Friday, January 30, 2015

The Medical Profession - To The Right Of Capitalism

This little Peruvian girl's parents take her to the doctor only
when necessary.  They pay for the visit, and for whatever
procedure, they go home, and that's all there is to it.
It worked that way here in America pre 1975.  How
did things morph into the ridiculous as it is today?

There was a time when it was said, “Offer a good product or service, and charge a fair price”.  Well, if you are unfortunate enough to have learned this in previous generations, or ever, for that matter, you will be left smoldering in the ashes in the inferno of monopolism that has become the new American Way.  I don’t have answers for any of this, only observations.  My objective here is to put out this information in the simplest form possible, without all the pedantic bullshit, so that people can see what is going on, and so those with a platform may one day decide to step up and do something.

Today I’ll be using the medical profession as my display monkey.  I have no actual proof of this, all of what I say here is a result of my own experiences and observations.

Sometime over the past twenty years or so, the entire medical profession has adopted the same cheap sales tactics as all other businesses that involve sales – which of course, makes up over 98% of our lives.  Before the current state of the profession had morphed into what it is today, the better the doctor, the better he was at diagnosing and treating a patient – with good results, the better his reputation would be, and the result was the sky was the limit as far as income.  He could place himself in more upscale neighborhoods, and his fees could be significantly higher.  Folks who were financially better off than others didn’t mind paying for good, competent health care.  As used to be with capitalism, if a doctor (or any business person) tried to gouge patients (customers), he would gouge himself right out of the market – same goes for if he was less than competent at his trade – people would provide feedback to friends and family, and pretty soon, the dishonest, and the incompetent, would be out of business – as it should be.  Well, it does not work that way today.  When you go to a doctor, dentist, or even mental health care professional, they will partake in the huge scam that has become the business.  First, they have been trained to do a couple of things – other than how to “treat” illnesses and conditions – in fact, I would say that “treating” the patient has become secondary to the business or sales part.  The main objective of the health care professional is to get a lifetime membership from the patient – get him or her to visit the office as often as possible – hopefully for the rest of their life.  They will use technical mumbo jumbo, scare tactics, “policies”, “standards”, bullying, and there’s not a damn thing you can do about it.

Here’s my own personal experience with two dentists I had the misfortune of visiting.  A year ago, I was eating a burrito, at which time I bit into a piece of metal that somehow made it into the thing, and cracked one of my back teeth right down the middle.  So, I make an appointment to see a dentist.  On my first and second visits, I didn’t even get to see an actual dentist, I see only the assistants, they ask me why I’m there, I tell them about the cracked tooth, they tell me I must make another appointment.  So, my third visit, I finally see a dentist, he takes X rays, tells me what I already know, but he tries to sell me on every dental procedure known to the human race, and a few others; he then, like a tornado, gets his prescription pad out and asks me what kind of pain killer I prefer.  I told him I don’t use drugs of any kind, so no thanks, I tell him to just yank the tooth that is broken.  He says, “Well, I can’t do it today, so make an appointment for the extraction”.  So, two months later is the soonest, I get in to the office, he takes a quick look in my mouth, says, “I don’t have time to do it today, make an appointment for the extraction”.  Ok, so two more months (approximately SIX months with the broken tooth) go by, it’s back to the dentist’s office.  His assistant puts the blood pressure contraption on my arm, takes the reading and says, “Oh, your blood pressure is high, I don’t think the doctor will be able to do the extraction today, you’ll need to make another appointment”.  He comes into the office and gives me the whole spiel about how I could “stroke out” in the chair because my blood pressure is eight points higher than his supposed limit.  Funny, the readings at my previous visits, when he had other excuses, were comfortably under his limit, only when “I don’t have time to do it today” was used twice did he come up with these bogus blood pressure readings.  I try to convince him to yank the damn tooth anyway, but he insists he’s not going to do it, implying that there is some law that doesn’t allow him to perform the extraction, he tells me I must make still another appointment.  Two MORE months, back once again, the assistant comes in, puts the blood pressure device on me, and this time, the reading is outrageous – something like 190/150.  I figure he has control over that device (being able to tell it what reading to show) – and being that he expected me to maybe have gotten some kind of bp medication, he set it to make up for my blood pressure being normal – to that ridiculously high reading.  I tell him there is no way in HELL my blood pressure is that high, he ignores me, and insists he’s not going to perform the extraction.  So, two things here, first, my blood pressure has always been what is considered borderline - around 130 – 140/95 – 105 – been that way since I was about 20 years old (that I know about), it hasn’t gotten any worse, so it appears that’s just the way it is with me – similar to persons whose blood pressure is low – not because of any condition, but because that’s just what their body does.  I’ve never had any symptoms of high blood pressure – again, being borderline generally does not cause problems, especially since that’s just the way my body is.  The other thing is, after my fourth visit to the dentist – after he claimed my pressure was high, I went straight to Safeway – to stick my arm into their blood pressure machine – which I’d been doing for the past ten years or so.  My bp was 135/97 – this was less than an hour after leaving the dentist’s office with that ridiculous reading.  Funny thing, in a previous time needing an extraction (before I learned about flossing), I had a tooth pulled in one visit – no rigamarole, no excuses, I was in and out in about a half an hour.  So, after going back for the SIXTH time, and him sending his assistant in to tell me my bp was still too high, that I needed to make STILL another appointment, I told the assistant that I had had enough of the runaround, and that I wasn’t coming back.  So, I make an appointment with a different dentist, which I went to today.  He’s this little mousy guy, but he has basically the same line of B.S. – tells me I need every procedure in the universe.  Let me say here that I take immaculate care of my teeth, and while I’m not a dentist, I know that other than the broken tooth, my teeth are just fine.  He wanted to yank perfectly good teeth, and put me in dentures.  I of course told him that was crap and that there was no way in hell I was going to allow that.  As I did with the previous dentist, I tried to get him to pull the tooth, but same, this mousy guy wouldn’t do it, saying I need to make another appointment.  I managed to ask him if there was some law that dictated he could not pull teeth if the patient’s bp was above a certain number, he said, “No, it’s a standard” – meaning he could do it if he wanted to.  After telling him what bullshit I thought this whole thing was, and how sick and goddam tired I was after a YEAR of this runaround, he finally said he could send me to some kind of oral surgeon to do the extraction, because “Should anything happen on the table, they’re equipped to deal with it”.  Before that, though, he prescribed some kind of antibiotic, claiming that I have some kind of infection, I would need to go to my regular physician to get a “Medical Release”, then go to the surgeon.  I know damn well I don’t have any goddam infection, there is no redness, no swelling, no pain, and before that last ditch effort, there was no mention of any infection – even when he was looking at my X rays – the infection was an afterthought – another cheap bunch of bullshit to convince me that he couldn’t do the extraction right then.

Here’s the math:  I happen to know that a dental office visit normally costs between $120 and $200, add to that whatever procedure is done.  X rays are in the hundreds, which I had once from the first dentist and two sets from the second one.  So, let’s say my office visits were $120 each – multiply that by seven total visits (six to the first dentist, one, so far, to the second), I believe that’s $840 just for the office visits.  Add three sets of X rays, today’s prescription, and whatever kickbacks he gets from the surgeon he referred me to, my guess is just from one patient (me), my insurance company has paid out around $2000, and I’m not even close to being done with it.  Think about the fact that the first dentist brought me into his office six times, charged $720, plus his cut for the X rays (which a separate person did) and did absolutely NOTHING.

Ok, here’s the rest of the story.  Pre HMO, pre “Medical Coverage/Insurance” days, doctors would charge what they charged – it was usually reasonable and affordable.  For the poor folks, there were county hospitals and free clinics – that did not charge people who made less than a specified income.  So, when these insurance companies and HMOs came along and took charge of the whole medical profession, that put a very low ceiling on their (the doctors’) income.  There are claims adjusters, who do the billing, there are certain prices set for whatever office visits and procedures.  If a doctor or dentist charges more than what is stated, or they attempt to call for certain tests (X-rays, MRI, etc.) that are beyond stated limits, the insurance company can refuse payment, and, if a particular doctor or dentist does this on a regular basis, they (the insurance company) can launch an investigation.  I happen to know all of this because someone close to me paid medical claims for twenty two years.  Let’s not forget the possibility and likelihood of kickbacks in all directions – as opposed to before, when it was the doctor and the patient.  The result of all this is that not only do the doctors and dentists have a ceiling on their income, but the insurance companies get their cut, which, you guessed it, all comes out of the customers’ payments – in the form of the ever rising costs of health care.  So, now all doctors make basically the same income – whether they are better than another doctor, and not mattering what neighborhood their office is in.  To be fair, doctors and dentists in more affluent neighborhoods usually accept the higher tier insurance policies, which may have slightly higher ceilings for office visits and procedures, but still a ceiling, still it is dictated what they can and cannot charge, and what tests and procedures they can and cannot administer.  So, we have the medical professionals who are angry at the insurance carriers, so they must now find other ways to make up their income.  One of those ways is to gouge the insurance companies the best they know how.  They know how far they can push, and it seems the easiest one is to keep the patient coming in for endless office visits.  Another moneymaker is to be peddlers for Big Pharma.  We’ve all seen how fast any medical professional whips out the old prescription pad, and we’ve all been on the receiving side of endless office visits.  Compare this to thirty years ago on back, where a doctor could almost always offer diagnosis and treatment in one visit, prescribed meds only if he thought they were necessary, and would only recommend a certain test also only if he thought it was necessary.  Occasionally one follow up visit would be recommended.  So you see, the medical profession is quite different today than it was pre mid 70s.  On top of that, today, everybody is sick, on meds, and pretty much has a lifetime membership for weekly or monthly visits to the doctor’s office.  Today there are huge medical centers that take up one, two, and three city blocks – three, four, and five stories high – sometimes even bigger than  that, and you know where the money to build and maintain them came from, right – yes, from US.  This is opposed to the little neighborhood doctors’ office in the days of old – in the days where most business people prided themselves on being fair and honest.

So, Big Insurance has taken over the Health Care system, doctors are angry, are finding other ways to make up their income, including gouging as much as possible, and are peddling drugs for Big Pharma (huge kickbacks for that).  Health care costs, already ridiculous, are constantly rising, most people are in the doctor’s office once a week or so, and are taking handfuls of pills two, three, four times a day and more.  Everybody is fat, sick, and stressed, oh yeah, and gouged to death by these parasites disguised as HMOs and insurance companies.

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