Sunday, November 11, 2007

A health care lesson

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.


Bones said...

I was already pissed and now I'm even more pig-biting mad!

My lovely Oakland-based doctor decided a few years ago to just stop taking insurance. She got a lot happier, and it was fine with me to pay out-of-pocket, even though I had insurance. Is that not just fucked up? Yes, it is! And we all know it!

But I didn't know about the abyssmal benefits of private practice. I hope the insurance companies see their handbasket coming.

Anonymous said...

I have no health insurance for that reason. I pay out of pocket for that reason. I regularly see a Chinese medicine-based doctor (non western doc) for *preventative* care.

I send myself and others to physical therapists that mostly see clients who pay *out of pocket*. When something's not right with my body mechanics & I can't fix it myself as an exercise therapist, then I see a chiropractor or other people that focus on body mechanics.

Having family in the medical industry, if I TRULY need an MRI or an xray, they slip me in....

In your case, it's different. You have a slew of inexplicable mysteries abundant in your body. If you lived down here, I could refer you to TWO separate medical offices of women that are alternative AND regular md's. Their client intake form is 1-page insurance and TWENTY-FIVE PAGES of your health history. They look at the whole picture.

They're out there. They are not co-pay affordable. It sucks, but it's at least out there.

Hang in there.
xo, S

Chemical Billy said...

Bones, I'm ready to buy them all first-class handbasket seats.

And S, ma belle, I'm not worried about me, but thank you for the good words. I have good insurance, and SF is rife with marvelous health care professionals. But it ain't right, is all. It just ain't right.