Saturday, December 3, 2016

Best Laid Plans of Liberal Progressives

December 3. 2016

By Anna Morris, Co-Editor, FFOA NEWS NETWORK

  About four years ago I had a medical disaster involving a hospital monopoly, meaning it happened in a place with medium population that no longer has private practice or any alternatives to the government sponsored maelstrom. My experience was so bad that I moved back to my birth state of Idaho and avoided as much medical care as possible, even at risk of my life. 

     The best laid plans of mice and men and medically abused patients often go astray. After four years in my own insulated vacuum, I was recalled to the site of my former shame to care for my business partner who had become seriously ill. This was a long standing agreement between us as I have medical training and much practical nursing experience. Since my partner is ill I have popped back into the same hospital monopoly milieu from which I ran. Though my most pressing personal needs are still met in Idaho, I have had a few occasions to access the system recently for personal needs. Due to the illness of my friend I also have many opportunities to observe care and quality of care within the monopoly.

     The system pushed the "Primary Care Physician" (PCP) mantra. Though there are walk-in clinics with generous hours, the practitioners are reluctant to treat anything unless the patient has or agrees to have a PCP. I am private pay so in my opinion that is none of their business. 

     Last year my partner and I both had a severe cold that didn't go away. After six weeks of dragging I began to run a low grade fever and felt like I had pneumonia so I went to the walk-in clinic. The state is down on prescribing antibiotics and though the reasoning is good, sometimes antibiotics are needed. I will rate the practitioner as F minus. She told me I was desperately ill and needed to go back to Idaho to see a specialist. I asked what kind of specialist and what should I tell him or her? Just see a specialist. No antibiotics unless I had a PCP for "follow-up"! I guess this is an Obama Care rule or something. She asked me if I was nauseated and I told her no but she kept pushing anti-nausea drugs instead of antibiotics, why I do not know. 

     I politely but coldly told her I would take care of myself, walked out, went home and took some antibiotics I obtain legally for use in animals on my ranch. I soon coughed up chunks of yellow and green material and was fairly well two weeks later. 

     My partner continued to drag along and a month or so later he had a deadly case of pneumonia which occasioned my recall for heavy nursing duties.

     I was able to observe excellent care in the actual hospital and ER. I have come to the conclusion that actual medical care is done in those two places, not that anyone should aim to be an in patient at the hospital. Obama Care as well as the state's health transformation, blah, blah, blah, was supposed to cut down on use of the ER but after experiencing and witnessing many interactions at the monopoly owned clinic I believe if I am sick enough to see a doctor the best real care is found in the ER and it is probably worth the $600 plus not to get jerked around by politically infused employees posing as doctors and practitioners.

     Of course some of the latter are very good, very competent and doing the best they can in a system that works against them. One can sense the pressure for such doctors to fill in the Obama Care, government created blanks about diabetes, weight, hypertension, lifestyle, etc. These poor doctors seldom get their heads away from their laptops to look at or touch a patient. 

     Perhaps folks in big cities are used to regimented short visits with their doctors, maybe through a managed care scenario. I am writing about what most would call a small town where the doctors used to have independent offices with one or two nurses and one bookkeeper/receptionist for staff. Those old time doctors, practicing right through the 1980s were able to address each patient and his or her needs on an individual basis. When "health care transformation" such as the Oregon Health Plan, took place in the 1990s, those old time doctors suddenly took early retirement. Those transformations seem to have been created to deliver depersonalize care to the masses.

     One of the few good things about the "transformation" is the availability of "health portals", email accounts directly to the doctor(s) and the monopoly system. I use one of these, sometimes daily, when my patient is really ill and I believe it has saved my patient's life. That is a dramatic statement however the new system seems to make sure there are shortages. If the PCP wants to see the patient "in a month", scheduling is likely to offer the "only available slots" in six to eight weeks. It amazes me how the Obamatized health care transformation has created instant shortages. The portal short circuits this garbage, especially if one had medical knowledge, wants results and does not need a lot of hand holding.

     The care shortage has worked a bit of a miracle. In previous articles as well as on Twitter I have frequently blasted the Obamatized system as making a visit to the doctor a skin crawling experience. Best laid plans not only go astray for mice and others, but certainly for liberal bureaucrat types like Jonathan Gruber who think more flow charts and projections, backed by laws and mandates, will solve the medical crisis they have caused in the first place! Case in point, a bedrock belief of Obama Care is that everyone must stay healthy as a patriotic duty so there will be "enough to go around." To this aim Michelle Obama grew her White House veggie garden on toxic soil while preaching about My Plate and insisting mac and cheese should be made of skim milk and cauliflower. The Third Reich was more to the point in regulating lifestyle; do it for Fatherland and Fuhrer. 

     The UN/WHO has the gall to castigate American medicine for doing too much "sick care" when enlightened nations do only "well care." 

     Four years ago in the heavily Obamatized state of which I write, the PCP and his nurse were government factotums most interested in smoking and or other tobacco use. When some Gruber-type figured out the e-system could not run without an answer to the question, "Have you EVER smoked," patients could be blackened forever in the permanent record as drug using deviants. They also became low hanging fruit for when the REAL lifestyle rationing begins. Every encounter, every time, by doctor, nurse, receptionist, coder, X-ray tech, etc., etc., was supposed to begin with questions about smoking! If a patient was stupid enough to admit tobacco use, the questioning and haranguing to accept "cessation intervention" was to increase exponentially. Ditto for alcohol use. Obama Care only allows one drink per day for women, two for men; more than that is "alcohol misuse." Just ask the DSM-5!

     At this time the doctors, nurses, et al are so overwhelmed with schedules, time limits and laptops that they have no time for government spy work. Just answer no and never to the tobacco questions and they will never ask again I suppose due to lack of time. Usually they never get around to questions about alcohol use. Best laid plans of liberals most always become a stinking morass of ineffectiveness.

     Obama Care and certain state efforts were distribution and redistribution schemes. Health Care, not just medical care, as in treatment for the sick and injured, was to be available to all. It was to be especially available to "under served populations" like African Americans, Native Americans, LGBTQ, etc. 

     I have no idea how well these targeted populations are faring under the "transformation", but I do know there is a pernicious, legalistic rationing of sorts being practiced. It has been whispered that there is tort reform somewhere in Obama Care. It appears to me this equals doctors rejecting certain patients with certain conditions.

      Though I receive excellent care in Idaho for chronic, severe pain, my back became suddenly excruciatingly painful while I am temporarily stuck in the land of the hospital monopoly. Thirty years ago in this same area I would have started with an orthopaedist who would probably have ordered X-rays at minimum. If something emergent was going on s/he could offer options. Otherwise I could tough it out until I could take the results to the pain clinic in Idaho. 

     Surprise, surprise, surprise, as Gomer Pyle used to say! The orthopaedists in the monopoly will NOT do ANYTHING for a sore back. PERIOD! I have an idea my problem is arthritic in nature and know I have not been injured. I assured them I was self-pay and not beholden to an insurance company to make decisions for me. In addition I said I was not necessarily seeking treatment, since as soon as possible I plan to access specialists in my home. Finally, I made it plain I was NOT seeking any drugs!

     NOTHING concerning the spine is addressed through the hospital monopoly which "serves" an extremely poverty stricken area. I could however, they informed me, despite my out of town status, obtain a Primary Care Physician who might order some X-rays or scans. Roll the dice, fill out the government questionnaire, get weighed so they can report my BMI to Michelle Obama, answer the initial tobacco questions, (lie if necessary), pay the fee and get informed that the monopoly does nothing for sore backs? No thanks! If it gets bad enough I will avail myself of REAL medical care in the ER.

     The sum total for the liberal plans of "health care transformation" as I see it equals few if any choices, no access to some care, and the poor which are supposedly "served" are certainly screwed! Imagine a poor person living under the shadow of the hospital monopoly. Whether or not Medicaid pays his bills, nobody in the monopoly will address his painful back, probably for fear of law suits. This particular state is on the federal sh*t list for drug abuse so doctors there pretty much will not prescribe pain medications that might work. There is no opportunity for the poverty stricken patient to get a second opinion or go outside the monopoly. The monopoly does not treat back pain, period. If the patient is too poor to travel, he is screwed. If he can travel he will need to drive about 200 miles to where treatment is available. He will probably end up in the ER even though the liberal progreessive goal is to cut down on ER use. If the poor patient is actually seriously injured he may become so disabled he will become an in patient in the hospital or possibly flown by helicopter to the big city where treatment is available. With basic big government luck, such a patient may lose his job flipping burgers at Burger King and his whole family can go on welfare. That would be a likely WIN/WIN for Democrat voter registration.

     For me, I know my spine is deformed and full of arthritis. I spit on government-centered, alleged "health" "care". As soon as my patient can travel we will journey to Idaho. If I misjudge my situation I will go to the ER for some REAL care. That is only a couple hundred more dollars than jumping through hoops to get a PCP I do not want and possibly for no help with my main complaint. Gone are the days when a patient hired a doctor. Now the doctors decide IF they will accept the patient. This may or may not be a definition of "regardless of the ability to pay."

     Beyond that I am pleased to see the system that was planned to ensure "healthy lifestyles" and to punish lifestyle crimes such as smoking, is collapsing under its own weight.  Doctors and practitioners are obviously overworked and distracted with government mandates. There is a shortage of them. Perhaps those who want to stay in medicine are seeking careers somewhere in the third world where people are thankful for the most basic care and there are no lawyers to institute suits.  

     I see very little actual practice of medicine in the monopoly's clinic. It may appear my personal opinion is bitter and jaundiced which is correct, however others in the "community" say exactly what I am saying. "Primary Care Physician" is frequently followed with the word "useless", rolled eyes and a snort. The PCP is a government cipher put in place to deliver "well care". 

     Someday in a perfect, liberal progressive world, if Democrats can figure out a way to keep Obama Care, ungrateful patients who fail to stay well should be euthanized when their "sick care" takes too much time away from enforcing the government ordered fruit and veggie, no tobacco, no alcohol, no meat, and certainly no bacon, death to couch potatoes lifestyle. But as I gleefully report, the best laid plans of liberals often go astray, imploding from sheer stupidity and ignorance of real life. 


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