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Old 07-24-2011, 07:00 AM   #43
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Well, I'll throw my two cents in. Being politically correct with government has never been one of my strengths. Ooops.

The confidentiality of our medical records has never been truly secure. True confidentiality would require a level of moral character and moral center that is simply beyond the grasp of people who can all too easily be compromised. A sad but true fact.

Having medical records become electronically accessed by persons not actually within the office where hard copies reside just adds another dimension to that.

People will be people.


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Old 07-24-2011, 08:01 AM   #44
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jason, thanks for posting the information.

i've seen many doctors over many years. i've often offered new doctors my old records but only once has a doctor wanted them. they just seem to only want their test results. it will be interest to see how much use this system gets.

it relates to airstreams because i feel better in my trailer and might not need medical care if i stay in it more often. :-)
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Old 07-24-2011, 10:07 AM   #45
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The issue here is that our system is broken, simple as that. While we do have fantastic technologies as Dr. Zigi points out we still lag behind many countries in life expectancy and birth survival rates. Why is that?

IF you can afford care in this country you will be fine. Because we have so many who can't, the statistics get skewed and that is where we are in this, the greatest country in the world. Those that have, get, the others do without.

Zigi points out that anyone can walk into a hospital and get care. That probably is true but what about access to all things preventative? It is a very complex issue. People who can not afford health insurance do not get the care they often need.

I have health insurance but I pay dearly for it, like in the low 4 figures and no, it isn't diamond level coverage either. So, as a retired public sector employee I pay more than $1K each month to cover myself and my wife at the same time many others pay little to nothing for their coverage. The system is broken. Now if you are a doctor, things might look a little better to you. I know of a couple who work in a hospital and pay nothing for their coverage, nothing. Those that have, get.
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Old 07-24-2011, 10:27 AM   #46
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Whats going on here Your all getting off topic on my off topic
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Old 07-24-2011, 10:36 AM   #47
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Having been in the military, I'm pretty sure the US Government pretty much has my health records. All the dire predictions of what happens when the government has your health records haven't come true, at least not in the past 40 years. If anything, the government doesn't want me in the system so they don't have to pay a claim I may initiate. You know "the government is here to help, but first we have to see if you qualify, then there are the forms to be completed in triplicate, then we'll need to schedule a visit to set up an appointment to discuss the need for someone to review your paperwork that seems to be missing some important data, etc. etc, etc, etc, etc, etc, was this stage 4 carcinoma, let us review this and we'll get back to you"
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Old 07-24-2011, 10:43 AM   #48
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Whoops. You are correct and I am sorry for changing directions.

On your off topic, I actually think that sharing health records was supposed to be a good thing not so long ago. I remember there being a move to reduce costs and one of these ideas was to go to a computerized system of record keeping to help keep costs down and to prevent errors in treatment. At the time it sounded pretty good. I know as a patient that I had to wait many times for them to "find" my records and I was never sure if they were complete when they did get them.

But, your points are well taken in today's world of computer hacking and information selling. The real issue I see is how insurance companies will deal with this information should they get their hands on it. I don't trust the insurance companies if you haven't figured that out.
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Old 07-24-2011, 10:48 AM   #49
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The issue here is that our system is broken, simple as that. While we do have fantastic technologies as Dr. Zigi points out we still lag behind many countries in life expectancy and birth survival rates. Why is that?

IF you can afford care in this country you will be fine. Because we have so many who can't, the statistics get skewed and that is where we are in this, the greatest country in the world. Those that have, get, the others do without.

Zigi points out that anyone can walk into a hospital and get care. That probably is true but what about access to all things preventative? It is a very complex issue. People who can not afford health insurance do not get the care they often need.

I have health insurance but I pay dearly for it, like in the low 4 figures and no, it isn't diamond level coverage either. So, as a retired public sector employee I pay more than $1K each month to cover myself and my wife at the same time many others pay little to nothing for their coverage. The system is broken. Now if you are a doctor, things might look a little better to you. I know of a couple who work in a hospital and pay nothing for their coverage, nothing. Those that have, get.
I completely agree with your assessment that our health care system is "broken", in that we cannot provide all levels of care to all people. I have no immediate answer, and have struggled with this dilemma for as long as I can remember.

One of my colleagues explained that he thought we will evolve into two types of health care: Preventive--such as vaccinations, cancer screening, mammograms, lab testing and the like to afford folks information as well as basic treatments--and we all can agree that everyone should benefit from this type of care....

The next tier of care would be "Advanced" and herein lie the problems. Should a chronic alcoholic and smoker receive a heart and lung transplant which, because of the costs, would exclude the basic heath care to many, many others? What about the knee replacement? .....the ethical questions emerge hauntingly.

There is the question of being able to fiscally support health care. This is beyond my "pay grade" to comprehend. The insurance industry drives us all crazy as patients because they "cherry pick" subscribers who they believe will need health care and deny those with pre-existing conditions, and many of us have preexisting conditions.....it is not fair. But a government endorsed system is not the answer.

As the government ratchets down the reimbursements to hospitals and health care providers, even for the basics of health care, then there will be increasing refusals to see those patients....that's US folks!!!! Then our only recourse will be the emergency rooms which will be inundated with similar patients. We will compete for health care with folks who now have "government insurance", have no physician relationship, or cannot find a physician...remember the numbers of available physicians compared to the population requirements is declining....or the physician will not accept patients with that particular form of reimbursement ( which is not enough to meet overhead expenses-before personal salaries!). I have seen patients go to the ER for a sore earlobe(!!!) because they had FREE "insurance".. i.e. medicaid.

Obviously medicare is in trouble as well as Social Security. When SS was started, the average life span in this country was 59! SS benefits started at 65! The math is obvious. ( In 1900 the average life span was 48...at the time of Christ it was 34) We will most likely take more from these programs than we "contributed".

I agree that this thread doesn't apply to Airstreaming other than it affects us all, and brings to our immediate attention that our " meter " is running out and we had better be focused on having a helleva good time in our remaining futures.

Ps. No, as an Ob/Gyn I couldn't make house calls. ( home deliveries are for pizzas, not babies :-) ) but my father did as a primary care doc, and my dad taught me charity and service- for which I will be eternally grateful.

Pray for solutions. We desperately need them! God Bless....Zigi
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Old 07-24-2011, 10:49 AM   #50
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I think we have two different discussions going on here. First is Jason's info about electronic medical records, and the other about the state of healthcare in general.

I don't mind my records being electronic. It should make for less paperwork, speeding up the process all around, and in the long run save money. However, there is room for abuse, and it should NOT be tolerated at all. After I "opt-in", (read my earlier post), NO person or entity should be allowed to use, disseminate, sell, etc., my info without my express written consent. This goes for private business and especially the government. (Florida has sold its residents info for millions, and should be required to give the residents the money back).

Now, can this info be hacked? Sure it can. I understand that nothing is perfect. But safeguards should be in place, and that is all I could really ask for.

I think we have great healthcare in the USA. The problem is if you can afford it or not. There are many issues that effect affordability, some of which most people don't want to admit. However, our government doesn't run things very well, and I personally don't want them to have total control over healthcare.

The next thing you know the government will tell me what kind of polish to use on my trailer, tell where to go to have it repaired, where to camp, and then turn around and sell all this info online!
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Old 07-24-2011, 11:02 AM   #51
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Yep Jason, We all went off topic, on the off topic, of the off topic thread!! Whew!!!
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Old 07-24-2011, 11:03 AM   #52
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Zigi, My wife did OB with her family practice till I made her give it up after the twins. To much time away from home.

The problem isn't really the health care. It's the insurance companies. Zigi you know what I'm talking about.
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Old 07-24-2011, 12:01 PM   #53
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Reform in the keeping of health records has been needed because docs have poor penmanship and trying to read them fast and accurately is often impossible. Many have switched to computers and when the records are printed, they can be read. Having examined doc's reports, they are often incomplete and full of conclusions rather than facts. But that's better better than when they were written.

If I am on the road (Airatream connection) and have to see a stranger/doc, I want him or her to be able to access my records. Only through an online system can that be done. In the long run, this should reduce overall costs as more people will be treated properly.

Right now with full Medicare coverage I am paying $4,000/year. Then there's the money I paid into it for many years. I need the system (and records are only part of it) to be efficient. If Medicare is changed to a voucher system, I will have to pay far more and probably won't be able to get insurance that actually covers anything I have since by now I have many pre-existing conditions. My wife, not yet eligible for Medicare, will have the same problem. We may not be able to afford travel if Medicare is gutted, and may have to sell our Airstream. We need an efficient system.

I have talked to docs who live or worked in other countries with universal health coverage. They are/were happy with these systems and got paid very well. Those systems (Canada and France) were far simpler to work with. One can find problems with any system—they are created by imperfect people—but the statistics prove the US is failing.

Records are one part of the larger problem of making the system efficient. The costs of changing to a universal health care records system are being subsidized, generously it seems to me. It's a pain to change anything and it takes time, experiments, mistakes and successes. When I was working, I hated it when the state supreme court changed rules and forms because I had to learn something new. Many new rules made sense, some I didn't agree with, but I had no choice except to lobby the bar ass'n and to accept them.

My father was a general practitioner long ago—he had to retire at 57 in 1970 because of a heart condition. He opposed Medicare, but when it happened, his income doubled showing how many seniors weren't getting health care. When the tables turned he was glad to have Medicare. The AMA opposed Medicare and soon docs lost control of their practices to the insurance companies' whims and bureaucracy. With this, it is clear, there is an ever increasing shortage of docs. Other countries do not have these problems.

Changing to the new realities is stressful. Docs want to help patients and too much time is spent with contradictory requirements. Efficiency is necessary and it's coming regardless of politics.

Records reform goes with other reforms and changes. Each part of the system is dependent on another, so it;s hard to talk about records reform without talking about the entire system.

And Jason, I think it is great you help your wife with your 4 children so she can actually practice medicine. Many women docs practice part time because they have families and it is good to have a helpful husband.

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Old 07-24-2011, 12:45 PM   #54
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AND what is the alternative, what we have now?
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Old 07-24-2011, 01:06 PM   #55
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Zigi,

The problem isn't really the health care. It's the insurance companies. Zigi you know what I'm talking about.

I couldn't agree more! Now keep that thinking going as you listen to some of the "options" that are being placed on the table. I fear the insurance companies far more than I fear other alternatives. Talk about death squads!
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Old 07-24-2011, 01:17 PM   #56
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In a perfect world, having all my medical records available electronically would be a good thing. Unfortunately, I have visions of someone that either has no idea what HIPAA is, or doesn't care, disseminating my personal info, or selling them to a pharmaceutical company to mine for advertising. I'm also not thrilled about some bureaucrat somewhere deciding he wants to look over some records. It's not supposed to happen, but I know it does. Having "the world at their fingertips" would make it easier for a nosy office employee, or somebody that needs some quick cash. Call me paranoid (thanks).
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