Archives for posts with tag: insurance

We’re all sick of the health care debate. But those who are sick, trying not to get sick, or taking care of others who are sick don’t have the luxury of absenting themselves from this debate.

They (we) are looking on in horrified fascination as the GOP makes its plan known: dismantling Obamacare and leaving millions without insurance — replacing it with stopgap subpar underfunded skimpycare.

The so-called “skinny plan” is chockfull of real harm. 15 million more uninsured. 20% premium increases. And that’s before the skinny bill is stuffed even more full with add-ons designed to pacify the elements in the GOP who take moral exception to Medicaid. (The poor should refrain from getting sick, you see. Government should not be involved in healthcare. We should go back to the good old days, whenever and wherever those were.)

It’s as if the check-engine light was blinking on your dashboard, and in response your mechanic doused the car with gasoline and set it on fire.

If you have a Republican senator, call them and tell them your healthcare story. Ask them if they came to Washington to harm the sick. If you have a Democratic senator (or if your senator is Collins or Murkowski!) call and thank them for standing up for what’s right. You can also go to the Indivisible website to be patched through to those in red states, whom you can connect directly with their senators. (I’ve done it. It’s addictive.)

Yes, life is full of complications. Things are hard. There’s plenty to do besides this sort of advocacy. You have work to go to, kids to raise, doorknobs and toilets to fix. If you are involved in whatever else you have to do, no one should criticize. But if you can just take a moment to speak up, you’ll feel good, and we’ll all thank you.

Here’s a great article about the physical exam, its historical roots, and why its benefits are not clear.

My reactions are manifold:

1. Not surprising. I’ve been telling people for years that there is no great evidence for *any* particular visit interval. My understanding: the “yearly visit” was invented by those great protectors of American health and welfare, the insurance companies.

2. The studies that show little effect of the annual physical, i.e. the ones which have gotten the most press recently, are measuring the wrong endpoint. Sometimes people like to see their doctor to maintain the relationship, so that the MD is there if they are needed.

3. Doctor-patient communication is not yet as good as it should be across the board. Nor is the visit optimized to get the most out of the relationship. When (if!) those improvements occur, we will move the needle on the next go-round of such systematic reviews.