Who Cares About Your Healthcare?

Be Your Own Advocate

It has become obvious to clients and providers of healthcare services that managed care has nothing to do with care! It has everything to do with money and the denial of care. Before HMO’s and managed care, clients could choose their Physician, Physical Therapist and Orthotist/Prosthetist. The decision was based upon trust and confidence. The primary consideration was the level of care that was received. Providers had to satisfy the client’s needs or loose their trust and confidence. Competition among providers was based upon who could provide a better service or device. The necessary time was devoted to make the proper assessment, plan the most effective treatment and follow up to insure an optimal outcome.

Insurance networks consist of contracted providers who are willing to accept lower fees. The sole purpose of the networking system is to lower costs for the insurance companies. Care is not a factor! Providers who accept the lowest fees will get the most work. This volume mentality may work in industry, but the healthcare assembly line has people on it! Competition today is based on who can do it cheaper and faster. In essence, real competition has been eliminated.

It is evident that the insurance companies do not care about your healthcare! It is shameful that the corporate greed that spawned Enron, Health South and numerous other scandals has found its way into America’s healthcare system. Healthcare has indeed become a business like any other. Healthcare costs were rising before managed care but the money went to the person providing the care. Healthcare costs continue to rise. Premiums have skyrocketed but there is less care. Physical Therapy services have already been capped while Prosthetic and Orthotic services are in the process of being capped or reduced to one in a lifetime. More money is being spent now but it is going to the corporate elite of the insurance companies. Healthcare dollars are being spent to increase the bottom line of the corporation rather than focusing on care!

In this era of managed care, business has taken precedence over professionalism. Physicians, Physical Therapists and Orthotists/Prosthetists no longer have the last word regarding healthcare. Services are approved or denied based upon cost rather than professional judgment. Employees of large insurance companies have become the decision makers! In an effort to maintain their practice, many professionals have succumbed to the dictates of big business interests.

In order to maintain exclusive contracts with the insurance companies, providers must play by the rules. Keeping cost down becomes the primary motivation. As reimbursement continually decreases, so does the quality of care. Less time is spent with the client and less costly treatment is provided in an effort to remain profitable. The insurance companies make more while providers makes less. YOU receive less care! Incomplete, ineffective or inappropriate treatment is not cost effective. It is a waste of money!

In the case of products such as braces or artificial limbs, fit and function are not prerequisites for payment. Coordinated treatment may be unavailable. As choice becomes more restricted by the networks, outcomes and client satisfaction are no longer important. Many providers work for large corporations that include orthotic and prosthetic companies and hospital chains that make deals with the insurance companies to lower costs. As employees, even well intended practitioners must work to increase the bottom line for the corporation. It is no longer safe to assume that all providers care about your healthcare! While there are still conscientious professionals still practicing, they are in the minority and you must seek them out.

Managed care is the result of the influence of big business on politics. Special interest groups make large donations and sponsor lobbying efforts to promote the interests of the insurance companies. Windfall corporate profits and exorbitant salaries for CEO’s are overlooked as more Americans receive less care or become uninsured. Our elected officials are more concerned with corporate interests than those of their constituents. The rising cost of healthcare is front-page news. Medicare and social security as we know it are threatened. The cost saving solution is always to reduce the level of care. The savings is never realized as it is redirected towards corporate profit. Medicare HMO’s make a profit by providing less care or denying care!

While our elected officials talk about healthcare reform for the people they represent, they pass legislation favorable to corporations and the legal community. The laws they create do not influence them. They are able to receive the best treatment possible for themselves and their families. Politicians care more about getting re-elected than they do about your healthcare.

Who will care about your healthcare if you cannot rely on insurance companies, practitioners and politicians? YOU must accept the responsibility for your own healthcare! Can you afford to leave it up to anyone else? Take charge of your healthcare by voicing your opinions to your employers if you receive benefits through work, your legislative representatives and professionals. Become involved and informed. Ask questions and demand answers. You know what you need but you do not have the medical knowledge to provide the solution. Seek out professionals with the expertise and desire to assess and treat you as an individual. Don’t rely on the experts but work with them! Education is the key to understanding. Make decisions in your best interest based upon outcomes and value rather than cost alone. With the help of a caring professional, YOU can put the care back into healthcare!……………..Be your own advocate!