It’s Not Brain Surgery

Government run health insurance programs often reimburse physicians at rates that are less than the actual cost of treatment and as a result, some physicians are choosing to opt-out of the system. Today, 13% of all physicians no longer accept Medicare and nearly 33% refuse to participate in the Medicaid program.

Ayn Rand wrote about State controlled healthcare in her 1957 novel, Atlas Shrugged:

“I quit when medicine was placed under State control, some years ago,” said Dr. Hendricks. “Do you know what it takes to perform a brain operation? Do you know the kind of skill it demands, and the years of passionate, merciless, excruciating devotion that go to acquire that skill? That was what I would not place at the disposal of men whose sole qualification to rule me was their capacity to spout the fraudulent generalities that got them elected to the privilege of enforcing their wishes at the point of a gun. I would not let them dictate the purpose for which my years of study had been spent, or the conditions of my work, or my choice of patients, or the amount of my reward. I observed that in all the discussions that preceded the enslavement of medicine, men discussed everything—except the desires of the doctors. Men considered only the ‘welfare’ of the patients, with no thought for those who were to provide it. That a doctor should have any right, desire or choice in the matter, was regarded as irrelevant selfishness; his is not to choose, they said, only ‘to serve.’ That a man who’s willing to work under compulsion is too dangerous a brute to entrust with a job in the stockyards—never occurred to those who proposed to help the sick by making life impossible for the healthy. I have often wondered at the smugness with which people assert their right to enslave me, to control my work, to force my will, to violate my conscience, to stifle my mind—yet what is it that they expect to depend on, when they lie on an operating table under my hands? Their moral code has taught them to believe that it is safe to rely on the virtue of their victims. Well, that is the virtue I have withdrawn. Let them discover the kind of doctors that their system will now produce. Let them discover, in their operating rooms and hospital wards, that it is not safe to place their lives in the hands of a man whose life they have throttled. It is not safe, if he is the sort of man who resents it—and still less safe, if he is the sort who doesn’t.”

Obamacare was designed to provide universal healthcare coverage, but with one critical oversight; the focus has been almost entirely on the patient, with little or no consideration given to those providing the care.

The United States already faces a growing physician shortage. Can we expect it to get worse?

Effective January 1, 2015, a provision of Obamacare goes into effect that will tie physician payments to patient outcome. Physicians will see their payments modified so that those who provide “higher value care” will receive higher payments while those who provide “lower quality care” will receive lower payments.

Ask yourself, should you ever become extremely sick, what doctor would want to risk their “higher value care” payment to treat you?

Enough Said

Trifocals

The lady from my eye doctor’s office called me at work on Monday to tell me my trifocals came in. I hurried to my vehicle and drove straight there to pick them up right away. I have not worn eyeglasses before, so this was a new experience for me. After properly adjusting and fitting the frames to my perfectly dimensional face, the lady gave me a few instructions on the proper care of my eyeglasses. I received my “free” eyeglass case and complementary cleaning cloth and was on my way. Whew-whoo!

I have learned a lot since wearing eyeglasses these last few days. Probably learned things that those who have worn glasses for years already know about, but this is all new information for me. Here are 10 things I have learned so far, in no particular order:

1. I had no idea how much I was NOT seeing.
2. I paid my bill. It turns out the complementary cleaning cloth was NOT free.
3. My nose in NOT perfectly centered between my eyeballs.
4. Either my right ear is lower than my left ear, or my right eye is higher than my left eye, or both.
5. Right angles are not 90° when viewed through corrective lenses. 90° is just an average in this scenario.
6. The focal point for any object that I wish to see clearly is not equal to any of the three focal points for which my trifocals were prescribed.
7. When eye muscles wear out, neck muscles are probably not far behind.
8. My eyes, ears, nose, cheeks, and forehead are not symmetrical, not even close. If I were ever to lose my job, the old saying, “heads will roll” does not apply to me. My head would never roll, not even on a steep slope. It’s too out of balance.
9. My headaches have nearly gone away in just three short days, so I hate to take my glasses off, ever.
10. When it rained yesterday, I would have been better off without having left my glasses on.

When I asked my eldest daughter what she thought of my new glasses, she told me they make me look smarter. I am not sure if she was implying anything about the way I looked before I wore glasses, but I will take “smarter” as a complement any day.

Live and learn.

Mac Attack

When my kids were young, I used to swing by McDonald’s on my way home from work every Family Night to pick up Happy Meals. I remember how I always had to make sure I got the right combination of boy and girl toys. The Happy Meals were cheaper on Family Night so as a provider trying to make ends meet, Mickey Dee’s was my lowest cost option. While it is true that my kids loved these little toys, the low price was undoubtedly the overriding factor in my decision.

Today there are several debates raging over the toys that come in Happy Meals.

One point of contention seems to be that McDonald’s specifies the gender preference of its toys. Maybe I am just being a little dense, but I think if a toy is born that way, why not specify? The bashers believe that toys should be gender-neutral. After all, “What father wants his sons to be limited in their choices?” Ah.., me.

Another point of concern surfaced recently because apparently kids in San Francisco are eating these toys and getting fat. I totally understand why the San Francisco Board of Supervisors are trying to curb childhood obesity. After all, fat kids might grow up to become fat adults, and what adult looks good in a pair of leather jeans when their ass is too fat. Plus, imagine the disappointment of ordering a Happy Meal and spethifying a boy-toy, only to find a tiny plastic Alien figurine in your box. I am sure that would be very uncomfortable.

Welcome to San Francisco, did you want that with fries or a fruit?

Urgent Care

One afternoon last week, I unexpectedly had to leave work to rush a family member to the local Urgent Care facility. From what I have heard about Urgent Care, its services fall somewhere in between a Doctor’s office and a full-fledged emergency room. It is kind of like a medical halfway house. Of course, without the recovering addicts, parolees, and the chronically insane that one might find in a real halfway house. I did not know what to expect at Urgent Care of Guymon, but I was tremendously impressed with the professionalism and exceptional care received. Everyone there, from the receptionist, the nurse, the practitioner, everyone was unusually pleasant. I have spent a fair amount of time in a Doctor’s office over the years, and, unfortunately, taken far too many trips to the ER. Those are the kinds of places you do not want to visit, unless you have to, but the Urgent Care of Guymon was different, somehow.

After describing symptoms, and undergoing various tests, the health care professionals determined that my loved one was in need of some fluids. So, off we marched into the fluids room. The fluids room is where we spent most of our three-hour stay at the Urgent Care. This modest sized room came furnished with a TV, DVD player, a small selection of DVDs, and one large overstuffed dark blue recliner rocker. I am sure Urgent Care has to operate on a budget, but a second recliner would have been nice. The nurse was helpful, however, and brought in a straight chair. So I gave up the recliner. These health care professionals giveth, and, they taketh away. After making thy cup runneth over and taking some blood for testing, they hooked up the saline solution. With all that behind us, and only a liter of fluids left to drip, they turned down the lights, and I took a nap.

It was quiet. We could occasionally hear the nurses talking, but we both began to wonder aloud if they ever had any other patients. Then finally, we felt relieved when we heard another patient out in the hallway. We felt safe there, and more patients meant there was a reasonable likelihood they would stay in business, just in case we were ever sick enough to need the Urgent Care again.

I remember years ago, 1980-something before I had a daughter-in-law, her father had been to see the dentist. Afterwards, he mentioned that he actually enjoyed getting his teeth cleaned, and looked forward to his next cleaning in six months. I go in twice each year to get my teeth cleaned, but I would not say I enjoy it or look forward to having it done. I was never able to understand why he thought getting his teeth cleaned was so neat, but now, I totally get it. I, now look forward to getting sick enough to go to Urgent Care of Guymon, and setting in that overstuffed dark blue recliner myself.

One liter of saline solution later, the nurse practitioner came in to review the lab test results with us. There was nothing on the test to be overly concerned about, but there was one more lab test needed. This additional test would require making a deposit. Now, since, the patient had already made numerous deposits for three consecutive days, which had contributed to the dehydration in the first place, you would think one more deposit would have been possible while still at the Urgent Care. This was not, however, to be the case. Fortunately, Urgent Care was gracious enough to give us a take-home night depository kit. Then speaking in a hushed tone the practitioner quietly explained, after making a deposit it is necessary to store the kit in the refrigerator, to keep the deposit from spoiling. We promised to follow these instructions, of course, because you would not want to go to all that trouble and then just let it go to waste.

I went back into work as normal the following day. At the end of my workday before leaving the office, I phoned home as I often do, and spoke those three little words, “What’s for supper?”

A feeble voice on the other end of the phone murmured, “Leftovers.”

Suddenly remembering the events from the day before, I quickly replied, “I know you are still not feeling 100% Dear, so how about I just swing by KFC and pick something up. It’s the least I could do.”

”That would be nice,” she whispered, and nice it was.