Hidden healthcare costs

       Much has been written about decreasing government reimbursements causing healthcare cost increases.  This in NOT about that.  Others have written about insurance company greed causing increases, also not about that.  Millions have voiced opinions about big Pharma causing the problem, this is not about that either.  Those are all major problems, but we all know about them.
       I am writing about a lesser known, and lesser effecting, aspect of the ever increasing cost of healthcare.  But just because it has less of an affect, doesn't mean it has none.  I am speaking about the problems caused by Joe and Jane consumer.
       I am not talking here about preventive care, or even the propensity of some to ignore a simple problem until it requires emergency attention.  (a stitch in time and all that.)  No.  Instead I am speaking to the same thing my brother spoke to in his commentary on bad driving; You are not more important than anyone else.
       Ask anyone who works with scheduling, or outpatient services and they will tell the same set of stories.  Jerk patient forgot appointment.  Jerk patient was half an hour late and expected immediate service, jerk patient refuses to return phone calls when an unexpected event (like a Doctor being in an accident) causes a schedule change.
       The end result is that everyone else scheduled that day suffers.  Even if the person is bumped to the end of the line it results in the same end product.  OVERTIME.  Yes, you may be surprised to learn that those of us in the hospital biz. expect a paycheck.  It is a labor of love, but also one that needs to feed our families.  Since we do draw a paycheck, the hospital is subject to the same labor laws as any other business.  That means when we work overtime, we get paid time and a half.  Do you think medicare and insurance companies reimburse at a higher rate when that happens?  Of course not.  Remember, a hospital is like a farm, a lot of money moves through it, precious little stays in it.
       So, be a decent human being.  Keep your appointments.  If you can't, call.  We'll be happy to reschedule you.  Take care of small problems before they become big.  You wouldn't let a hole in your roof go until the house fell down.  And you wouldn't expect homeowner's insurance to pay for the house if you did.  But in general, do your part.  Even if we had full on Government run care, taxes would go up to cover ignorant behavior like this.  So it holds true no matter what.
       Big Pharma, yeah, they are a problem that needs fixing.  So is insurance.  So part of you being a good person is to go vote too.  I'm not telling you who to vote for, but I will demand that instead of just punching a ticket, that you research the voting records of those running.  They speak volumes.
       Theodore Roosevelt said it best: "A vote is like a rifle: its usefulness depends upon the character of the user."

This is theft

       I just wanted a York Peppermint Patty.  I went to the machine at work and paid my 95 cent for a 60 cent candy.  The candy was dispensed, but rather than release my nickel, which in retrospect, I'm not sure I have ever seen this machine do, it told me I had a credit.
       A credit.  So now my options were to, A: Buy another overpriced candy, or B: wait for someone else to, and hope they have a nickel, or C: walk away.
       This is petty theft, and it happens every day.

       Technically it is not theft, though.  The next person will get your nickel.  It's only an extra 5% over the 50% markup you've already paid.  (or 10% of the 50% markup).  The next person will just get back a Dime as change.

       It's not theft, technically it's an involuntary redistribution of wealth.  I'm surprised government hasn't put a stop to this, after all they had the market cornered.

"B" Ark. Problem solved.

       "Yes, so anyway," he resumed, "the idea was that into the first ship, the 'A' ship, would go all the brilliant leaders, the scientists, the great artists, you know, all the achievers; and into the third, or 'C' ship, would go all the people who did the actual work, who made things and did things, and then into the `B' ship - that's us - would go everyone else, the middlemen you see."


He smiled happily at them.


"And we were sent off first," he concluded..."


..."It's a funny thing you know," said the Captain at last, "but now that I actually come to tell the story to someone else ..."


-Douglas Adams-
The Restaurant at the End of the Universe


       If the world only worked that way.  Send all the middlemen into space.  I would be happier.  See it all goes back about a year ago... (fade to one year ago with tinkly music...)


       There I was, beginning a book.  Not my Magnum Opus.  Not the first great novel of the new millennium.  Just a novel set in Chicago by someone who actually lived there, or you know, had seen it once.  Unlike most other books set in Chicago.  I worked on it sporadically; adding bits here and there.


       I got to a point where I'm about half done and learned, by reading about such things, that most people pitch a new story idea before they ever begin writing.  I went on to learn how the publishing industry works.  


       Mostly there are a series of shysters who try to steal from people who have done the actual work.  Just like the patent system.  Unlike the patent system, no publisher will even accept a manuscript, (the patent office will), unless it comes from a literary agent.  


       We are forced to deal with middlemen.  


       In my line of work there are companies who will not sell supplies directly to a hospital, because they have a contract with a distribution company.  (I'm looking at you Welch Allyn)  Naturally there is a mark up involved.  (For the record, the Affordable Care Act fails to address this.  Sad, as this one is an easy fix).  


       It may not solve every problem, to eliminate the middlemen, and some are actually quite necessary.  But would it hurt to just get rid of the ones that don't need to be here.  I'll donate some time to help build the rocket.  (And add Rocket Scientist to my Resume)