Beyond Insurance

Do you ever feel as if your health care is falling through the cracks? That you must constantly be paroling your doctor’s staff to get things done for you? Do you feel that when you see your doctor he/she appears not to know who you are? If the answer is yes then you are among the many who feel that a personal relationship with your physician is a thing of the past.

In many ways this is true, Medicare and insurance/third party payers are part of the problem and a doctor that doesn’t set limits on how many patients he/ she resides over, is another. Unfortunately things are going to get worse before they get better. With the new Affordable Care Act more than 9 million Americans have signed up for insurance through federal and state exchanges (based on a recent Rand Corp survey). Prior to this an estimated 40-50 million Americans have been categorized as uninsured. These new comers are now searching for a physician and can crowd an existing physician’s census, many of which have no limits and can amass 2000-5000 patients per provider. Access to a physician will become more difficult still leaving many to go to urgent cares for acute illness or the local ER. Call backs and timely refills will suffer due to volume. Wait times for a visit will be on the order of weeks to months. Timely appointments will become hours in the waiting room due to overbooked schedules.

It is simple, the laws of supply and demand; you have one physician, and this person can only devote so much time to any one patient. Inevitably someone is bound to suffer. Is it any surprise that an increasing number of physicians have opted out of Medicare and other insurances for reimbursement of their fees? Did you know that it takes an enormous amount of man power and overhead cost to navigate the insurance system? To meet the cost of this a physician must see more and more patients. When a doctor opts out he understands that the needs of a patient and the designated time a provider needs to give is something no one, no entity, no insurance should come between.

Why should you be turned away when you need to see your physician the most? Is it not a wonder that many people experience a great deal of anxiety about their health issues when they have to read between the lines, often not understanding their medications or diagnoses, referring to the internet for their information often to be scared enough to run at any provocation to an urgent care or ER. I have heard this countless times. I have seen this become the inevitable reason of why people leave their physicians in hopes that a new doctor will have more time for them, often to be disappointed. I have had this happen to me, and to my family. I have also been to blame. Understanding that you may still have Medicare or other insurance and still see a fee-for-service physician is to understand the value of the product; an outstanding doctor, and the rewards of great health.