Florida health-care

[Nancy]

I've been reading some pretty terrible things about Florida's healthcare on another site, which has some pretty ill folks.

What they are saying is that Medicare and Medicaid patients are having a very hard time trying to find doctors who will take care of them, and that some doctors are even "firing" their established patients who have complicated cases, and some are "dogging it" to try to get them to leave.

They are also saying that insurance companies are limiting the number of high risk cases each doctor can have. And necessary things such as oxygen for serious lung conditions are being triaged, grouping them together with all serious conditions such as patients who are in nursing homes. The lung patients are being asked to wait for their supplies and in some cases do indeed run out before being resupplied.

They are also saying that there has been a limit put on serious and complicated cases as to how many ER visits they can have.

In one case it was so bad that this person was referred to Hospice care, even though there is now treatment for her condition, and her doctor would not refer her to a specialist, eventually "fired" her and the woman has very few options, since she is on Medicaid. She knows that there are now treatments for her condition which would save her life. I can't imagine what that would feel like.

Those of you who live in Florida, is this what is really happening, or are these reports exaggerated?

 

[LUVMyBirman]

Hi Nancy,

Can you tell us what part of Florida these reports were coming from? I received some very good health care in Orlando. Also, the Naples area at Cleavland Clinic. I am not a Medicare patient at this point in time though.

We plan to buy a second home in the next 3 years in the Naples area. Holding tight until we can permanently move down. Which at this point..... is a good 10 years away. Nice to have something to look forward to.

 

[Nancy]

The people seem to be from all over the state of Florida. And it is also affecting those with private health insurance and those who self-pay.

The latest post I read mentioned that one of the doctors was having his patients sign a waiver re: the fact that he carries no liability insurance, and therefore will only do things "by the book", nothing new or innovative.

The website is PHA.org which is the pulmonary hypertension website. Most of these posts are currently on the first four pages of the website.

 

[Ross]

God I hope that isn't true. Sounds more like a way to control the population by killing off a few people to me. Conspiracy theory coming into play?

 

[hensylee]

Nancy, I have heard such reports in the past, but pumphead can't recall where, but it wasn't just Florida, I think.

I received top-notch care in my recent hospital stay. When pneumonia entered the picture, I had people from everywhere 'taking care' of me. I have Medicare and a supplemental policy - no extras.

Think we all ought to know that HMO's and other 'groups', if not already doing it (and Nancy's post says it) are denying treatment to costliest patients - who will then die early and no longer require the expensive treatments which cause insurance companies to lose money. This might sound cruel, and it is, but I have heard it discussed in circles by those who are in a position to evaluate these sorts of things.

Face it, y'all, euthanasia is definitely coming to the U.S. as it has already in HOlland. Tho, that's not what it's called.

 

[Nancy]

Sounds like a medical "Star Chamber" doesn't it? And the insurance companies are running the whole show!

 

[hensylee]

Think about it Nancy - the drs are directed pretty much by the HMO and like-groups as to how they can practice medicine. We have all read about patients being denied access to medical care they need because HMO would not approve it! Hell of a mess, isn't it?

 

[Nancy]

I know the subtle aspects of this have been going on for a long, long time. What has shocked me about the things I have heard is the overt nature of the actions taken, i.e. "firing" complicated cases and leaving them with no help in a desparate situation, referring someone to Hospice and telling them they are going to die, when there is treatment which could save a life.

Denying lung patients who are on oxygen and need it to survive, the ability to get refills.

I don't know, how did the insurance companies get such a stranglehold on medical care, and how come there doesn't seem to be much that can be done to keep them from "killing" sickly people. There are always plenty of regulations, but with this kind of thing, where are they.

I guess we should be aware of it, it could portend things to come all over, and many patients here on this board are high risk and high maintenance.

I know doctors where I live have had rallies objecting to the high cost of malpractice insurance.

 

[LUVMyBirman]

It's darn scary for sure. I am very aware of the HMO descrimation. Had always insisted we stay in a PPO for that very reason. Not saying that is 100% safe either.Convinced that if we did not hold private health insurance back when my relapse/tamponade hit. I would be long gone by now!

 

[bvdr]

Our company's health care cost.

Our company's health care cost.

just went

 

[bvdr]

Our company's health care cost.

Our company's health care cost.

just went through the roof. We were notified that our part of our employees health insurance cost was increased from $151,000.00 to $219,000.00. We have 61 employees. This is just for employee coverage. Family coverage went up from $514.00 to $819.00. We pay 250.00 a month for each employee.

This is not a profitable year for our company. We have no intention of dropping coverage but it was a real blow. We don't even want to switch to another blue cross plan since I've already found doctors on our current plan. And unfortunately I have become one of those high maintenance people.

I really think we still have the best medical care in the world but we have gotten to a place that it is also cost prohibitive. I truthfully wonder how an insurance company can afford to offer coverage at any cost..............................Betty(bvdr)

 

[bvdr]

Clarification

Clarification

Oops. I hit the "enter" by accident. My husband and I are the owners of our company and are also both employees. We therefore are affected by both the employer's contribution and the employee's.

One of our sons is also an employee as is one of our daughter-in-laws so we see the effect of this first hand.

Over the years we have seen the coverage get reduced as well. We have tried "off-brand name" insurance companies and have gotten burned in the process. There just isn't an easy answer...........Betty(bvdr)

 

[srwieland]

Working in healthcare myself, I've been very aware, to my great displeasure, of these trends you're referring to, although I did not have the impression that it was limited to or special to Florida. My sister works in healthcare administration in the Charlotte area and seems like things are going south there too!! (Is that a good or bad thing? Does it even make sense to you Yankees!)

I know for a fact that, beyond the overt means of denying service to those with Medicare or Medicaid (or, for that matter, any but those who have the best insurance or who are wealthy self-payers), there are many covert arrangements in place to effect the same result. As the great divide between increasing costs and declining revenues expands, its survival of the fittest and the weaker ones get squeezed out one way or the other.

As a healthcare manager, I have no love for the insurance companies (who make our lives miserable but probably account for some of our bureaucratic job security as well), but before we put all the blame on them we should consider who they get their ideological political support from as well (not to name any names!).

Let's just say that, in the last few years, this downward trend in healthcare service availability has increased manyfold.

 

[hensylee]

Amen to that Steve. It surely is a boondoggle and there seems no end or beginning to the string for unraveling the mess.

 

[Nancy]

Hi Steve-

Thanks for your perspective. I appreciate it.

The overt actions I believe we can all recognize, firing patients, dragging heels, denying services, giving substandard care.

It is the covert actions that may be even more troublesome. What may that involve?

Both seem to be effect the same end, the demise of high-risk patients.

I don't think I like that at all, at all, being the wife of a high-risk patient, although we have fairly good insurance coverage.

I am automatically very, very vigilant. I'm wondering how much more vigilant I will have to be in order to keep Joe safe.

This is scary stuff.

 

[Gisele]

Florida

Florida

It seems to me I had heard something years ago about physicians in Florida and the limit on medical malpractice suits. It was so long ago, I don't remember the detais, but I remember thinking--those poor patients in Florida who don't get proper treatment. I really wish I could remember.

Hey Gina--Naples in three years???? I will be in St. Pete in 6.5 years! I can't wait! Of course I think I might have a problem finding a good cardio guy down there. I remember when patients would move out of the area, some would ask their current doc if they could recommend a doc in the new area they were moving to. Most times they could come up with someone--you would be surprised how one doc knows of another doc and so on...........

 

[srwieland]

Just to mention a few Nancy, some patients are repeatedly sent to the back of the waiting list, never getting an appointment, although there's no paper trail of this.

Also, some patients are referred to places they'll never be seen, or where the care is far inferior.

Other patients are told that something is not a problem when it really is, so they'll go away or seemingly not need to be seen again.

Certain diagnoses or treatments are given because they will result in better payment or less cost.

There a lots of things that doctors and others involved in healthcare can do without getting caught. It's kind of like certain kinds of profiling or discrimination. Maybe there's nothing official that minorities are not given loans at certain banks, but the statistics show that it just doesn't happen very much, even if their particular financial status doesn't fit their 'minority profile'.

I don't think everyone is going to be able to get everything when it comes to healthcare, but I do believe that we can manage things well enough to not have to deny anyone certain 'essentials'. Even though I have great insurance at this time, I have grown children who don't and, with my heart condition, I know that if I lose the coverage I now have then I will be in dire straights myself like so many others.

I don't think anyone should assume that they might not ever be in such a condition themselves. I just watched Vanilla Sky last night (Tom Cruise has everything then gets his face mangled in a car accident and his perspective on life gets a major realignment!). Whatever our political persuasion, let there always be some compassion left in it.

 

[Nancy]

Honest post, Steve-

There always needs to be compassion, Also behind every patient there needs to be a big B---- or B------

 

[LUVMyBirman]

Gisele,

I see you are like me. Always planning ahead We hope to have our vacation home in 3 years or less. Can't make a formal move for 10 Really don't want to move my daughter again. Check out the Cleavland Clinic in Naples for healthcare.

The hubby wants FL.... I would prefer Austin. May have to flip a coin on that one. He shouldn't care as long as golf is unlimited

 

[Gisele]

Thanks Gina

Thanks Gina

We plan on moving down there year round when husb retires from the department. The city is offering an "early out" but it only adds five years to the years on the job, and he misses it by two years, so we have to wait the full seven years. By then I wonder if I will have grandkids and if I do it will make it harder to leave (my son has been married for one year now).

We love the gulf coast and we want to be near the water in a condo. No more lawn care, etc......

Can't wait!