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COTA Thoughts

Socialized Medicine?

Published September 25, 2008 10:51 AM by Tim Banish

What do you think about having the government control the health care system? Do you want Congress making up rules and regulations concerning your health? It's already to the point where many insurance companies tell you what you can and can't have anyway. The real problem I see with this is the fact that a large number of medical reviewers employed by the insurance companies are not qualified to make decisions concerning your health care.

Most insurance companies hire and use nurses as their medical reviewers. Now, there are many nurses that could be very efficient doing this job, but from my knowledge most nurses accept a position like this because they want an easy 9-5 job away from patients. And I'm not saying that every nurse doing this job is a no good loafer. However I do know that many are also offered a bonus system when they can contain costs. Hmmm... No Mrs. X, you can't have that surgery you desperately need because it would cut me out of my big fat bonus this month.

So with government control, the only thing I see is another added layer of government hired reviewers directing the insurance hired reviewers. Does that mean two people saying no in order to get their bonus?

And, what would that mean for OT? I am dealing with a patient right now who has a private Medicare insurance. Yes, while they were in good health the lower cost supplement insurance was fine. Since their medical needs were limited, there were no problems because they were actually paying in more than they were using. Just what the insurance company wanted. But the policy includes limits on OT, PT, prescriptions, long term care, and accident coverage. Now that they are in need of coverage though, guess what happened? The insurance company called one afternoon to say that they had one more day of coverage- period. No extensions, no secondary assist, no appeal. This person must now pay out-of-pocket to continue therapy.

I can foresee government controlled insurance working very similar to this scenario. Too many people controlling your money, and receiving a hefty salary to do so. And I also see cuts for fees paid to doctors, hospitals, therapy, etc. This means fewer dollars to flow down the ladder to the people who actually earn the dollars anyway. (Do you read pay cuts here?) I do, at least for us. I'm sure the CEO's and other higher ups won't see any salary reductions though.

Until next time, hope all your thoughts are good,

Tim

 

3 comments

well........it's for sure that under bush and all the previous 'de-regulators', the current health care system is a mess.....and it's possible that now we will have an administration that is more focused on people than profit. the health care insurance industry, like the drug manufacturing industry, are little more than greed mongers who have done little for the health and care of the general public, and have made a number or top level management personnel very rich........under a responsible administration, gov't. controlled health care could serve the people in a responsible way, not the interests of the CEOs. i think we all need to stop being afraid of the good this can do.

miles

Miles Pustinsky, Peds - OTA December 8, 2008 8:31 PM
Philly PA

Thanks Patricia-

The government seems to always have their hand in too many things. Involving themselves with healthcare will only create another layer of management to have to earn money for.

Just my opinion-

Tim

Tim Banish, LTC - COTA/L October 13, 2008 4:56 PM
Cincinnati OH

I disagree with the government having anything to do with health care since seeing what happened to Canada and other countries that have socialized medicine.  Look at what happened with medicare and medicaid they can't keep up with what they have going right now.  And as tax payers we have to put money into the healthcare and end up paying for everyone, including people from other countries.  The people who need it cannot afford the medicines because they don't cover the medicines needed for the people on fixed income.  I see the medical field people getting the shaft more than the help for the people that need medical assistance.  I think that the government should not get involved with any more medical problems.  

Patricia, schools - COTA/L, RRR OK September 29, 2008 6:31 PM
Durant OK

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