Posts Tagged ‘Medicaid’

The Great Money Shift

July 8, 2009

Primary Care Physicians (PCPs) are getting a pay raise! That’s great news, they certainly deserve it. But it’s not new money – we really can’t afford to put much more in the Medicaid/Medicare system – the government is re-shuffling the deck. Increases in one area means cuts in another, and Cardiologists are among those taking the hit this time. The American College of Cardiology… as you can expect, they aren’t happy campers.

But what is the answer? I’m not smart enough to know. I think that whatever the answer is, it’s gonna hurt – and that is the last thing that politicians want to do. But given the choice, I’d rather take some pain now than the hurting thats going to happen when Medicare/Medicaid payments outrun the national economy. We haven’t seen that kind of pain.

Work It!

June 4, 2009

There really shouldn’t be any doubt about it – if you have a chronic illness such as a heart defect, you have got to take care of yourself. Obtaining health insurance is difficult if not impossible – yet we are the ones who need it, as we’ll need doctor’s appointments and prescription medication more often than most people. Public assistance (Medicare or Medicaid here in the United States) is available, but both programs make you jump through bureaucratic hoops and limit the amount of pay you can earn. Most CHDers I know have bum hearts but sharp brains, and we’d rather not go that route.

One of the best things you can do for yourself is exercise: you’ll feel better, and hopefully you’ll be able to hold the doctor at bay for a little longer. You usually can’t weight – lift yourself off of your medicines, but improve your health and the doctor might not need to see you nearly as often. After I went into heart failure and then had a stroke, my cardiologist wanted to see me once a month for eight months – That’s the cost of gas to from my home to Atlanta and back (about 500 miles one way), meals, and a hotel room every 30 days. It adds up.

So do what you can to take care of yourself. First of all, discuss your exercise options with your doctor. If you propose to start walking, he’ll probably be cool with that. If you want to climb Mount Everest… I doubt he’ll agree!

As you may know, I walk. I would have loved to have walked the Bolder Boulder, but my cardiologist had said “No.” because of the altitude, and I followed his advice.  A good brisk walk that gets your heart rate up is a great thing. It gives you time to sort through your problems and make important decisions. It also gives you a natural high, a sense of feeling good and actually doing something to help yourself. And recent research has shown that feeling lasts a lot longer than you might think – even though you don’t “feel” it, your body is supercharged! Obesity and Diabetes make a case of heart failure worse, so it stands to reason that if you are susceptible to heart failure, avoid the other two. Exercise can reduce your risk of both conditions.

So go for a walk. Play in the neighborhood. Put some music on the stereo and dance around the house – I promise I won’t laugh, I can’t dance either! Just do something. Just get up and start taking care of yourself!

Do yourself a favor and move those muscles;

Fix the right problem

March 2, 2009

It’s going to be a wild few weeks in Washington, as Congress begins to debate President Obama’s first budget. I can’t even begin to predict how it will turn out. And while I do have my opinion, I won’t share it with you – I try to  avoid discussing politics here. Every now and again it is necessary, but for the most part this blog concentrates on Heart Defects.

But today we have to talk politics, just a little bit. Part of the budget involves rethinking our health care system. Admittedly, cost are getting out of control, private insurance makes you grit your teeth, and Medicare is a pain. You think an encounter with the Internal Revenue Service (IRS) can ruin your day? The IRS are rank amateurs when compared to to Medicare!

But before we start to run around and make things worse by trying to fix it, let’s look at what we have:  Somewhere in America a cell phone rings. Its owner, an Emergency Department nurse for a major hospital, is being called to duty. A child was born with a Congenital Heart Defect in a rural hospital just an hour ago;  the patient is stable and is being brought in for evaluation followed by  surgery. She takes one final sip of her coffee, tosses the cup, and heads back to Emergency.

Meanwhile, in the Republic of Vietnam, just over 1000 children have recieved lifesaving operations to combat their heart defects. The program is ending, and it has been such an accomplishment that the State President and the city’s Party Committee Chairman both attend.

And the Children’s Heart Fund of Ethiopia finally has an operational hospital… 22 years after being officially recognized. As of February 17, they had already performed fifteen surgical procedures and ten catherizations.

My God… can you imagine living with a Heart Defect – or any chronic illness – in one of the countries of the world that doesn’t have the resources to provide the level of medical care that Americans are used to? Or in a country like Zimbabwe, where Cholera is rampant, inflation is eleven million percent (11,200,000% as of August 2008) and the President seems to be plumb fool crazy?

Trust me, America has one of the best Health Care systems in the world. The debate shouldn’t be about trying to make it better… just about paying for it. True, every system can be improved, but when you try to do too much – try to fix health care and the payment system, and tie the two fixes together – that’s when the problems occur. So let’s do one segment at the time.

We need for every American to have a doctor – someone they can see for “little things”. Coughs, sprains, a broken finger, the flu… the day to day things that you might need to see your doctor for. These doctors can also pass us on to a specialist if that is what we need. To accomplish this, we naturally need more primary care doctors. We ain’t got them right now, so there’s a good starting point: Figure out how to get more people into Primary Care medicine.

And we need to figure out how to pay for this medical care. Going to the doctor is not cheap, as we all know. It doesn’t matter if you have private insurance or Medicare/Medicaid (or neither), we need to figure a way to make medical care affordable – without drowning ourselves in the paperwork. We also need to make sure the medical staff is fairly compensated. “The workman is worthy of his hire,” the scriptures say, and certainly a trained physican, nurses, and medical staff are much more than “workmen.”

And we need to figure out how to do this without bankrupting individuals or our government.

We’ve got quite a challenge ahead of us.

“Like sands through the hourglass…

December 4, 2008

… so are the days of our lives.”

Ever notice that the sand in the hourglass on the daytime show Days of our Lives never runs out? It just keeps going forever and ever and ever…

To bad it has nothing to do with reality. There was a very alarming report in the Boston Globe that states the bad economy could drain Medicare part A pretty quick. When that money runs out… it’s gonna get nasty. Doctors are already upset; the government is running them out of business. Some doctors are doing their own laundry to save money and others can’t afford to replenish their drug supplies. It’s getting scary out there, folks.

If I were a doctor I’d probably be looking for something else to do. Some of them are, and others are changing their mind about going into medicine in the first place. The Association of American Medical Colleges (AAMC) recently did a study that showed the numbers are dropping as the demand is rising. Massachusetts is already getting slammed. The Canadian system isn’t the answer, either. USA Medicine is ahead in technology, but the men and women of the Maple Leaf have better office systems. An alliance is looking pretty good right about now.

Dr. Wes bemoans the fact that healthcare costs are climbing more than inflation. Health Insurers are willing to forget about pre-existing conditions (Yay!) and insure everyone if the Government does certain things. (Now wait a minute… where’s the money coming from?) And whatever happened to all that savings that was supposed to occur if we switched to generic drugs?

We need to close the bar and then check ourselves into rehab.