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Thread: sinner's thread

  1. #1
    Senior Member
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    Default sinner's thread

    apparently it has been locked. i posted this am, then went out to train with my wife, so i don't know what happened.

    i'd like to publicly apologise to sinner if it was my post that precipitated it. that story needed to be told and should have stayed on the board for a long time.-Paul
    there's no good reason to fatten up a retriever.

  2. #2
    Senior Member YardleyLabs's Avatar
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    Quote Originally Posted by paul young View Post
    apparently it has been locked. i posted this am, then went out to train with my wife, so i don't know what happened.

    i'd like to publicly apologise to sinner if it was my post that precipitated it. that story needed to be told and should have stayed on the board for a long time.-Paul
    I assume sinner deleted it himself. I had actually prepared a reply that failed when I submitted it because the thread was gone.

    I agree that the case described represented an instance of an insurance company making a decision on the need for medical care that overrode the desires of the treating physician. This happens every day. The commercials about how health reform will invite bureaucrats into making medical decisions ignore the fact that the bureaucrats have already won. Unfortunately, they not only control the treatment offered, but do it with no liability for the consequences of withholding care.

    The decision made in the story told hinged on the fact circumstances of a patient's living condition relative to the medical care provided. Many patients, at the time of discharge, still need ongoing care and without it are likely to face serious consequences. Historically, health care providers considered this in making discharge decisions. Today they still know the facts, but cannot extend treatment based on the results of that assessment.

    In 2001, my father had minor hernia surgery. He was 77 years old, lived alone, and had a history of heart problems, cancer, and recently completed chemo. Normally the procedure would have been performed on an ambulatory basis. Because of age and condition, the insurance agreed to an overnight stay. His doctor wanted to fight to get approval for another day in the hospital, but my father told him not to bother and went home. A physician friend tokk my father home and scheduled to check in on my father mid-morning of the following day. The friend woke up worrying and went to my Dad's house at 7 AM instead. My father was lying unconscious and blue on the floor of his kitchen having aspirated vomit while asleep. 14 days and $250,000 later Dad was much better.

    The "insurer" in this case was Medicare, which is actually much more flexible than private insurance companies in similar situations. Had my father not prevented the doctor from intervening, Medicare probably would have approved the additional day. However, my Dad's doctor told me that private insurance companies would almost never make an exception under similar circumstances.

    My own view is that cost control by third party payers is necessary given that patients are not in a position to make economic decisions about health care. However, there needs to be oversight on how those decisions are made and insurers should not be held harmless with respect to the consequences of their coverage decisions.

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