Last week, President Obama held a Town Hall Meeting in my hometown of Bozeman, MT. What a big day for such a small town in Southern Montana, and for Friday, Bozeman was on the worldwide map. Most of these town hall meetings have been held in small town America, where many have been hard hit by the downturn in the economy. As a healthcare provider I have been listening to the debate from both the media, my colleagues, and my patients and I find it hard to find a place to land. I know the economy has affected me, but as a provider who does not bill insurance, I find the struggle of where to stand in this mess.
As one of the wealthiest but not healthiest nations, the US is in a nasty predicament. Obama himself has begun to call this "insurance reform", and that is exactly what it is. This is not about taking care of the health of this nation, it is about insuring everyone in this nation. Insurance does not provide that we will be taken care of, it does not provide that we will be healthier, and it surely does not provide for prevention. There are only a few states that even recognize insurance coverage for "alternative" practices, and with the strong AMA lobbyist backing, it's going to get even harder for us "alternative" practitioners under a government run insurance program. (I really dislike the word alternative, as it makes us look less important, but its the word most people relate to.) My association, AANP, fights for us, but compared to the AMA, we are a little fish in an ocean of sharks.
What many consumers do not understand is that insurance companies tell doctors what they can diagnose, what they can prescribe, and even how much they will pay them for a certain procedure. Costs explode when invasive and unneccessary tests are done for fear of liability, again creating a whole other game for insurers to rake doctors and patients over the coals. "Alternative" therapies are actually more cost effective, and over the long run would save the American taxpayer billions of dollars, so it is vital that doctors and consumers in this field speak out.
And this is what I feel is missing in the debate- true PREVENTION. That word has been thrown around over and over, and yes mammograms and colonoscopy's save lives, but what about teaching someone to grow a garden, and prepare the food, or how to exercise, or learn about effective and cheap homeopathic medicines, these small things can improve a life, not just detect a disease, and they save everyone money.
I also am part of the largest group that insurers discriminates against: women. Women are charged higher premiums because they use most of the healthcare, mainly related to pregnancy and childbirth. Even in this most essential of human functions, insurers decide where and how women give birth. For 12 years I paid $50 per month extra on my insurance premium for a maternity rider, of which I was under the impression would pay for a pregnancy and birth. After 12 years of paying, I was informed that I could not have my baby at home, or in the hospital unless I had an emergency C-section, they paid for up to $2000 of my prenatal care and then I was on my own. My entire care with a midwife for prenatal, birth, and 2 months postnatal cost me out of pocket $2700, the average C-section starts at $13,000. God forbid I had complications during pregnancy that forced me to have my daughter in the hospital without C-section, it would have been a financial nightmare. I also represent the majority middle class who makes too much to qualify for assistance, but too little to afford any over the top expense like a hospital birth. How is this scenario cost effective? It's not, and it's what is driving up costs and creating more unnecessary stress. I hope for a change that supports a person's right to chose their doctor, their treatments, and their health over the bottom line.
Let me say however, it is my patients who give me most hope. They have chosen to take their health into consideration over what their insurance tells them is "covered". They have sought out help usually after every "coverable" drug, invasive, and unnecessary test has been run on them, only to be found that what really helps them is not covered by their health insurance. My patients teach me everyday that true health does not come from somewhere else, it comes from within.
Learn how to be a healthier human being, teach your neighbor how to do the same, and be an example that others would want to follow. Incentives should be given to those who prove that they have made better choices, and doctors should be able to care for their patients without being squeezed into a ten minute window and dictated to on how to diagnose their patients by insurance companies.
The debates are heated for a reason, people are scared of change, and even more scared of the government controlling that change. If you think insurance companies are powerful, wait until the government has the market, it should get very interesting. I just ask that you let your legislators know that you want true prevention care, and that "alternative" medicine creates health and wards off disease. This new change in our country will be hard, but true healing will ALWAYS be up to you, no matter who is insuring you.