Another Observation From the Bedside on Health Care Reform

       My colleagues and I don’t discuss Health Care Reform at work much, out of respect for one another’s views.  Like most of the public, none of us is well versed in any of the issues under debate.

   I had a patient the other day (isn’t this how most nurses begin a story? “I had a patient….”) who has not met the specialist writing her treatment orders. Her previous specialist contracted with another health care system, and was no longer covered under my patient’s insurance plan. So she randomly picked a new one from a list of specialists who are covered by her plan. She has an office visit scheduled with her new physician a month from now. Her insurance provider told her who her physician couldn’t be, and she accepted this as part of her life as a patient.

     My point is, patients are already told who they can and can’t go to for medical care.

     Yes, I have the choice of choosing my own physician, from my insurance company’s preferred providers list, but I will pay a much larger deductible if I choose a physician not on the list. I don’t think this concept will change under Health Care Reform. Doctors set their fee schedules, then contract with insurance carriers. If the carrier and the doctor can’t agree on a  fee schedule, both look for other partners. If the doctor of my choice and my insurance carrier don’t agree on how much my doctor will be paid for services and procedures, I have to find another doctor. This has been going on for years, so I’m surprised when I hear people yelling at town hall meetings that they don’t want to be told who they can go to for their medical care. It makes me wonder if the people who are yelling this have ever been patients.

     Again, I don’t claim to be an expert on Health Care Reform. This is simply a personal observation from the bedside.