Tag Archives: health care

America Has a Problem, and We Refuse to Face It

licensed from Adobe Stock

On June 30th of this year, America achieved a milestone that set this year apart from previous years. And no, it had nothing to do with eating contests or Celebrity Jeopardy. No, this had everything to do with how many mass killings we achieved in the first half ot this year. We had 28 mass killings (more than four deaths in one instance) wheras in 2006, we had 27.

27 of those deaths involved guns (4 of which involved AR-15s) and one involved an arson, so this could easily be one of those articles about how guns are out of control. But I’m going to spare you from that. Instead, I want to talk about something more important, a factor that we should have been talking about a long time ago.

I’m talking about mental health.

One thing I’ve always found to be interesting is that after one of these minor massacres, politicians tend to stake them out on specific platforms. Liberals will generally commit themselves to the idea that guns need to either be removed or regulated while conservatives will pretend guns don’t exist at all and say either we need more thoughts and prayers or they will talk about the need for mental health focus.

And then they’ll never mention mental health again.

The reality is that we need mental health coverage and focus for a lot of people who have been targeted as needing such coverage, but in reality that costs money, and one thing conservatives won’t do is spend money, unless it’s to cover defense spending.

And while liberals are generally for mental health coverage, they’re generally not interested in focusing on it as long as their energy is centered on controlling or eliminating guns.

The biggest problem we seem to be facing is that neither side is capable of focusing on more than one issue at a time. But it shouldn’t be hard to see that if we started to focusing on mental health, we might solve one of the bigger problems that has reared in American society.

Let’s look at mental health in recent history: In 1967, the Lanterman-Petris-Short Act allowed for those struggling with mental health to be placed in mental hospitals in hopes of improving their mental health. But there were a lot of problems during this period, including horrible methods of treating those in custody. In 1977, President Jimmy Carter created a presidential commission on mental health with the idea of reforming a lot of these procedures. In 1981, when Ronald Reagan became president, he ended the Lanterman-Petris Short Act and pretty much kicked all of the people with mental health issues back onto the streets. Today, we don’t have much of a process with dealing with mental health issues unless police or medical officials can get a patient to admit that he or she intended to cause someone else or themselves some type of bodily harm. Then, and only then, can they admit someone into a medical facility as a danger to themselves.

That’s where we are today and why police services have such a hard time handling risky cases of potential mass killings. Their hands are tied, and the citizens are left fending for themselves.

Unfortunately, the only way to solve this is to either be viligent all the time (which is practically impossible) or for our elected leaders to do something to protect the people. Either this has to happen from Congress, which is the entity that in all theoretical terms should be the one to make such a thing happen. However, the president can do so as well through executive order, although ironically such an order would be constitutionally appealed by members of Congress and then sent to the Supreme Court, which in today’s environment, would probably reject the order on those grounds. That would leave a challenge to the Supreme Court, but if there’s no court case that is making the grounds to the Supreme Court, then they have no grounds to hear one. It is doubtful another fanciful cake bakery case would make its way to the Supreme Court covering this issue, so that’s not an option either.

In the old days we’d argue that if we wanted to get such a thing done, you’d need to write your member of Congress, but our country now exists within a vacuum, meaning that our representatives rarely respond to our interests any more these days, so one can only wonder if the second half of 2023 is going to lead us to reach another zenith in numbers of mass killing deaths.

For context, in 2019, there were 46 mass killings. We’re now at 28, which means we’re 18 away. I hope we don’t continue this trend. But all I have is hope, which isn’t much considering both hopes and prayers haven’t helped us in the first six months of this year.

A Small Sliver of the Health Care System in America

Okay, Story time with the Legospaceman: (either you’ll find it interesting, or at least it will let me blow off some steam)

The doctor who put a graft into my arm (who can’t seem to remember if it was a fistula or a graft) was told months ago that I had lost all feeling to the index finger of that arm. He indicated that was normal and that the no feeling and numbness would go away. A month after that my finger started to feel pain.. He looked at the finger and said “It’s healing”. The next few months were series of the nurses at the dialysis center constantly indicating that they didn’t think it was getting better. Calls to the doctor were impossible to make because no one answered. Finally, I walked into the clinic and said I needed to see the doctor (of which I had been informed that this breached some kind of unwritten protocol). Saw the doctor. He looked at the finger and said “I really think it’s healing.” Fast forward another month and the head nurses decided they were going to contact the nephrologist and inform him that in their opinion something needs to be done. Get an appointment and he arranges a new surgery to repath the graft (or fistula). A few weeks after, he sees me again and says “it’s definitely getting better.”

Anyway, about seven months of this have taken place, and I’ve been in pain the whole time. Advance a few more months into this timeline and I see him once more because “no, it’s not getting better.” He sends me to a plastic surgeon with the idea of cleaning out the debris that has accumulated as this finger was “getting better”. The plastic surgeon says he doesn’t want to clean it out until we’ve had an xray to make sure it’s not infected (which means he’ll have to amputate part of the finger). I go and get an xray and it turns out that the finger is NOT infected. I go back to the plastic surgeon and he says the only option is to amputate.

This is kind of where I am now. My nephrologist has honored my request of getting a second opinion, so now we’re in a holding pattern waiting for some mysterious doctor to entertain me with a second opinion. Meanwhile, my finger has made it so I haven’t had more than two hours of sleep most nights during this period.

Navigating the mess we call health care in America…and solving it!

The time finally came for me to have to decide on what medical plan I was going to choose for myself as I no longer hold the job I used to hold, and my options are either find health care for myself, or pay extortion rates to fund COBRA from the last job. As anyone who has ever used COBRA before knows, it’s massively expensive and really not worth the amount they require you to pay.

So, I went on the health care exchange network, and let’s just say that they don’t give a whole lot of qualify information. Oh, they give information, but it’s a lot of numbers and charts that when you start to analyze it, well, it doesn’t make a whole lot of sense. I kind of wanted a list of what I’d actually be paying for, but because our system is so badly designed, the information is constantly hidden behind numerous clicks of continuous clicks.

I used to be with Priority Health (which was my employer’s plan of choice because, well, they owned it). Turns out, it’s horrible when you have to actually pay for it. Turns out, it wasn’t all that beneficial back when I actually had it. It was ALWAYS expensive, no matter how many “We’re the best plan around and here’s a six page document explaining why” notices we kept receiving from the company.

So, I’ve been trying to get actual information on which plan to choose right now, and let’s just say that I’ve been kind of going back and forth, trying to get that information. I called one plan to ask information, and after two hours on hold, I finally got someone who sounded like he knew less about their plans than I did. Not good.

So, that’s kind of where I am right now. Hopefully, I’ll have this fixed, in this century.

Edit: Got off the phone with Blue Cross/Blue Shield a few minutes ago. They solved the whole situation for me. So, no more complaints, which means I now have to go out of my way to find something to complain about. Sheesh.

The Underlying Problem of Giving Them the Pickle

Pickle

Just recently, I was working for a health care organization that seemed to be having some difficulty in customer service. As a result, the higher-ups thought it would be really beneficial if the education department (of which I was a part) took up the task of teaching customer service to the front line employees, specifically the people who engage patients when they come to the hospital system. So, after a few meetings that consisted of management explaining how customer service needs to improve (in which I was reminded of the infamous pro dominant adage of “We will beat our slaves until moral improves” but I digress), we were then shown a motivational film that’s been making the circuit called “Give Them the Pickle.” In case you’re not familiar with this film, it features the creator of the ice cream parlor Farrell’s as he explains how a customer got really upset in one of his establishments because he asked for an extra pickle and was then told that pickles are extra, or something like that. This started a whole series of adventures where this owner decided to change the customer service model of his franchise forever. There may have been an “and they lived happily ever after” at the end of it as well. I’ll admit, it was motivational and it was a good presentation. But it seemed to miss a few things, specifically when dealing with the company where I just worked.

First, the problem inherent in our company has a lot more to do with service than just customer service. To begin with, customer service tends to be lacking WITHIN the organization, so that quite often it can be a bit difficult to deal with other parts of the company because of the silos that have been created and maintained. When you have that sort of atmosphere going on, telling those same employees that they now need to focus on customer service when they’re having enough trouble providing company service to each other, well, there’s a dysfunction already harming the larger issue.

One day last year, I was on the bus near the main hospital when I overheard a conversation between a bunch of the passengers. One said something about our hospital, as in he’s never been there and people always told him to avoid it. And then people chimed in about how the people that worked there were rude, the services were all overpriced, and not a single one of them failed to mention our competition as the better facility to go in case you ever need health care needs fulfilled. I brought this conversation back to my organization when I first heard it, and the immediate response I received from management was a reinterpretation of the message, that they were complaining because they couldn’t afford the good health care that was provided by our establishment, not that it was overpriced; when it came to the customer service part, they just continued talking about how because they were already miffed at the prices, they would interpret anything else as negative. Basically, they had solid information from people who were complaining, and the response was that obviously they were confused about what they were complaining about, so nothing needs to be changed.

This is the organization that now needs to “improve” customer service by teaching employees how to give free pickles as ice cream parlors. Keep in mind that we don’t give out free health care, free testing supplies (or tests), cut rates on surgery, an actual better product than any other health care facility (even though the argument keeps being made that they do, based on a sample size of none, as statistics don’t really make a lot of sense when you’re comparing to yourself (one divided by one still does manage to equal one).

So, how do you improve customer service when you actually don’t pay any attention to the public to whom you are now supposed to be providing better customer service? The simple answer is you don’t. The solution isn’t really a riddle, but an acknowledgement that perhaps we need to go out into the population and talk to them, find out what they would like from a large hospital system that claims to know what they need without actually asking them, and perhaps worrying less about pickles and more about why people might be there in the first place. I was in the hospital last year with a kidney problem, and I was scared during the time I was in there. One of the worst doctors I’ve ever experienced was one who was actually from the place where I worked. She didn’t care one iota about how her patients felt, and she was kind of a moron as well (which as a communications person, I attributed to the fact that she had zero listening skills, which made her diagnosis work absurdly bad).

Which brings me back to the whole communication aspect of this whole situation, which you probably should have guessed it would come in at some point or another. If you want to figure out what’s wrong with your customer service, talk to your customers and try to find out. It’s a good thing to look at comment cards and all that, but quite often a comment card is one of those things logged AFTER a bad experience, which means you don’t really have the opportunity to fix what was wrong, and like the place where I worked, they probably never will.

Some of these things should go without being said, but unfortunately I think that’s the problem. They haven’t been said, and thus, people are now convinced they have the answers after having watched some old entrepreneur talk about giving pickles to customers when they ask for them.

Supreme Court health care decision reveals how clueless mainstream reporters really are

Like a lot of other people, I was waiting on the Supreme Court decision over health care legislation. At the time, I happened to be in the hospital awaiting the decision, but that’s really not a significant factor. However, when CNN, and then Fox News, announced the decision IMMEDIATELY after it was written, I didn’t get very excited. The reason being: I figured they’d probably get it wrong.

And they did. CNN first reported that it was repealed. It wasn’t. Fox News then announced something equally stupid, and they were wrong as well.

The important question is Why did both of them really screw up the decision?

Well, the answer is simple. Reporters write differently than Supreme Court justices. You see, the reporter process is to report the decision first, and then they continue to write the story, filling in relevant facts later. The most irrelevant facts are left for the end, just in case an editor has to snip the end of a story. This way, the important parts of a story remain untouched.

The Supreme Court doesn’t work that way. If they issue a 30 page majority opinion, that means that somewhere on page 17 or 18 you might actually get the decision. Everything else is legalese and details that back up that decision. Quite often, you can read for pages and still have no clue where they’re going with the decision.

I learned this in graduate school when I used to have to write briefs on Supreme Court decisions. There were times when I’d read through the whole thing and still couldn’t tell you what was the decision. When you’re a reporter, you’re expected to be able to figure out that ruling quickly, and what happened was they failed at it. They kept trying to read the first few pages of the brief and basically got lost. So, when they got it completely wrong, it made complete sense.

That’s why I waited. I figured after a couple of hours, someone would actually read through the whole thing and then report what actually happened.