Real Patient Lives vs. Corporatized/Government Healthcare, Part IV

The insurance and government dominated system is failing our patients. A physician friend of IP4PI shares this shocking example about the system claiming another victim:

A 59 y/o man presented to my last employed practice, with an almost elephantiasis swelling bilateral legs.  He had pinpoint marks on the skin of his legs.  He held up a jar with what looked like a couple of tiny maggots.  He said, these come out of those holes every so often.  I said how long has this been going on??  He said 1.5 years.  “I’ve mentioned to several doctors, they just shrug and don’t do anything.”  I said we would do something, and called the hospitalist immediately to admit for workup and treatment.  I was directed to the nurse gatekeeper for approval for admission.  What’s wrong, she asked.  “4+ edema in both legs, which are also full of maggots.”  Hmmm, she said.  There is no medicare admissible diagnosis of ‘maggots in legs’.  What about his rising creatinine of 1.7?  Not bad enough to qualify under guidelines.  Call us back if it gets worse.  I did try to do some outpatient workup, but I think the man was disgusted.  He never followed up.  He was dead within the year.

Insurance Contracts that Respect the Patient – Physician Relationship?

Friend of IP4PI Charles “Chip” Smutny, DO writes in:

Does anyone think about or have we even tried to come up with our own physician based contract proposal to insurers that could be a way of negotiating our independence as an alternative to their railroading contracts? Since we know that DPC works, cost less and provides better care more efficiently and that insurance will morph to continue to keep its revenue stream, perhaps we should offer up a contract of our own.

Since we don’t like their offer should we have a counter proposal that requests what we want in a legal document that can be validated and support legal recourse in “a partners agreement” instead of the current “employee-employer contract” and that the insurers must be accountable to in court to this new contract?

Simply stated it might read something like this (with 11 pages of legalese from our lawyers that structures the responsibilities and supports the clarity of the following):

  • patients come first
  • physicians have a right to receive pay for services rendered.
  • insurers pay patients according to their contracts, not physicians
  • patients pay physicians directly
  • patients have the right to decide what they will accept as personal risk in their health and in their financial circumstances.
  • insurers may not interfere in any way with the decision making of the patient in concert with the physician.
  • insurers may not set pricing restrictions on physicians. They may however set limitations in their service contract with the patient on what they will cover in their contract.
  • physicians have the privilege and the right to support their patients in their efforts to obtain quality healthcare delivery and insurance coverage
  • physicians have the right to personal privacy and protect patient privacy by only allowing data stripped of unique identifiers to be collected and stored centrally.   Centralized charting must not contain any unique identifiers other than the physicians delivery of care office information.

Please add on or discuss as you see fit!

This discussion might lead to some sort of standardized counter offer to insurers since so many physicians are afraid to leave that system which has steadily moved toward indentured servitude.

Who loses in a true free market solution for health care? Not patients.

Friend of IP4PI Dr. Rico writes in:

Just ask yourself who loses out in a true free market solution – Insurance cos, Elites of academia and Quality/Certification cartel, and administrators and it’s clear why these special interests object so strenuously. It’s no secret there will always be millions of people who can’t pay for insurance, but let’s identify those costs clearly so taxpayers will understand the impact, as they are the ones paying for it. There can’t be a worse method of shifting costs to taxpayers than the current ACA subsidies. To state that current system works great as long as subsidies are maintained is ridiculous.

-Edward Rico, MD, MBA, FACE

House GOP’s Affordable Healthcare Act is Not What the Doctor Ordered or Voters Demanded

While IP4PI appreciates the efforts and goals of the Republican Affordable Healthcare act, it is far from the “full repeal” that was promised over the last two election cycles. As independent physicians, we believe that it doesn’t go far enough in repealing the failed ACA, protecting patient choice and permitting the free market to produce excellence, efficiency and economy. We recommend that big money special interests like pharmaceutical industry, hospital industry, health information technology industry and insurance industry not have undue influence in the process as they have for decades but physicians and patients.

1. Full repeal of ACA/Obamacare by reconciliation.

2. True inexpensive high deductible insurance plans competing across state lines for maximum choice, efficiency and economy.

3. Medicaid block granted back to the states where each state can provide flexible solutions for their citizens.

4. Health savings accounts HSA us should be expanded for use for all medical needs so that patients can select any care or items related to health with their own value systems.

5. Primary care and basic specialty care paid directly to physicians by the patients who selected them. Prices to be posted whether per incident or monthly membership model like DPC Direct primary care.

6. Executive, legislative and judicial for branches of government must abide by this law for their own healthcare.

14 Principles for healthcare freedom

Articles critiquing GOP ACA change bill

Dear Senators Dr, Rand Paul, Ted Cruz and Mike Lee,

March 1, 2017

Dear Senators Dr, Rand Paul, Ted Cruz and Mike Lee,

Thank you for having the courage and taking action to hold your GOP congressional colleagues accountable to the citizens of the United States in demanding the full repeal of ACA/Obamacare.  It is highly complex, burdensome, unaffordably expensive and failing miserably to the detriment of our nation and its citizens. Bad law is bad law and must be fully repealed. Personal responsibility, free markets and true charity are the solutions to the nation’s healthcare ills.  Please see the IP4PI 14 point solution for healthcare freedom.

Please contact me anytime at the address and phone number above during office hours and at my mobile phone 000-000-0000 anytime. Thank you again for continuing to support the great citizens of our country as responsible individuals with freedom and liberty.

Best wishes for good health,

Craig M. Wax, DO

Family Physician, Media Host and Healthcare Policy Expert
National Physicians Council on Healthcare Policy member
Founder of IP4PI, Independent Physicians for Patient Independence
Practicing Physicians of America, VP for Healthcare Policy
Host of Your Health Matters
Rowan Radio 89.7 WGLS FM
http://wgls.rowan.edu/?feed=YOUR_HEALTH_MATTERS
Twitter @drcraigwax

CC:    Donald Trump, President, US
Mike Pence, Vice President, US
Mitch McConnell, Senate Majority Leader
Paul Ryan, Speaker of the House

Achieving Highest Quality Care for American Heroes – VA to Vets Series by Dr. Wax

IP4PI Founder Dr. Craig Wax has published a trilogy of op-eds devoted to American Veterans:

VA to vets: Delay, deny, wait till they die.”
As a physician, I have the privilege of knowing and helping thousands of individuals. One patient in particular stands out as a victim of government’s malignant ineptitude. He is an affable, hardworking 71-year-old male, who is a veteran of the Vietnam War. There was no Veterans Day parade for him but scorn and disdain, given the anti-war sentiment at the time.
Read more: http://www.washingtontimes.com/news/2015/dec/1/craig-m-wax-va-vets-delay-deny-hope-they-die/

More VA delaying, denying, and more vets dying.
This is the second installment of my VA mistreatment and stonewalling veterans series. These experiences were shared by a patient, who is a Vietnam veteran.
Read more: http://m.washingtontimes.com/news/2016/jan/31/craig-m-wax-more-va-delaying-denying-and-waiting-u/

A Veterans Affairs reform that can work.
I have been heartened in recent months to see moves towards exactly this solution, which was previously touted by Dr. Ben Carson. Executive branch officials working on this issue have given strong indications that they see Tricare as the model for veterans healthcare.
Read more: http://www.washingtonexaminer.com/a-veterans-affairs-reform-that-can-work/article/2603066#!

Real Stories of the ACA nightmare # 12- “Two out of three ain’t bad” – Meatloaf

A Canadian physician writes: “54 year old woman. Diabetic, hypertensive, high cholesterol. On Atorvastatin, Ramipril, Metformin. Presents to me with HbA1C of 8.9 – I adjust Metformin. Next visit, HbA1c is better, closer to 7.8. But BP is 190/100. I adjust the Ramipril. Next visit A1C is 7, BP is 135/80. Patient tells me not to check cholesterol. Because, she finally admits, she can only afford 2 out of 3 medications at a time, and she’s picking and choosing which ones to take depending on how horrified I am at the visit. But the cholesterol drugs are so expensive and her heater broke, so she needs a new heater, and she doesn’t want to know my reaction if she stops her statin.”

Posted with permission from the across the border