Recently, Bones asked what makes me pig-biting mad?
I have a wonderful nurse practitioner who has been my primary care physician for a few years now.
Correction: I had a wonderful nurse practitioner. Last week, she left private practice in order to work in public health. She's thrilled to be going back to her original focus - research & education - but here's the part that surprised even me (I'd considered myself well-informed about many of the health care issues in this country): working in public health instead of private practice, she will be making more money, getting better benefits, and working better hours.
"Really?" I said, astutely.
She went on to tell me how she was lucky to get the bare-bones benefits she had at the practice she was leaving. Many private practices, she said, don't offer benefits at all.
That five- or ten-dollar co-pay you make for your office visit? The practice depends on that to make payroll.
It's our beloved insurance companies who are making the money. Not the people who make us well when we're sick.
One thing I loved about seeing her was that she always seemed to have an appointment open when I was sick, and she always spent a generous amount of time with me. She listened to me, and she took the time to communicate clearly.
Apparently, she routinely got in trouble with the insurance company for vile, subversive behavior like this. In order to keep appointments available for people who were sick, she inevitably would have time slots that weren't filled. And this was a cardinal sin. The insurance company comes down hard on any practitioner who doesn't have every single time slot filled.
Good luck, then, getting an appointment when you're sick.
My wonderful nurse practitioner isn't an exception, either. More and more, brilliant and talented practitioners are leaving private practice in order to get out from under the thumb of insurance companies. They're leaving private practice, too, according to the dictates of the "free market": because they can make more money and get better benefits in public health than they can in private practice.
Allow me to repeat this: practitioners are leaving the private sector to work for the government so that they can earn more and have less interference from above.
Pig-spitting mad? That doesn't even begin to cover it.