Wednesday, April 11, 2007

Acting White: vs. Acting Sneaky

Forgive me; this blog is not about sneaky blacks or whites, but rather about the sneaky health care professionals, of all types, deserving of our caution. I just had a eye-opening conversation with my son’s neurologist.

To back up a little, when consumers choose a doctor or health care provider each gets to evaluate the other for acceptability. The provider wants to assure their compensation for services, while the consumer wants assurance of health care quality and greatest coverage toward need. Everyone is fully informed and gives their consent via agreement. This is fair.

Now switch over to the growing cadre of provider organizations, including many hospitals, who may very well accept you as a patient or client, but also ‘grade’ your insurance in a way that instructs and motivates their staff to enhance or lessen the care options they present to you, without your knowledge. In this case, your sigh of relief from knowing you are accepted could be very premature.

My son’s doctor has just move from area-leading Children’s Hospital in Oakland to a clinic in SF whose philosophy of care does not secretly discriminate based on the carrier of the client. Specifically, he described Children’s compensation to their physicians as a formula calculating the patient services they recommend and how much the patient’s provider pays for that particular procedure/service. Under this situation, the doctor’s paycheck is placed in direct competition with their presentation of best care alternatives.

I understand that health care is financially squeezed and this means hard choices on all sides, but the idea of a bean counter, in the examination room, with his hand in the wallet of the doctor, unbeknownst to the patient, is just plain wrong. In fact, this explains how, a few years back, my late father was prescribed a needless 10 minute medical helicopter ride between two hospitals, at a cost of $13,000. The guys in accounting knew his insurance would pay up so that meant, ‘fire up the chopper boys - we got us a ‘full-retail’ customer!’.

Absolutely sinister.

James C. Collier


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