Wednesday, May 6, 2009

The "its not my money test"

I had two patients in the office today with the exact same complaint. I explained to each that it will usually get better with time and if necessary some anti-inflamatory medications but given the severe I could not rule out anything bad and that a MRI would help rule this out. One patient had United Healthcare and explained that he would have to pay 30% of the scan upfront and since he has a huge deductable he wanted to see how his symptoms were and that he would get the scan if things changed. He could afford the scan right now. The other patient had Medicaid. When I explained the same things to him, he jumped right up and said get the scan, "after all its not my money!"

As I mulled this over, I wandered to the doctors lounge. There several of the other docs were having a discussion about healthcare costs and wondered why have health insurance at all? Why not universal governement health coverage like Medicare and Medicaid. I couldn't control my usual introverted quiet self and let go.

I explained that people spend more carefully when it is their own money that they are spending. Like the difference between the two patients that I saw earlier. One of the docs immediately pointed out that one got the MRI where the other didn't. I told him that this does not mean he got the best care, it just means he spent the most money. As people who are disconnected from the cost spend more and more, suddenly there has to be cuts. Since it is not your money, the people whose money it is (Government) will then decide on how its spent and will have to limit it. With private insurance you are contracting for and paying for future care and have some control of how that is spent. Its your money not the governments that is being spent. The nephrologist jumped in and explained that he was doing dialysis on a patient from Canada who was here to have her CABG because she could not have it back home.

So, we can give the government our money, they then make that money theirs and they decide how it will be spent; or we can save or use our own money to help pay for the care that we want.


SeaSpray said...

I agree with the thrust of your post 100%.

The only reason I'd want universal is that having balances to med bills ads up when you have a lot of tests, procedures and hospital stays or God forbid..something catastrophic. I like that no one's credit would be ruined or they won't lose their house.

That being said... I am more afraid of the quality and availability of health care being compromised and the intrusion of government... possibly dictating how care should go based on financial feasibility vs risk, etc.

If we think insurance companies are shrewd, disingenuous and obtrusive... just imagine the governmental red tape.

This is probably a silly statement... but I think of introverted quiet surgeon as an oxymoron. It just seems that because surgical residencies are so hard core and because you have to take control in the OR.. be take charge people.. it's hard for me to envision introverted. But I guess you have the professional personality and then off the clock your more quiet side.

SeaSpray said...
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SeaSpray said...

I hope you don't mind I mentioned/provided link to this post in Dr Rob's current post:

You always have good insights our political/legal/medical systems.