I wanna be a Troublemaker.

I’ve always had a soft spot in my heart for troublemakers, rabble-rousers, and agitators.  I suppose there are firebrands on every side of an issue.  In my opinion, there are way too many on the Right and they skew many people’s opinions that direction, even when it runs counter to their own benefit.

How many examples should I give you?
Healthcare, a field with which I am intimately familiar.
Every change that has ever been proposed to healthcare has been vociferously fought against; from the first days of Medicare for the elderly until now.   We take Medicare for granted now, but in 1965 and 66, when it was being created, it was a different story. People were ready to take up arms against it. Kinda like they are for the Affordable Care Act, much derided as Obama-care.
Medicare was not an immediate success either. As with any big system, there was much groaning and growling to get its engine started.

After a mis-start with Hillary-Care in the 1990s, we ended up with more problems than we had before.  The reaction to the attempt prompted the creation of MANY HMO’s based loosely on the Kaiser Permanente model.  And that basis appeared to be “The looser the better”. This is when women were pretty much forced into what was affectionately called “Drive-thru Deliveries” of their infants and patients having chest pain had to wait for permission from their Primary Care Provider to be rushed to the ER for heart attack symptoms or their HMO wouldn’t pay. IN LESS Dramatic terms, we also had patients spending quite a bit of time in front of a windshield driving from lab, to imaging center, to healthcare provider as the HMO contracted services from the cheapest providers within a 50 mile radius of the patient’s approximate location in a zip code.
This sucked for providers also, as they were paid on a per-patient in the plan basis, not per-visit, or per-incident. Doctors earned a few dollars as a flat monthly fee (or quarterly) for each patient on the plan.  This worked well, so long as those patients didn’t get sick.  First patient to get sick in a month, immediately became a loss-leader for the doctor. Should a major outbreak of something occur, the poor doctor was literally poor, because he wasn’t getting any more money from insurance.

It took several acts of Congress to straighten out the market that was a little too free. Pregnant women were allowed to get out of their car and spend a day or so in the maternity ward and no counter signature was required for serious and critical cases to go to the ER.

But still, problems remained.  BUT, let’s talk about that later.

Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s