Debate Magazine

Medical Malignancy: A Broken System

Posted on the 26 June 2011 by Technocowgirl @TechnoCowgirl

Centers for Medicare and Medicaid Services (Me...

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   Sick since childhood, the hospital
and doctor’s office have been my second home. Now –twice removed, the
malignancy lies within my attitude toward the medical system as a whole:
unethical behavior by staff, over-charging Medicare/Medicaid (even outright
fraud), over prescribing narcotics, performing unnecessary tests and visits,
not to mention the all-around bad attitudes –especially within the emergency
departments. Oh, how I long for the days of bedside manners and house calls; a
time when monetary status did not dictate a person’s care and respect (a person
that paid with a chicken got the same care and respect as a person that paid
with gold).

   It is not only the hospitals and
physicians that I am ‘dressing down’; the medical system branches out much
further –so does the culpability. The system in its totality is broken beyond
repair and the fault is a collective one: patients, physicians, pharmacists,
pharmaceutical companies, state and government agencies (Medicare/Medicaid),
nurses, taxpayers, Mental Health services, and the American voters all share in
the guilt. A person does not have to be an expert to see that the medical
system needs a complete over-haul.

   Let’s first discuss the culpability
of the patients: patients have a misconception that physicians are God –or that
they have a cure-all pill that requires no effort on their part for recovery;
moreover, patients tend to feel as if they must hide certain facts, or that
certain facts are not worth mentioning. Additionally, drug addicted patients
have jaded the attitude of the system by abusing the medical system and
emergency rooms –which makes emergency room and primary physicians project an
attitude toward any person in pain –treating all as addicts first and a person
second. The largest part of the patients culpability stems from NOT reporting
abuses by staff and government programs –as well as, committing certain frauds
themselves, which in turn costs everyone more money in one form or another
–driving up health care costs. Patients need to discard the attitude of
entitlement and replace it with an attitude of gratitude.

   Physicians, by default and position
have a higher level of culpability: more and more doctors are over prescribing
narcotics to patients that are at high risk for addiction or relapse –this
practice is presenting problems that reach far beyond the medical system; in
addition, when these over prescribing physicians finally see an issue, instead
of recommending psychotherapy or rehab, the doctor cuts off the patient’s
supply (the CYA syndrome –cover your ass) leaving them to search out other
alternatives (drug dealers). Emergency room doctors should call for a drug
therapist when a known addict comes in looking for a fix, not do expensive
tests then send them back into society with no options or hope for recovery
–the emergency departments become a revolving door for addicts treated in this
manner. In today’s medical world, it seems monetary status dictates the quality
of care and the amount of respect that a patient receives at a facility –it
used to be that the primary reason for becoming a doctor was because the person
wanted to HELP the sick and injured get better (the hero complex), however, now
the primary reason seems to be early retirement and financial gain (the Donald
Trump complex).

   Additionally, physicians have an
obligation to spend more than five minutes with a patient; it is the new ‘norm’
in the medical system to discuss only one issue per visit with five minutes to
do it in –with this practice mainly focused toward Medicare/Medicaid patients.
This practice ends up costing taxpayers more money in the end; while making the
hospitals and doctors more money. I have always joked with my doctors stating,
“Don’t do anything you do not want to pay for –because you are paying for half
this visit, and furthermore –you are only getting half the cost too” (referring
to them being taxpayers). Trust me though –just like any other business, they
will make up the profit somewhere! Physicians (whether intended or not) commit
fraud or know that the system that they are contracted to are committing fraud;
they say nothing –which makes them as unethical as the system they are
contracted through. Finally, doctors need to treat every patient with respect
and honesty –regardless of the insurance group or method of payment used to pay
the bill with; leave the personal problems at home –sick patients do not want
to receive a bad attitude with that high-priced bill –the hospital or office
understaffing, underpaying, complaining co-workers is not something we care to
pay to hear –or for that matter, feel like hearing. Just do the job that you
are paid to do, without the ad-lib attitude and drama.

   Pharmacists have their culpability
as well, although, I have not yet decided to what extent. The only practice
that I really take issue with as far as pharmacists’ culpability is this: many
pharmacists have known that I had an addiction problem in the past (I am sure
to tell all doctors that to protect me from myself) –prescription after early filled
prescription, these professionals said nothing of the over prescribing
practices of my physicians (though they made ‘off the record’ remarks).
Statements made by these pharmacists made it painfully clear that they knew
what was going on with certain doctors –yet they said or did nothing to put an
end to it; this is unethical behavior as well as being part of the problem –not
the solution. This unethical behavior earns pharmacists an F in ethical
behavior and obligation.

   Pharmaceutical companies have a
higher level of culpability than say, the pharmacists and patients –yet not to
the degree that doctors do. These companies give doctors incentives and
kickbacks to push and prescribe their drugs –especially new drugs; advertising
these medications on television, Internet, and magazines –just like a dress or
automobile. Caution should always be used when prescribing any medication
(especially new drugs) –trial and error are for the research process, not the
prescribing process. Pharmaceutical companies should not be allowed to offer
incentives to doctors or advertise medications –especially narcotics.

   State and government agencies have a
different type of culpability –in the end, the economic buck stops with them; state
and government agencies are obligated to protect patients and their rights –as well
as the responsibility of making sure fraud and abuse is not how taxpayer money
is spent. The Medicaid and Medicare dilemma is a major factor in the downfall
of the medical system and its branches of services; Medicaid, which is an
entitlement, is the source of most red tape, high costs, and fraud –causing a
widespread disapproval of the program and its services. These government-subsidized
entitlement programs are close to extinction –almost completely bankrupt; there
are no acceptable excuses for this financial plight –it is a simple case of mismanagement
of funds and authority.

   Nurses (men and women) tend to be
most culpable in the sense of attitude and not reporting abuse and fraud; in
addition too, discussing personal issues with patients and bringing drama into
the workplace via attitude. It was just recently that I paid an unexpected visit
to Helen Keller Emergency Dept. in Alabama; the staff there (except for one
nurse named Glenda) was rude at best –I heard every excuse in the book after
stating my disapproval of the staffs’ attitude and their complaining about the
work conditions at the hospital (except for the rude physician that seemed to
not have the time to complain –just be rude). The result being, I removed
my own IV so that I would not have to deal with one more rude staff member –that
is just how fed up that I was in the few hours spent getting poked and prodded
on, leaving with nothing except an attitude and the taxpayers a bill. I warned
that my recourse would be a prime spot on my blog stating this headline –“Helen
Keller Hospital Blind to Patient Needs”; deeming this ER the worst in the
country thus far! Finally, nurses get so rapped-up in their personal issues
that they make mistakes on notes and administering medications; this is not an
acceptable fallacy by medical staff.

   Taxpayers surprisingly have a
limited liability in this issue as well; taxpayer money supports state and
government programs that spend money with little to no concern, however, they
still give over 1/3 of their income to unthrifty spenders –virtually with no
resistance. Taxpayers must demand that these agencies ‘shape up –or ship out’,
and start holding the states and government accountable for their actions –or lack
thereof. It has gotten to the point where physicians do not want to accept
these insurance options because of the regulations, restrictions, and standards
used for payment of services; moreover, after these agencies decide to cover
medical costs –it takes years for the doctors and hospitals to receive reimbursements
from state and government agencies. American taxpayers have to take a stand
against such behavior and stop these agencies from mishandling taxpayer money,
however, this would take more effort and courage than most people are willing
to muster up. Taxpayers have certain obligations of citizenship that they are
not taking seriously –it is ‘The Peoples’ job to make sure that state and
government agencies do their job, and if they do not –it is ‘The Peoples’
obligation to have them removed and replaced.

   Certainly some taxpayers will
disagree, but they have not seen the unbelievable misuse and abuse of the
entitlement programs that they pay for. I have had many surgeries due to cancer
and other illnesses –seeing the system from the inside with an outsider’s view
is disheartening at best. Medicaid has paid more to prevent tests and
procedures than if done when requested –not to mention the costs of
medications, emergency room visits, therapy, psychologists, and other
entitlement programs that I was ‘farmed’ out to –all to prevent paying for
surgery or preventive care. Additionally, test and x-rays have been
unnecessarily preformed (two of the same x-ray in one day –simply because
one doctor did not care for the other and wanted his own copy). All of these
facts are disturbing indeed; yet they are just the tip of the ice-burg –I would
have to write a complete book to present the horror of the broken medical
system in its totality.

   Mental Health Services’ level of
culpability is lesser in some areas, yet, higher in others. As previously
stated, childhood adversities were no stranger to my sisters and I; needless to
say, I have done my time on the couch (in psychotherapy) –in fact, I could
write a separate book on the faults and culpability of the Mental Health
Services in America. At an early age, I ventured out into the world without
direction, this is when I sought out professional help; what I received instead
was a lot of pills, many appointments, and a plethora of annalistic theories
that kept me baffled for years. It was not until I stopped going to Mental
Health and discontinued psychotherapy drugs that I started to grow and
understand that only I could change my direction my life was headed –and that
getting an education would be essential to my success (I am now in a BS in
Communications). In 1993, a panel of psychologists, professors, and judges
deemed me challenged, with a borderline IQ of 72 –assuring me that I would
never learn enough to tote garbage at McDonald’s; looks as if they were
mistaken – costing taxpayers a lot of money.

   American voters have a minimal level
of culpability: voters are the force behind those on office and position.
Americas must start voting more wisely; ‘The People’ have an obligation to
research the ethical behavior and standards of those running for public office –this
obligation is being neglected. Would any of you hire these people to run a
business that you built from the ground up, if so –if they done their job in
the way Washington D.C are doing now –would you fire them? Of course;
therefore, why would we let them run a Nation ‘The People’ built from the
ground up? The right to vote goes beyond marking a ballot, simply so you have a
“right to complain” (the old theory, if you do not vote you do not have the
right to complain); this theory does not hold water to say the least because,
if you vote the tyranny in –you have no right to complain either. We ‘The
People’ have to shed this half-ass patriotic attitude, and devote ourselves
fully to this country and its electoral process –for if we do not –we will reap
severe consequences.

   In conclusion, America has a broken
medical system that must be addressed firmly; if indeed the issues within these
programs are not addressed, the American public will suffer severe consequences
–especially the old, vulnerable, and weak (not to mention our military vets
that utilize these services). The healthy and rich are making choices that affect
the sick and poor  -this is the main
problem; one cannot possibly know what the sick and poor need –unless they have
been sick and poor themselves. Additionally, I bet if these officials were put
in a position of illness and poverty –the decisions they make afterward may be
different. Finally, nations that act and decide selfishly will fail and fall at
the feet of the sick and meek –history has proven this fact.

  Side Note: Best Hospital in the Country for overall service is St. Charles Medical Center in Bend & Redmond Oregon…

Worst Hospital in the Country  for ER care and attitude is Helen Keller Hospital in Muscle Shoals, Alabama scoring an F for rudeness and inefficiency 

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