As the title suggests this will be a politically based post for me. I have worked in the so called healthcare system in one form or another now for almost 30 years. I began as a phlebotomist working within a hospital and eventually became a RN. I love my career, I hate the system that I have to work within on a daily basis.
I have watched insurance change over the decades from something that was an affordable benefit of employment to the current financial drain it has grown to be. Even Obamacare, that was sold as a bill of goods to save the system, is falling apart, as insurance carriers are bailing out. It has been hard seeing patients who have worked and paid into the system for years get ill and need care, some for the first time, still have to make decisions not based on need but based on what they can or can not afford. This is not healthcare!
This reality hit home even harder this past week as my own Father was in the hospital. He has medicare and a secondary thanks to his retirement so he should be set right? Nope, well not unless he has a family or caregiver fighting for him. Medicare deemed him safe for discharge home even though PT, OT, and his case worker was saying otherwise. It took family fighting the system, therapies evaluating my Mother’s abilities to care for him at home, and his MD’s writing letters to medicare for them to see how they were wrong. If all that did not happen the hospital would not have had the option of rehab for him because medicare has a 3 day minimal hospital stay requirement and he had been there 2. So even though he had the need medicare was going to push him out the door!!!
Sadly his scenario is not unique, I have seen this scenario played out many times and where there is no family involved we do what we can to fight for the patient. To me though we shouldn’t have to, the bottom line should be what is best and safest for the patient! Not this bullshit about what is cheapest for the insurance company as if they are there caring for the patient. For example, if my Dad did go home, It would have been 1-2 days until home health got there to evaluate him and up to 1 week for all his services to be in place. Mind you PT and OT had determined he needed 24/7 care so what exactly did medicare expect to occur during this time that he had no services in place? They were expecting my Mother to take full care of him even though she is not capable of it. As a healthcare provider we are to take a holistic approach to patient care yet the insurance has blinders on to reality. If what they wanted had occurred there was a high chance they would have ended up with 2 patient’s in the hospital before his services started.
I am thankful we were able to fight on the behalf of my Dad, that the staff of the hospital not only stepped up but got the MD’s involved to the point they wrote letters to medicare, and that my Dad will be going to rehab until he is strong enough to be safe at home. He had family there fighting for him even though his insurance (and my Mom) kept saying he could go home. Yep sometimes even family can have a negative impact however that is why therapies did an eval on her abilities to do transfers with him and such.
Sadly our system is not set up with our best interest in mind, it is set up to make money. People forget that fact. Some people want a single payer system thinking that will fix everything. Who truly wants to be on medicare or medicaid? That is what it would end up being, probably under a new name with pretty new banners, all government controlled as if they have our best interest at heart