Mood:
a-okNow Playing: "Alias Smith & Jones"(3)
Frodo has taken a big look into America's Healthcare System and he found a few holes big enough to drive a truck through. What is most unfortunate is that such a truck careening rudderless through our friends and neighbors is going to hurt some people. Bilbo is an example.
Bilbo did not understand what the people at the hospital were saying when told that there was a need for "rehab" after a stint in the hospital. To Bilbo, that sounded like "nursing home," and Bilbo had no intention of sitting in a wheelchair and watching "Wheel of Fortune" re-runs while playing cards "with a deck of 51." Nobody explained that the costs would be covered within available coverage, and that the intent was merely to prepare a bed patient to resume normal activity.
Bilbo can be awfully stubborn, but there are also times when Bilbo is totally deferential to someone in authority, and therefore comes forth as totally powerless. Such was the case when the attending physician wrote a prescription which would cost $400 for a single dose, and the drug was not covered by Bilbo's insurance. Bilbo did not know what to do when the local pharmacist pointed out that there was an alternative "formulary" which was so covered, and was considerably cheaper. A telephone call to the primary physician by the pharmacist was not returned.
Sam took charge. Having just recently come through the loss of the gallant Howard, Sam knew some of the terminology and the rules first-hand. Sam explained to Bilbo that the "rehab" was there not only to help Bilbo gain strength, but to prepare Bilbo for the changes in daily life which come with the constant input of oxygen. Sam arranged for part-time in-home health care so that Bilbo could have personal attention to daily needs, and that any necessary errands could be handled without Bilbo attempting to utilize a motorcar. As an alternative to "rehab," such costs are borne by Bilbo and Frodo's physical presence was required for Bilbo to be discharged from the hospital.
The attending physician, although obviously technically competent, exhibited no comprehension of resources available to the patient and seemed disinterested in anything that did not fall directly from a textbook. Had a conscientious young pharmacist not noted the cost of a prescribed item, it would have been paid, no questions asked. Sam went beyond the attending physician to Bilbo's pulmonary specialist and explained the situation to his office manager. The result being a new prescription, and a savings to Bilbo of more than $380.
Bilbo is back at home. Frodo and Sam have returned to the Shire. The system that has somewhat restored Bilbo to normalcy has to be measured as succesful in its ability to make Bilbo better. What it reveals also is a haphazard and ineffective process of customer service. Technically-oriented people, no matter what their area of expertise, routinely communicate in a language of their own, as if they were Klingons, and all the rest of us are expected to understand or suffer the consequences of our own stupidity. The people at the IRS probably had the same teachers as did many of our primary care physicians.
Bilbo's situation was complicated by the fact that the long-time personal care physician had recently retired, and the new attending physician, now released from any further involvement with Bilbo by Frodo & Sam, was not properly attuned to patient need. What Frodo found, to his xenophobic reaction, is that every new doctor he could find was named Mehta, Singh, Allamahie, Saliba, Pak, Harada, or Bhutto. It seemed as if every physician to whom he was referred had a "green card," rather than the appeal of Robert Young or even Maximillian Schell. The dedicated young pharmacist, snubbed by the "doctor" involved, was Hispanic.
America's Healthcare System, successful in part, is a fricking mess in toto. It is, indeed, no longer "Kansas" out there, and Frodo fears for those without proper insurance, those with limited resources, those without a strong family network. Don't let anyone tell you, dear reader, that systemic change will only lead to something worse. What's worse than a driverless truck bearing down on someone too sick to fend for themselves?
