The great irony of health care reform

The great irony of health care reform is that really, nothing is new.  Everything, it seems, remains cloaked in secrecy.

Yes, there are things called exchanges now.  And millions upon millions of dollars will be spent on Internet, social media, TV, print, and radio advertising touting the law.  There will be counselors there to help people make an informed choice.

But there’s still a new complicated, unreadable law that promises much, but delivers, well, we’re still not really sure.  There have been so many promises, but no one knows (yet) what we’ve given up in return for the monstrous bureaucracy, new payments, and massive consolidation of doctors offices and hospital systems that this law has already created.

Sure, the least risky adult population under 26 can stay on insurance, but now millions of young people who make $20,000 per year will be signing up for something that costs one tenth of their salary annually ($163 per month x 12) and have no idea in the world what they’re getting (really) for their money.  They get well doctor visits, but what does insurance company B have over insurance company C, or company Z?  Why do people have to add a zip code on their websites — have some areas gotten political favors in exchange for lower costs when others don’t?

No one has a clue.

And that will total out of pocket costs really be in terms of co-pays and co-insurance kick in?  What happens when an insurance company refuses to pay for a service because it wasn’t the service they chose for people covered in their plans?

No one has a clue.

And how long will people have to wait for an appointment after January 1st, 2014 for their Medicaid care, in a system that already can’t pay its bills?  If my clinic’s any indication, today, this minute, it’s already a two and a half month wait for a routine follow-up appointment.

You see, there are only so many of us, and millions more patients on their way to Great Expectations now.  But as the new law has been taking shape, there has been downsizing, trimming of staff, more work for those who remain, and lots of doctors and nurses dropping out, moving on, or retiring early because they’ve been given sweet deals, or really had no choice.

Many are already frustrated, burned out, or getting to the point (sadly) that they really don’t care any more as more an more administrators are hired to tell health care workers how to work without doing the real work themselves.

So things will have to change under the weight of it all, and they will.

But for now, it’s all new, so enjoy.

Wes Fisher is a cardiologist who blogs at Dr. Wes.

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