Friday, April 3, 2020

Retrospective #413: “End Date” TBD by insurer

A couple of years ago my wife left a post-surgical office visit with a written prescription for physical therapy (PT) and instructions to call for another office visit when the PT was completed. So, I asked my wife how long was the course of physical therapy that the doctor prescribed. She looked at the script and read, “End date: TBD by insurer.”
My first reaction was surprise, then anger at the doctor for abdicating to the insurer on medical decisions, then anger at the insurer for making medical decisions, then anger at government telling insurers how much they will reimburse insurers for making medical decisions. Healthcare decisions that affect a patient’s recovery from surgery should always be a matter between doctor and patient, not insurers, whose principal interest is the bottom line. And not government, where politicians and their staffs are not qualified and are generally corrupted by conflicts of interest.
So, the doctor is not to blame. He or she is in business too – albeit small business, but Retrospective #365 on changes in Medicare demonstrates that even the giant American Medical Association was helpless to alter the course of the “reforms” to Medicare that were enacted to pay for the Affordable Care Act (“Obamacare”). Healthcare represents about 17% of the U. S.’s Gross National Product. It’s a behemoth that overpowers everything else.
So, let’s review: A doctor defaults the duration of physical therapy to the insurer. And insurers are governed by government reimbursement policy written by the staff of politicians who have no business doing it. But ultimately laws are passed and regulations are promulgated in this way. So, it’s a mess, but what’s a patient to do? Answer: Take control.Take your healthcare into your own hands! Seriously, it’s your health!
My doctor offers “Concierge Care.” I suspect he’s looking for a way to get out from under all the restrictions, regulations and reporting (the 3R’s) described in Retrospective #365. With Concierge Care he has less overhead for coding and billing, and he gets paid an annual fee.  It has to be more rewarding, and not just financially.
I declined his Concierge Care offer, though, because under the Medicare as primary and GHI secondary supplemental insurance that I have from being a former NYC manager, I have very good insurance coverage. Virtually everything is covered and paid for. I even get the Medicare Part B premiums, deducted from my pension check, refunded! And my Medicare Part D prescription drug coverage is subsidized by the NYC Management Benefits Fund.  I am also in pretty good health for my age – much, much better than I was 18 years ago, when I was morbidly obese and had “borderline” everything. When my current doctor took over my former doctor’s practice, my new doctor studied my chart and suggested I see him just once a year. Instead, at my insistence, I see him 3 times a year, primarily for blood work.
So, my pitch to you is this: Take responsibility for your own health. Don’t rely on your insurer to tell you what to do or how long to do it. And don’t let the government tell you what to EAT. They’ve been wrong with the dietary advice they’ve been dishing out for the last 60 years, much longer than any government official or practicing physician has been working. Remember, too, your doctor is/was not educated in nutrition, and the RDs and CDEs in practice today obtained and keep their licenses by learning what the government’s huge, failed nutrition experiment dictates.
If you’re overweight or pre-diabetic, ask yourself, how did you get that way? Haven’t you been trying to eat a “healthy diet” the way you’ve been told to do for most of your adult life. And haven’t you been exercising regularly? Then what caused you to gain weight or become pre-diabetic or a diagnosed type 2? Answer: Insulin Resistance. And if you are Insulin Resistant, you are Carbohydrate Intolerant. Does it make sense to continue to eat a “balanced” diet, a diet that is 55% to 60% carbohydrate? That’s what “everything in moderation” means and the way government and the medical establishment told you to eat. But isn’t that how you became Carbohydrate Intolerant? Then why would you continue to do the same thing over and over again and expect a different result? That’s the definition of insanity!
Think about it, seriously And just for reference, think about how feed lot beeves (plural of beef) are fattened up in their final weeks. They are fed grains, and corn, from a trough. A 100% carbohydrate diet. It’s a surefire way to fatten them up! Prime beef, with a thick outer layer of fat and lots of interstitial marbling. Hmmm good.

1 comment:

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