Adventures in Healthcare

I work in healthcare IT. I wouldn't exactly call it an adventure.

Does maintaining sanity count? :m172:
 
I used to work in Healthcare IT in uk
Not naming them, but a few years ago a large pct in England lost a ext hard drive with a lot of patients data on, they got fined a small amount ( around £100k I think) as they said the data was encrypted so even if it ended up in the wrong hands, it couldn't be accessed.

Anyway a few weeks later it turned up, as they said the data was encrypted, but the encryption key was stuck to the hard drive, they were fined a further £700k and put under IT review


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"oops. we didn't think it'd actually turn up..."

I used to work in Healthcare IT in uk
Not naming them, but a few years ago a large pct in England lost a ext hard drive with a lot of patients data on, they got fined a small amount ( around £100k I think) as they said the data was encrypted so even if it ended up in the wrong hands, it couldn't be accessed.

Anyway a few weeks later it turned up, as they said the data was encrypted, but the encryption key was stuck to the hard drive, they were fined a further £700k and put under IT review


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This is what I personally know. I apparently became sick in 2009 at the best possible time. I retained the same job but switched companies. I had excellent health insurance (I did not know how good until I started working where I do now) and with the switch to a different company it became even better. In short over 2 1/2 years I went in and out of the emergency room, had a hospital stay and saw multiple specialists. I had several MRIs, Cat scans etc... All and all racked up a bill of over 40gs none of which that I had to pay for other than low copays for the doctors visit that would order the tests.
Even so, none of them found anything that was causing my issue. None of them even gave me an idea where to look. With all of thoses tests all they could tell me is what I did not have.
I believe many people are under the false belief that there are "best doctors" out there. What you need are doctors who think. Not ones who step back and say "Well I cant figure it out, I guess its in God hands now."
In the end every single doctor I saw resorted to "Take this drug and see if it helps." So much so I started asking for medication after I did my own research and they would prescribe it.
Doctors are human. Human make mistakes, humans care about what they care about.
 
When my Dad was sick and dying of cancer, my Mom had to fight over the phone for almost a week in order for them to approve the medication he needed for the nausea. Finally, someone there didn’t brush her off and made it happen.
You’re Husband is dying and you are spending your time making frustrating and aggravating phone calls to insurance companies that you’ve paid for for decades?
Unacceptable.

Obamacare or the ACA is imperfect in my eyes because it still involves the insurance companies who have been the main driver of costs going up.
Supposedly (this is the BS we were all fed), the competition between insurance companies would drive down costs.
Really? When is that going to happen? Because we pay the most out of ANY country in the world and yet are ranked 47th in quality of care and outcomes.

I’ve seen it happen twice at hospitals where I worked…both were privately owned, and both got bought out by big Catholic conglomerates who immediately slashed benefits and the health insurance for it’s own employees.
The most recent one laid off 500 lower lever employees right before Christmas then gave the upper management million dollar bonuses.
It was all over the local paper.
Why is someone getting a million dollar bonus for laying off 500 people…fuck you.
They ended up having to scramble and re-hire most of them because the hospital could not function
(of course they were now paid less)….brilliant.

Sorry for what your dad went through. And yeah, Obamacare (like any third party payer system) is waaaay imperfect. It was nothing but a big gift to the insurance company lobbyists. Who benefits most from forcing (unconstitutionally IMO) everyone to purchase health insurance? I totally blame the third party payer system for the current crisis. I actually remember when a whole family could walk into their GP's office for physicals and annual shots, pay out of pocket and it wasn't some multi-thousand dollar drama. It was just a doc and his nurse (who doubled as the receptionist). Now, I notice usually 6-8 paper pushers at any regular, non-specialist physician's office. It takes often over a month to get an appointment, doctors often act imperious, their staff acts cold, like you are asking for an audience with the King or Queen instead of just a physical, there is all kinds of drama involving insurance, and everyone's exam, blood-work and shots run into the thousands, so yeah people can't pay anymore. And Obamacare has massive annual deductibles that basically apply to the income bracket that is the working poor. So what good did that do them? Everyone would have just been better off with an expanded Medicaid so long as we are sticking with third party payer. That or creating a system where more NPs and PAs could see routine issues at a reasonable cost (right now it still runs $160.00 out of pocket to see an NP for something routine like a UTI or sinus infection if you are even so lucky to get an appointment when you need it). Yeah, your average poor person will either go to the ER (where they will never be able to pay the bill back), or just get really sick, and then end up in the ER anyway (where they will really never be able to pay the bill).
 
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True story

Patient goes to hospital outpatient lab for routine blood work. Waits in line 45 minutes. Is told we cannot help you because we no longer take your insurance.

This is happening a lot!

True story.

My client - 9 yo with a rare genetic disorder - is steadily losing functioning. Family is barely below the income limits for the child to receive medicaid/ssi. She gets one of those prescription medication pumps installed in to her body. The month before she goes for a refill - which is a surgical procedure - medicaid cuts off because they "suspect" the dad would make a few dollars over the income limit. Mom tries to find a doctor/hospital who will perform the procedure....but they won't because they're not qualified.
Finally Mom begs the hospital to do the procedure because the drug is about to run out - and they decline.
Mom ran in to someone who knew someone who would advocate with SSA for her and she "happened" to get a hold of social security worker who did a back end work-around - and got the child reinstated back on medicaid/ssi.
THEN the hospital said they would do it.

All I can say it's a good thing I don't have photon torpedos.....
 
Regarding health care. There needs to be fixes applied. Everyone knows that. Socialists and conservatives alike. I think there are some up front fixes that would make everything instantly better for everyone such as putting some regulation on how much hospitals can charge insurance companies for their services. I mean common, $800 for two Tylenol tablets? That madness has to stop. It wouldnt even be that difficult. Just find some non bias intelligent people who know what they are talking about. Put them in a room and see what they can come up with.
Obamacare needs to be trashed and a real solution brought forward. But, how will that be accomplished?
 
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This is happening a lot!

True story.

My client - 9 yo with a rare genetic disorder - is steadily losing functioning. Family is barely below the income limits for the child to receive medicaid/ssi. She gets one of those prescription medication pumps installed in to her body. The month before she goes for a refill - which is a surgical procedure - medicaid cuts off because they "suspect" the dad would make a few dollars over the income limit. Mom tries to find a doctor/hospital who will perform the procedure....but they won't because they're not qualified.
Finally Mom begs the hospital to do the procedure because the drug is about to run out - and they decline.
Mom ran in to someone who knew someone who would advocate with SSA for her and she "happened" to get a hold of social security worker who did a back end work-around - and got the child reinstated back on medicaid/ssi.
THEN the hospital said they would do it.

All I can say it's a good thing I don't have photon torpedos.....

I think its safe to say that at a minimum in America, theres absolutely no reason it shouldnt be easy to do taxes and healthcare. You shouldnt have to guess whats going to happen should anything go wrong. You should know before you ever have to find out any other way.
 
This is happening a lot!

True story.

My client - 9 yo with a rare genetic disorder - is steadily losing functioning. Family is barely below the income limits for the child to receive medicaid/ssi. She gets one of those prescription medication pumps installed in to her body. The month before she goes for a refill - which is a surgical procedure - medicaid cuts off because they "suspect" the dad would make a few dollars over the income limit. Mom tries to find a doctor/hospital who will perform the procedure....but they won't because they're not qualified.
Finally Mom begs the hospital to do the procedure because the drug is about to run out - and they decline.
Mom ran in to someone who knew someone who would advocate with SSA for her and she "happened" to get a hold of social security worker who did a back end work-around - and got the child reinstated back on medicaid/ssi.
THEN the hospital said they would do it.

All I can say it's a good thing I don't have photon torpedos.....
I am a caseworker and I see this stuff happen a lot. I want to say single payer Medicare for all is the way to go, but stories like this and what I see make me skeptical of it.

I do really love my insurance. (I was a high risk pregnancy that required tons of stuff... And the insurance never once gave me an issue.) If single payer could be run like a good insurance policy...but then I guess you get what you pay for here..
 
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Women are treated for pain "less aggressively" -True Story
http://papers.ssrn.com/sol3/papers.cfm?abstract_id=383803

For all the bullshit inequality talk lately, this is actually something legit. If you are a woman, raise some damn hell if you have a medical issue of any kind. If you are going to really stop apologizing then the doctors office is the perfect place to begin practicing.
 
Regarding health care. There needs to be fixes applied. Everyone knows that. Socialists and conservatives alike. I think there are some up front fixes that would make everything instantly better for everyone such as putting some regulation on how much hospitals can charge insurance companies for their services. I mean common, $800 for two Tylenol tablets? That madness has to stop. It wouldnt even be that difficult. Just find some non bias intelligent people who know what they are talking about. Put them in a room and see what they can come up with.
Obamacare needs to be trashed and a real solution brought forward. But, how will that be accomplished?


It needs to go the other way though...it's mostly the insurance companies who are dictating price to the hospitals...so if they only pay 50 cents on the dollar for services that cost either gets passed to the consumer or the hospital preemptively charges ridiculous amounts to offset the insurance companies shorting them on payment.
 
Also more UK Healthcare It

Years ago we wanted to take some business from another company so we needed to show the client how our system worked with their data, they gave us a backup tape, but it was locked by the other companies protection we googled the name of that system, to our surprise the default password worked, I left in 2014, it was still working then.

Edit: I should point out that there is now a layer of encryption before you can get to this data,

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Since last Friday I've come down with a host of symptoms. Pain between my right shoulder blade and spine, which radiates onto the shoulder, neck, clavicle and down the whole arm, with numbness in the arm as well. I suspect it's thoracic outlet syndrome, but that doesn't matter right now. What matters is that the pain is interfering with my daily activities and something I should be focusing on right now.

My GP ordered a x ray and referred me to a physiatrist for further evaluation. Now the catch: The clinic doesn't have the materials for developing x ray images. Yesterday they said to come in 2 weeks, today they scheduled me in a fucking month. The physiatrist refused to see me impromptu twice despite me making it known this is a bit urgent to me. Getting a free appointment can take up to 2 weeks and the personnel told me to have the x ray done first. -_- Now I have it scheduled with my GP this Monday to see if she can mark my x ray as urgent or something. Fucking bureaucracy.
 
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Since last Friday I've come down with a host of symptoms. Pain between my right shoulder blade and spine, which radiates onto the shoulder, neck, clavicle and down the whole arm, with numbness in the arm as well. I suspect it's thoracic outlet syndrome, but that doesn't matter right now. What matters is that the pain is interfering with my daily activities and something I should be focusing on right now.

My GP ordered a x ray and referred me to a physiatrist for further evaluation. Now the catch: The clinic doesn't have the materials for developing x ray images. Yesterday they said to come in 2 weeks, today they scheduled me in a fucking month. The physiatrist refused to see me impromptu twice despite me making it known this is a bit urgent to me. Getting a free appointment can take up to 2 weeks and the personnel told me to have the x ray done first. -_- Now I have it scheduled with my GP this Monday to see if she can mark my x ray as urgent or something. Fucking bureaucracy.

You should have a meeting in the back alley when they get off work, and raise their hospital bills.

IF YOU KNOW WHAT I MEAN - *WINK*
 
True Story.

I met with an undocumented (illegal immigrant) hispanic Mom and her 9 yo son with cerebral palsy and a few other issues over a year ago. I tried to get her to sign up for CSHCN health benefits which is equivalent to medicaid....but covers illegal children. Even though we contacted her a couple of times she politely deferred and I let it go.

A week ago I get a visit from the Sheriff’s office representative, Laura, holding copies of the application with other info in her hand. She stated the Mom and family are petrified to sign up with a government program because illegals are being plucked from their homes and deported to Mexico.

Even though their son had NO insurance they still wouldn't apply due to their fears of being deported. This family arrived in TX back in early 2014 due to the violence (drug mafia related) in their villages and surrounding areas.

So I reassure Laura that no family has ever faced repercussions just because their illegal child was signed up and receiving health care assistance on the CSHCN program. She goes back...and talks to the sister....who talks with Mom's family...and they decide to trust me. She came to the office and completed the application with me and the interpreter instructing her to get the doctor to sign a form for eligibility.

The reason why the Sheriff's office rep was involved was because about two weeks ago the son was feeling good and decided to play with a soccer ball in their home...and broke his leg. They took him to the emergency room and he was fitted with a soft cast and released. They were told they needed to see a bone specialist. With no insurance and no real means to pay for a specialist they were forced to wait. In the meantime the child was not attending school due to the soft cast. When the nurse found out she contacted the Sheriff to investigate. After discussing what they found - the nurse called a Bone & Joint specialist to see if they would take on a patient who couldn't pay. By a miracle one doctor agreed and he was to see this doctor the other day.

The next day I'm on the phone with the head Administrators of the CSHCN program at the capitol of TX and I tell them the story of my undocumented client stressing he has no insurance at all...and ask them if there is way we can get him emergency benefits. You know...asking them if there is some way we can immediately put him on to receive services once his application is processed. Right now when people sign up they normally go on a waiting list.

Do you know they declined to even TALK about the possibility. They told me he would have to go on a waiting list.

This is what I see every day...
 
A patient complains to GP for several years of increasing abdominal pain. The GP ignores the patients complaints until the patients pain level increases to an intolerable level. The GP finally orders diagnostic imaging. The diagnostic imaging shows the patient has stage 3 ovarian cancer and will now be on chemotherapy for the rest of her short life.
 
A lady who shall remain unnamed went to her physician complaining of extreme pelvic pain and urinary urgency. He ordered a urine analysis, and said she didn't have a UTI and to go home and take some Motrin. She returned home and continued to experience pain and urgency. When she returned to her physician he suggested that maybe since her husband "traveled a lot" they should run a full STD panel. She knew this was not the case, but consented. Everything came up clean, and he diagnosed her with "housewife bladder," and "anxiousness". He prescribed her Valium suppositories to make sure her husband could still have sex with her (he seemed very concerned about this), as well as a med for over-active bladder. The pain became worse, the OAB med prevented her from urinating completely and she was in excruciating pain, so she stopped taking the OAB med and rarely got out of bed anymore except to pee. Upon further consultation, her physician joked that she was "the princess and the pee" and said she just needed to work on "holding it more." And maybe do some kegels. She insisted she was in horrible pain and pointed out that her abdomen was visibly distended. He suggested she was bloated and should go to the gym more often (she weighed 106 lbs). Soon she was urinating blood. Her physician's receptionist said he could not see her for another 6 weeks and suggested she go to the ER. At the ER they did a cystoscopy (tiny camera stuck up into the bladder) and discovered that this lady's bladder lining was riddled with ulcers and scar tissue. Cause unknown. Some relief was provided by washing the bladder with a special solution and prescribing medications appropriate for this situation. This patient suffered for over a year and had to pee blood before anyone listened to her.
 
A lady who shall remain unnamed went to her physician complaining of extreme pelvic pain and urinary urgency. He ordered a urine analysis, and said she didn't have a UTI and to go home and take some Motrin. She returned home and continued to experience pain and urgency. When she returned to her physician he suggested that maybe since her husband "traveled a lot" they should run a full STD panel. She knew this was not the case, but consented. Everything came up clean, and he diagnosed her with "housewife bladder," and "anxiousness". He prescribed her Valium suppositories to make sure her husband could still have sex with her (he seemed very concerned about this), as well as a med for over-active bladder. The pain became worse, the OAB med prevented her from urinating completely and she was in excruciating pain, so she stopped taking the OAB med and rarely got out of bed anymore except to pee. Upon further consultation, her physician joked that she was "the princess and the pee" and said she just needed to work on "holding it more." And maybe do some kegels. She insisted she was in horrible pain and pointed out that her abdomen was visibly distended. He suggested she was bloated and should go to the gym more often (she weighed 106 lbs). Soon she was urinating blood. Her physician's receptionist said he could not see her for another 6 weeks and suggested she go to the ER. At the ER they did a cystoscopy (tiny camera stuck up into the bladder) and discovered that this lady's bladder lining was riddled with ulcers and scar tissue. Cause unknown. Some relief was provided by washing the bladder with a special solution and prescribing medications appropriate for this situation. This patient suffered for over a year and had to pee blood before anyone listened to her.

The sad thing about your story and about all these stories is that they are so common here in the US.
I don’t know why anyone in their right mind would not want to go to single payer system and eliminate the insurance companies altogether.
We pay the most in the world for heath care and yet are ranked 47th for quality of care and outcomes.
We would not only save a shit-ton of money that is being funneled into the pockets of insurance companies, but it would free up a lot of the decision making that Doctors must now do (insurance and coverage should never be a factor in making a medical decision and yet it is commonplace to the point that no one thinks it strange when insurance denies something you have one or two or more Doctors saying IS)…not only do they have to figure out what is wrong with you, but they either can’t order all the tests you need because insurance deems it unnecessary, or the Doctors have to go the other way and order a whole bunch of tests to cover their own asses. Either way, it drives up cost and drives down quality.
There are many more example of course that I could give as to why we pay so much for so little, but I think you are probably familiar already.
Sad.
 
It is becoming increasingly difficult to find a doctor who is still treating patients as opposed to becoming a slave to insurance companies, drug companies, business mandates, and/or just plain laziness. More older doctors are choosing to retire early because the patient is becoming last on the laundry list of who to take care of. They are being replaced by younger doctors who are being taught and are willing to follow (without question) the current guidelines for substandard healthcare.

If people don't do their homework and research what their healthcare needs are, and then advocate for those healthcare needs, they can expect substandard healthcare, which, unfortunately is becoming the norm. The days of being able to trust your doctor and/or hospital with your life or healthcare are becoming extinct. Even those few and far between doctors who are still practicing the kind of medicine that puts the patients wellbeing first, are being worn down.
 
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