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Provider Perspectives
What’s it like for doctors under the current health care system?
Dr. Bill Albers, a pediatric cardiologist, has practiced medicine in Peoria since 1967. He is also member of a group called Physicians for a National Health Program, a group of 15,000 doctors advocating for health care reform. Dr. Albers discusses many frustrations facing physicians operating under our current broken system. Any reform plan must meet certain requirements. For instance, it’s imperative that Medicaid reimbursements be fair and timely, that systematic waste within the delivery system be squashed and that any state or national reform proposal not “band aid” issues or scrimp on benefits. Change must occur though, says Dr. Albers. Too many Americans are uninsured, underinsured or drowning under escalating costs and these factors undeniably correlate with health, wellness and care.
One of Dr. Albers most heart-wrenching experiences in his medical practice involves taking care of children when they are minors and then watching what happens when they turn 18, 22 or 24, no longer qualifying for Medicaid or their parents’ health insurance. What’s so troubling about this group of young adults is that many had previously done so well with treatment, then suffer major problems when they can no longer afford care or become uninsurable due to their pre-existing conditions. There is one case in particular, a patient of Dr. Albers since the age of 6, who had an artificial valve in his heart. To manage this condition the patient had to take medication to prevent blood clots and engage in regular maintenance doctor visits. But that young boy grew up, was booted from his parent’s insurance plan and did not qualify for disability. No health insurance company would take him on and he feared falling further into medical debt. He was proud man and would not accept charity care with his doctor’s office, rather deciding to manage this condition himself. That patient had a severe bleed in his spine, became partially paralyzed and ultimately died. This case is especially tragic because at least Dr. Albers’ patient was offered free or low-cost care. Most practices cannot afford to offer that. Too often uninsured patients who pay out of pocket for treatment “get substandard care and substandard outcomes,” says Dr. Albers.
Even if the consequences are not so grave, the cost of medical care remains the sole factor that uproots security and mandates life choices for many. Dr. Albers tells the story of one family who had a child with a relatively benign heart condition but no private company would insure them. The father was a self-insured carpenter and the family had to move from North Carolina to their original home in Quincy so that the grandparents could baby sit the children while the mother went back to work as a teacher in order to gain health benefits. Dr. Albers has witnessed much in his years of practice and believes it is both “immoral” and “indefensible” that we as a people leave millions uninsured here in the U.S. He goes on to say that more political leaders need in-depth knowledge of the health care delivery system with tools to be able to dispel fact from myth as proposals for change are introduced to Congress.
The Campaign for Better Health Care (CBHC) supports Illinois Covered, a state-run health care program currently being debated within the Illinois legislature. While both Dr. Albers and CBHC believe that ultimately a federal solution is needed to solve the national health care crisis, we can agree to disagree on how to get there. Dr. Albers voice needs to be heard because his story highlights the fact that most people, doctors included, see eye to eye upon at least one thing. We believe that our current health care system is broken and inefficient, that too often insurance status dictates care to the detriment of doctor-patient relationships and that we will remain on this awful path of great spending and limited return until the flaws within our present health care system are fully addressed.
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