much of this Consumerism is just silly. Our system has little transparency. Try to get the price of an office visit, x-ray, or a colonoscopy in advance. Worse, how do shop for quotes for an emergency quadruple by-pass? Do you want the low bid?
The same insurance industry that is demanding that you accept our data unquestioningly and to immediately change your habits is also trying to get you to challenge your physician. We want you to ask the doctor if that test is really necessary. We want you to be your best advocate with the rest of the health care delivery industry.
Of course, we're right, but only to a point. You probably could take better care of yourself. You probably should ask more questions of your health care providers. Don't stop with the doctors and hospitals. Question all of us, big pharma, the government, and the insurance companies.
Friday, March 6, 2009
At 8 AM that morning I was hit by an uninsured motorist. She was speeding through the curve on George Zeiger Boulevard when she slid on some ice, lost control, and broadsided my car. Her 1999 Subaru spun to a stop, her bumper no longer on speaking terms with the rest of the car. Slammed just behind the driver's door, my Honda and I did a complete 180. Out of control and air bags deployed, I finally stopped moving a couple of hundred feet later. I called 911, climbed out of the car, and went to check on the other driver.
My car had over $6000 of damage. State Farm and Page's Body Shop took care of everything after I paid my $500 deductible. I was not hurt. I was freezing. Standing outside with the police waiting for the tow truck to take my car away, I was very cold and disoriented. I kept asking for hot coffee. To their credit, the Beachwood police realized that I wasn't making a donut and coffee joke at their expense. Again, I was not hurt.
I mentioned the accident to two attorneys that week. Their immediate question, after some possible concern for my well-being, was whether I had been "checked out". Instead of being a nuisance, this accident could be an opportunity. Much to their dismay, I refused to see either my doctor or one of their suggested specialists.
Then the mail and phone calls started. In an effort to prevent me from being the target of a lawsuit, you'll pardon me if I don't name names. No longer forced to chase ambulances, these attorneys, chiropractors, and physical therapists troll the public records. All of their solicitations had a few things in common:
- Don't talk to the insurance company.
- Even if you aren't injured, you might be.
- I would need to talk to them to get the money I DESERVE.
- Don't talk to the insurance company.
One of the law firms, familiar from their TV ads, even sent a special DVD. I got Apollo 13 a few years ago and I haven't made time to view that. I'm going to sit through an attorney's spiel? Some of these direct mail ads were amusing. Misspelled words. Offices that are really just mail drops. Claims bordering on the absurd. And then there were the chiropractors, physical therapists and massage therapist.
What do all of these people have in common? They create unnecessary demand for health care services. Over utilization, which is by definition every test run for the enrichment of the provider with little regard for the patient, inflates cost and creates the need for more equipment. You are paying for all of this.
Please do not regard this as an indictment of all personal injury attorneys. There is some important work being done by honest attorneys who even the playing field by giving the victims of negligence and incompetence their opportunity for justice. Guys like Mark Obral quickly come to mind. My back pain from old basketball injuries is relieved by a great massage therapist, Wayne Dustman, a couple of times a year. I was happy to see that their offices weren't chasing accident victims. Just as there are good and bad insurance agents, there are honorable and responsible attorneys and health care professionals, and there are plenty who are not.
As we contemplate the changes in our health care system, we must again remember that everyone has a stake in the outcome. Creating unnecessary need for one's services is a human failing. Multiply that times thousands of providers and it could be a financial disaster.