Thoughts Before The Alarm Sounds

 While waiting for the doctor yesterday, I got to thinking about the ways in which visits to the doctor have changed over the years. I had plenty of time to think - I arrived ten minutes early to a crowded waiting room, and figured I would be there for quite a while. Thirty-five minutes after my appointed time my name was called, and I was taken to an examination room. “Not too bad,” I thought. Thirty-five minutes after that the doctor showed up! “Not too good,” I thought, “but not unusual today, particularly for a specialist.” Now to be honest, during the 1940s and 1950s there was a local surgeon with a similar arrangement. You almost always arrived to a waiting room with 20 people ahead of you. When your name finally was called you were ushered into another waiting room filled with the same 20 people! It was usually about a 30 minute wait after you finally arrived in the examining room. But this was very unusual for the time. Until the 1960s, when one needed to see o...

      Lancaster General Health is about to open four walk-in clinics in Lancaster County. Three of the clinics, called Wellcare Express, will treat minor problems such as bronchitis, colds, strains and rashes. The fourth, named Urgent Care, will be available for more serious problems: sprains, burns, cuts, etc. The Wellcare Express clinics will be attended by a nurse practitioner and a staff person, while the Urgent Care clinic will have a physician in attendance.       Although the Urgent Care clinic will be equipped with X-ray and laboratory equipment, the Wellcare Express clinics will not, neither will they draw blood. All will offer shots, health screenings, and school and camp physicals.       A visit to the clinics will cost $59, payable by insurance, cash or credit card. This covers the cost of being seen – the news release did not specify whether additional charges may apply, although I assume they...

      I believe that listening to ideas from the right side of the aisle is a good idea, and I certainly hope that the bipartisan healthcare summit to be held on February 25th does not degenerate into political posturing and name-calling by either party. Not all ideas put forth by either Democrats or Republicans are necessarily born without blemish, but almost all deserve some consideration.      One good idea from the right is to make health insurance available across state lines. Here is a true life example:       When Barbara retired, she lost the health insurance that came with her job. When she applied for private coverage, it was denied because she was taking two blood pressure medicines; if she had been taking only one, she could have got it. So she opted for the high-risk coverage offered by the state of California, at a cost of almost $900 per month; upon moving to Pennsylvania, the same coverage was $240 p...

      In my blog A Good Idea From the Right of 02/13/10, I mentioned the cost of preventive medicine which physicians are almost compelled to perform in order to avoid litigation. Without doing something to mitigate this problem, healthcare costs will continue to rise.       In a nutshell, what makes this cost difficult to control is that medical suppliers are paid according to the number of procedures they perform. The more procedures they perform, the more they get paid.        Republicans are concerned that the establishment of information-gathering panels (Sarah Palin’s “death panels”) to determine what treatments are most effective for specific medical conditions would result in government micromanagement of the healthcare system. The fear is that such management would lead to the rationing of treatment by government bureaucrats. In fact, Senate Republicans recently introduced "antirationing" legisla...

      It seems to be the popular opinion that the U.S. medical system is broken. Try as I might, I can’t seem to find anything wrong with it. We have the most advanced equipment – ultrasound and MRI machines, PET and CT scanners, x-ray machines, monitors, ventilators, etc. – the finest medical schools, and world-renowned doctors. But the medical payment system is in sad shape.       Medical insurance companies have two functions which are opposed to each other: 1.) pay medical bills for insured customers, and 2.) pay high salaries to executives and return maximum dividends to shareholders. Both functions are supposed to be paid out of premiums.       The question arises: Why is function two necessary in order in order to perform function one? The simple answer: It’s not.       If I perform a service under the assumption that I will be reimbursed, I don’t care who writes the check as l...

Huzzah! My book is finally the way I want it, and is available. If you are interested, please check out the sidebar on the right. Perhaps I can now get back to normal blogging. I am going to do something that all respectable conservatives, and unfortunately many liberals, think is a no-no: accept some arguments from the other (conservative) side. While I still think a single payer plan would be the way to go on healthcare, the chances of getting that through the legislature are slim to none. (By the way, why do “slim” chance and “fat” chance mean the same thing: practically “zero” chance? Should not they be opposites?) But I digress. So in order to keep from letting “perfect” be the enemy of “good,” I need to wrap my head around the 2,000+ pages now being debated in the Senate. But I think that the right has some suggestions that should be included in the bill: 1.)                    ...

One of the first promises of the Hippocratic Oath is “Do no harm.” New treatments of disease are coming along all the time, and I know that a great deal of a doctor’s time is spent in keeping up with the latest advances. But lately I would not be surprised if the average Family Practice Physician came down with a bad case of whiplash from tracking all the changes. The Obama administration has contributed to this situation. I realize the chief is pretty busy trying to get some sort of healthcare plan through Congress, but perhaps it would be a good idea for him to forbid any new recommendations until he has succeeded. We are getting mixed signals, and unfortunately, if one compares recent releases to earlier ones, they appear to support to the accusation that his plan is going to 1.) ration service more than is now the case, and 2.) run up the deficit. One of the highly publicized components of his plan is the idea of cutting down on treatment costs by diverting  more resource...