Hippocrates of the Hippocratic Oath
I was not sure my ENT specialist was a good fit for me even though I read the glowing praises framed on his office walls, praises coming from his patients, colleagues, and other doctors. The young man seemed to know what he was doing but his bedside manner was brief and rather cold.
I attributed his demeanor to his introverted personality, his professionalism, and to his respect for his patients’ time. Very punctual, he very seldom made anybody wait to see him, he was always on time.
One day I realized that he was much more caring on the inside than he let people see. A young woman with her mom and a three-year old in tow had an appointment to see the doctor. The receptionist, Lupe, asked her if she was prepared to pay for that day’s visit. The young woman had a grief-stricken look on her face and wondered how much the visit was going to be. The receptionist told her that she did not know because each patient was different, depending on the problem. The young replied in a sad and disappointed voice that she will reschedule until such a time that she would have enough cash on hand to pay for the visit.
Lupe kindly explained that her insurance, Obamacare, had a huge deductible, and unless she met this deductible for the year, it will not pay the doctor anything. She offered to ask the physician, left the young woman waiting, and returned to tell her that the good doctor will see her anyway.
I decided then that this man was the right person to see in an ENT medical emergency or a problem requiring a caring specialist. His humanity, in addition to his medical professionalism, punctuality, and his education in the U.S., made him, in my opinion, an exceptional doctor, a rare find.
At the other end of the spectrum was the endocrinologist’s office in Fairfax who told me, they are no longer taking any new Medicare patients, just the already established ones who were in transition to Medicare. The receptionist’s explanation was that Medicare does not allow their patients to be seen every three to six months as needed.
I was told previously by a doctor friend that Medicare made low and very slow reimbursements to physicians because of Obamacare; therefore I did not believe the office’s explanation. Personally, I would not want to be seen by a doctor who put her profit motive above the care for a patient, any patient.
But I pressed on. What if I paid in cash, could I then see the doctor? The answer was again no because, she said, they had a contract with Medicare and thus could not accept cash payment.
Having read the pertinent section of the law, I knew this was part of the Affordable Care Act as well, the euphemistically named piece of legislation Obama’s administration and Nancy Pelosi’s Congress forced down middle class America in the middle of the night, “pass the bill to find out what’s in it.”
We did find out all right, and we did not like the price we had to pay for it in order that the Democrat Party could unilaterally force an entire nation, one fifth of the economy, to become a socialized medicine nightmare for decades to come.
More insultingly, members of Congress have their own subsidized and separate health care insurance and can see whatever doctors they wish to see.
It used to be the case in America once when patients could pay cash for doctors’ visits and the fees were affordable. But that gradually changed thanks to modifications in health insurance, new cafeteria health insurance plans, in-network and out-of-network type of employer insurance, and health savings accounts that disappeared at the end of the year if unused.
If you lost your job or quit, the insurance terminated, and you were at the mercy of Cobra insurance for a while, at confiscatory monthly premiums, but nothing as expensive as Obamacare premiums today that can easily exceed a family’s mortgage and car payments combined.
Lack of insurance portability across state lines had always been a problem for Americans seeking affordable insurance. Aggressive law suits against doctors and medical malpractice awards by the courts, forced doctors to drastically buy more and more expensive malpractice insurance, making care more expensive for the average patient who did have insurance. The infamous $50 aspirin in a hospital setting were legendary.
As a student without insurance in the early 1980s, I paid $10 cash per visit to my children’s pediatrician. Once we could afford and bought insurance, each visit was $85. The pediatrician made a comfortable living, had a thriving practice, but he was certainly not a millionaire.
If you ask most doctors today what they spend a good portion of resources and time, it is not patient face to face care time but electronic documentation, record keeping, and staff to handle insurance justifications and payments – bureaucracy.
Primary medical care, day-to-day healthcare, is now provided by a general practitioner, a family physician, a gerontology, pediatric, or family nurse practitioner, a physician assistant, a registered nurse, and even a pharmacist who coordinate and triage specialist care that a patient may need.
Secondary and tertiary care is harder to find as physicians are cutting their losses and focusing on accepting private insurance rather than Medicare and Medicaid.
We are headed to a single payer socialized medical insurance which will limit doctor visits and access to procedures based on rationed care. The entity that will hold the key to your ability to pay for and receive medical care when you need it will be the federal government, the same bloated, out of control entity that spent your Social Security lock-box savings and has doubled the national debt in eight years of the Obama’s administration.
Hippocrates of the Hippocratic Oath