America. What Happened to You?
Julie Kliger
Experienced senior advisor focusing on early stage med-tech commercialization and 'real-world' translational implementation in the clinical setting. Expertise in medical and clinical errors, patient safety outcomes.
I remember being young, hearing my parents talk about how America had given them choices, options that their parents didn’t have.
My parents were born here, in America, but two of my Grandparents were from Europe. They fled the War. They were happy to be in America. They worked, had jobs, had healthcare they could afford. Sick kids were brought to the doctor and cared for by the family pediatrician.
Where I grew up there were many independent doctors who worked out of their homes, or near the local hospital so they could see their patients in the morning then go to the hospital to ‘round’ on their patients who needed to be in the hospital.
What Happened To Those Types of Doctors?
You know, the types of doctors who followed you throughout your life…who came to the hospital if you were admitted. Or came to the hospital to visit your parent or sister, because that's what doctors did—they cared about your whole family. Often your whole family was cared for by one family doctor. When I was growing up, more than 70% of doctors were self-employed. Today that number is around 15%.
What Happened To That Type of Care?
While I did not need to see my doctor much growing up, I remember that once, when I was 16 years old, I got Scarlet Fever. An odd infection for someone my age but non-the-less I got it. What started out as a bad sore throat developed into a more serious condition overnight with a high fever, body-wide rash and weakness.
Of course, I had no idea what was happening.
As turned out, my parents were out of town for a few days. My aunt was caring for me but she too was not available at the moment I realized that I was really, really sick. So, without any parents or adults around, and with a new driver’s permit in hand, I drove myself to my doctor’s office. I never called, never made an appointment, I just showed up. And guess what? He saw me and gave me the antibiotics I needed. He also helped me get a ride home.
Think that would happen nowadays?
What Are We To Do?
I thought about the ease by which I got cared for as I read the horrid story of the women whose leg got stuck in the gap between a commuter train and the platform but begged people to not call for an ambulance. “I can’t afford it,” she said. “It’s $3,000 for the ambulance.” And that's just to get to the hospital. Forget about the actual cost of getting treated.
Think about this for a second--I mean, really think about this…A woman, who is on her way to work in Boston, gets into an accident and begs people to let her bleed on the dirty platform rather than receive care—expensive care, perhaps way overvalued care—but treatment. To her, she'd rather figure out how to deal with it than to go into debt $5,000 or $10,000 dollars. Not many people have that cash in the bank--in fact 70% of Americans live paycheck-to-paycheck.
What Happened to Healthcare Being Affordable?
America spends twice as much on our healthcare as any other country. Our hospital costs are 60% higher than many other developed countries.
Even if you have healthcare insurance, it does not come cheap. Almost half of those who have insurance say they struggle to afford their deductibles and more than 25% of people say they put off getting care because of the cost. 60% of those who file for personal bankruptcy do so because of medical bills—and these folks have healthcare insurance.
It turns out that the insurance product or plan you choose becomes critical when you need to use it. On average, those who have health insurance still found themselves about $19,000.00 with out-of-pocket costs. If you’ve got that cash in the bank, you’ll be A-OK.
America. What Are We To Do?
As we embark on our July 4th let’s think about America…Let’s think about what we want it to be tomorrow, next year and the year after that. Yes, we want it to be the Home of the Free, and the Land of the Brave, but we also must want our country, America, to be the Land Where We Care.
About the author: Recognized by LinkedIn as a "Top Voice" in Health Care in 2015 & 2106, & 2107, Julie Kliger is a Healthcare Realist who is passionate about improving health care and improving lives. She is a consultant, speaker and author. She specializes in healthcare thinking redesign, organizational strategy and change management.
Rare and Chronic Condition RN Expert/Patient Advocate/Driven to Deliver Outstanding Customer Service
6 年Ambulances have not been covered by insurance for a long time and they will turn patients over to companies that will constantly call, mail, etc., patients until they can pay. It is awful. Not saying this was necessarily the correct decision given this situation, but we DO need to examine what ambulance services are really billing for, how we can get them to work with patients, and how can we improve this aspect of care.
EVP Client Service at Decision Analyst, Inc.
6 年The insurance companies are the ones who win big.? Consumers are the biggest losers, but docs and hospital's have their struggles too.? ?Just in the last week I talked to a doctor's wife.? As an independent practitioner, her husband had subpar insurance--this actually happens with some frequency among docs.? So, she skimped on healthcare for a year. This year got better insurance and went to see her doc.? ?She was just diagnosed with cancer that has already spread as a result of the delay.? That kind of thing should be very rare, but it is not.
Registered Nurse at Community Surgery Center
6 年I work at a major hospital and have the health insurance they offer. I pay over $200 per month for insurance just for myself. My deductible is $2000, so everything is paid out of pocket until I meet that amount. A few years ago I went to ER with a migraine at 3am. I thought my head was going to explode! That ER visit cost me $1800!!! It took me a year to pay for it. I was extremely grateful that the hospital worked with me and allowed me to make payments. I regretted going to the ER that night, but I had been throwing up all day due to the migraine and I was dehydrated, even feeling heart palpitations. I broke my foot 6 weeks ago and my doctor wants me to get a bone density scan. I refused because I don’t want to be stuck making payments for a year again!!! I will just take supplements and eat foods high in the vitamins and minerals my body needs to strengthen my bones, start yoga and resistance training. It’s a shame when someone in healthcare who has spent their whole adult career taking care of patients can’t even afford good healthcare. Do I need to look into supplemental healthcare? I wonder…
Legal nurse and healthcare consultant ready to complete your projects, large or small.
6 年I appreciate your difference of opinion and I am not in any way "dehumanizing" the woman in the story. Sounds like viewpoints contrary to the author's is not appreciated. An objective review of the story is the point, not anyone's personal or insurance situation.
Principal at D Mordo Consulting, LLC
6 年I think there's a lot more to the train story. Woman was no doubt in shock. No one who is bleeding profusely and in pain is thinking first about cost. They're not thinking, they're in panic mode.