Wednesday, August 10, 2022

The Nightmare that Health Care Became - By Dr. Lyn Olsen

 “They are trying to kill me!”  The worst words anyone wants to hear from their loved one.

One might imagine hearing those words when you are on the phone with your loved who is being brutally attacked as they cry out for you to save them. 

But it is not.  This fear-stricken cry for help from your loved one is caused by someone they trusted, that you trusted -- it is your doctor who wields the weapons of death.

The United States had the greatest healthcare system in the world.  This status was achieved because the doctors swore as part of the Hippocratic Oath to do no harm to their patient, but rather to do everything to save their patients’ lives.  This oath is exemplified in Dr. Ben Carson, who became the world’s greatest pediatric neurosurgeon because he did everything he could do save lives, even developing new medical procedures despite the naysaying doctors who would tell him it was impossible to save a life. His motto was “I do my best, God does the rest.”

The descent into the nightmare began slowly in the mid-1900s when government and insurance companies began their intrusion into healthcare with no concern for the fraud that would ensue. As a small child then I knew it was not going to end well when I heard a doctor at the hospital bragging that he could charge anything he wanted because Medicare would pay anything. Many years later when I was working for a worker’s compensation insurance company, we were told by the state government to pay all claims even if we could prove fraud.  Ben Franklin foresaw this potential for fraud if people figured out they could write themselves a blank government check which would cause costs to spiral upwards. This spiraling of costs was clearly seen when Obamacare (ACA) which caused health insurance premiums to soar upwards to $2000/month with high deductibles so that healthcare was no longer affordable – the professed intent of ACA.

Today, our health care system is on life support, afflicted by the diseases of greed, incompetence, immorality, selfishness, politicization, and loss of good sense and ethics which have seeped into every aspect of health care.  These afflictions have contributed not only to the demise of our once great healthcare system, but more sadly to the unwarranted demise of patients who should never have died, but did die because doctors no longer wanted to do everything they could to save their lives.

The loss of trust in healthcare is threefold: administrative, the patients, and ethics. Administratively, healthcare is buried under a plethora of regulations, standards, requirements, and laws which few doctors or their staff understand or apply properly.  Many of the most serious administrative issues relate to reporting and billing as evidenced in recent legislation that is trying to dam the flood known as surprise billing. 

The collection of patient data has exploded, and along with the mandate for electronic health records, serious problems developed. Breaches and theft of medical records numbered over 40 million in 2021. At the center of these problems are negligent activities, whether willful or deficient, with charts and documentation.  Apathy or negligence of duties can result in the wrong information, loss of information, or lack of correct information in a patient’s chart which can seriously affect a patient. Healthcare mistakes are the number three killer of Americans (400,000/yr).  Add to that, 12 million misdiagnoses every year are reported, but many more are not reported, oftentimes because patients seek help elsewhere or give up. And even when healthcare is provided, it may not be the right course and may cause problems of its own.  Faulty documentation in a patient’s file can result in denial of services or payment by payers as well as other problems relating to many aspects of life such as employment and benefits.

At the heart of many of the administrative problems is medical coding and billing. There is a plethora of serious problems that can result if the correct codes are not applied which constitute fraud or abuse. Healthcare fraud today is estimated by the government to be in the tens of billions of dollars every year. Fraud may occur if the codes selected do not prove medical necessity. The payer may then refuse to pay and the patient will either not receive the needed services or are forced to pay a “surprise” bill with exorbitant charges.  Another fraud issue is upcoding which is choosing a higher-level code than services provided so doctors can get more money or providing codes for services never provided. Failure to code correctly resulting in the payer’s refusal to pay can then be aggravated by the lack of proper appeals by the doctor to the payer.

These administrative failures were blamed on the patients who are supposed to know how the healthcare system and insurance function despite the fact even the highly experienced and qualified healthcare staff oftentimes do not know what they are doing, nor do the doctors or nurses. Patients are then conveniently left with little recourse for help or justice when the healthcare system fails them, and respectability for healthcare began to plummet.

Healthcare became a fatal setup eagerly embraced by patients who wanted the quick fix so their lives of pleasure were not interrupted. Wearing a mask or condom, or taking drugs or vaccines gave people that quick fix, and the truth was ignored because it was inconvenient despite the extensive warnings such as about the dangers of prescription drugs or the continuation of unhealthy lifestyles who believe taking insulin will let them eat as much sweets as they want. We became inpatient and did not want to wait for the good, but the quick easy healthcare fix isn’t saving us, it is killing us, and respectability for healthcare continued to plummet.

Perhaps the most egregious problem and the most damaging to the respectability of healthcare nowadays is doctors’ unethical violation of their Hippocratic Oath to do no harm to their patients. Perhaps the "Hypocritic" oath would be more appropriate because too many doctors refuse to do everything they can to save the lives of their patients. They justify their refusal by blaming the protocols of the hospital and the government, regardless if the patient dies. This refusal by doctors to do everything they can to save the lives of their patients is further exacerbated by the intentional exclusion of family and friends from participation in the treatment of patients which is well known to have a huge impact on the well-being and recovery of patients.  This loss of trust in healthcare has led to the replacement of respectability for healthcare with fear and distrust instead.

(Note: The term “doctor” is generically used to denote all the various types of healthcare providers as well as staff.)