Thursday, October 8, 2009

Managed Care

There has been a lot in the news about health care and how to reform or improve it. It can seem like the only issue is whether or not everyone gets insurance, but there are many more issues within the various proposals. Unfortunately, a poll released by some organization today, indicates that we, the citizens, don't really care about this right now.

Yesterday I received a letter from my insurance company and today I heard about a Medicare beneficiary multi state study on NPR. Those two things prompted tonight's thoughts, which are:

In the health care reform battlefield, commercials are launched that present management of services, tests, medicines and the like as a bad thing. I have NEVER thought that case management, especially from the physician's office, is a bad thing. I had reservations about managed care from insurance companies, but have become more understanding of the need for this.

My insurance company just sent out a letter to say that starting next month certain things, like MRIs, would have to have prior authorization for payment. The research discussed on NPR discussed fragmentation of care and how that does not improve health outcomes, and could worsen them.

With fragmented care, a person with a symptom may be sent to several different specialists who see the patient for just the one problem, order tests and prescribe meds and no one sees the whole patient and the whole picture. I DO want someone to care about the whole of me. I want that person to be my primary car doctor and I want him to have time and compensation enough TO care.

I don't mind that my insurance company wants in on this management. I want to preserve health care dollars myself. I do believe that we are over tested and over prescribed.

And you know, I don't think there is really any more that I need to say. Oh except this one thing, we already have people deciding which tests to order and medicines to prescribe.. they do not always do so with the best interest of the patient in mind. I am bothered by the scare tactics in some of the anti reform ads in this regard.

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