Q:  Is the U.S. medical system capable of dealing with ebola?  You be the judge:

About a month ago, when I asked a local upper level librarian about what he knew regarding ebola, and whether anyone at the library might be interested in doing a presentation that could cover emergencies such as Earthquake or Ebola, going over standard heath measures and preparations - water storage, emergency services, etc., his response was that anyone in the U.S. who was afraid of ebola was stupid.  So, are we prepared now?

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Today I received a letter from C**V**, the Workman's Comp company, demanding that within 72 hours I supply to them a whole collection of data, including a certified current urine test, documenting various prescription drugs and treatments I had been receiving from my WC doctor regularly for the past several years related to a neck injury.  This information is largely already in their hands and expecting me, the patient, to somehow come up with it in 3 days is absurd (the letter was postmarked the 16th and only showed up today, but the time is probably already out for legal purposes).  This does not even give time to contact my doctor.  The penalty for not providing the information in time is de-certification of the medications and treatment altogether. 

The trick that C**V** is relying upon is that I don't have an attorney, in as much as the original medical claim was quite straightforward and the only issue was compensation and future medical coverage.  I won both of those about a decade ago.  I first consulted with an attorney, who told me that I shouldn't need one.  Now I have my friends scouring the local area for an attorney for me.  Now, however, this is the third instance this year of C**V** turning the screws in an apparent attempt to force me out of the system altogether.  Just good business.

The odd thing that should be a tip-off to the fact that this is simply about money, regardless of little issues such as a moral responsibility to be even ballpark accurate was that the demand included drugs that were not even prescribed by the WC doctor at all, but rather came from my regular physician, covered by Anthem/BC or Cigna now, under Medicare.  Where did C**V** get that info and how did it get misclassified?  Did CVS, which has screwed up literally about 30% of all the hundreds of prescriptions for me over the past 22 years, screw up yet again by assigning billing for those drugs toC**V**?  If so, then predictably hundreds of dollars worth of additional time will go into resolving those issues.  More likely, this is just sloppy handling by C**V**.  Maybe it will get them some relief for having to pay for my meds and visits.  Maybe it will just generate more work, which they have probably figured out how to bill for.  Either case supports my point:

The U.S. medical system, whether the insurance aspect, the Workman's Comp system, Medicare, or ObamaCare is corrupt and incompetent to an extreme.  There is very little of care for the outcome or welfare of the patient and little attention to the risks and costs.  In California, profits for providers is set at a fixed maximum as a percentage of net expenditures required for patient care. This means that if your member patient is healthy and never sees the doctor, then you make no money.  If you can create all kinds of medical necessities out of thin air or the slightest pretext, and order more and more tests, and charge $200 for providing a standard aspirin pill, justifying it on the basis of having to do all the records, computer entries, and other paperwork,
then your profits rise accordingly. 

Talk about a truly idiotic and dysfunctional system.  We outspend every other country in the world and get mediocre care out of it because the system itself is structured to generate fraud and provides no incentive to actually keep people well.

Last week, I went for an unnecessary doctor's appointment.  When I got to the admissions desk, the three attendees insisted that I had to sign a paper making me an official member committed to only using 'HCP.'  Their write-in note also described me as a PPO.  This was the fourth time that I had been told this by someone at HCP, and also, as it turns out, the fourth time that the computer system for HCP had no record of me (I've only been going to that facility for most of 20 years).  I pointed out that I was on a Medicare Supplemental from A/BC, and that I had discussed my status with them at length, more than once, as I kept having the same problem at HCP.  Anyway, Admissions finally called the computer entry person and verified that I did exist (in fact, she was somehow just that moment entering my records on the system) and that I was neither HMO or PPO - AND - that I had no need to sign away my life to HCP.

This all cost about 30 minutes, making me lose my place in line, which cost another 40 minutes.  Meaning that it was pointless to return to work, unless I really wanted to exhaust myself.  Instead, I had a long discussion with HCP admin about this and the history of similar problems related to clueless, careless and untrained employees making costly and sometimes dangerous errors.

My new primary care doctor, who I had first seen a week or so before for a real and immediate medical issue was mystified.  "Why are you here?"  But the appointments scheduler had insisted that I still had to come in for my introductory meeting with the doctor to make it official that he was my primary.  So, my afternoon, the time off work, the gas, and a bill to my insurance, all useless.  The HCP scheduler had also insisted that I could only discuss one issue per appointment, when I had to see someone for the issue a week before.  I had other issues, and my new doctor and I discussed a couple of them with no real resolution at our useless meet and greet, as I didn't come prepared. 

Then there was my hernia surgery to the wrong abdominal area, after which the surgeon left immediately for vacation, neglecting to prescribe pain meds, which took me four hours standing at the lobby phone at then Talbert Medical to get authorized, with a huge stapled WOUND across my belly.  Or the time I got sent for a heart test which magicaly transformed into a set-up for a mammogram.  Or the staff sociopath I discovered at the facility who apparently deliberately screwed things up for patients just for fun.  Or the unbelievably filthy conditions and nightmarish treatment I got - twice - from the hospital next door.

The above are just a sampling of what I can personally relate.  I could write for pages about the screwups regarding various surgeries, or the nightmare of trying to get signed up with Medicare, or the 20 years or more that I lived with a hernia before a doctor finally took my pain seriously, or the way that doctors now are being 2nd-guessed at every turn by bean-counters at various bureaucracies, such that access to many older drugs that are cheap and actually work are now impossible to get prescribed or paid for by insurance, while those that make the best return for Big Pharma sail past with little regard for cost vs. benefit over existing meds.

Do you really think that this system can handle ebola?  I think that our doctors are generally ok, but the system as a whole is a near disaster already, without the enormous challenges of a major plague.

http://philosborn.joeuser.com/article/386090/The_Claims_Games