Honored to know you, Joe. Can’t wait to read Beyond….

Too late to include this lovely trifecta in your book, but regarding
the inefficiency of current healthcare…

This week I saw three patients on whom I had ordered pulmonary
function tests–tests where patients blow into a machine that records
the volume and rate of flow to determine the efficiency of their lungs

1 report was received as an interpretation only, by the pulmonologist,
which mentioned that one of the parameters tested was decreased, and
recommended a repeat test in 1 month. This report was not accompanied
by the actual test results, so I could not tell if the decrease was
significant or not, and as it took the staff here several months to
obtain authorization for the test, there is no way in heck we’ll get a
repeat auth so soon without the full results. the parameter reported
as decreased, BTW, was the single most important measure on this test
for that particular patient.

1 test was received as results only, without the physician
interpretation. The automated interpretation mentioned a possible
problem in a function that is not represented by a single value on the
results that I can interpret myself, and there is no pulmonologist
report. This test, BTW, was done 2 months ago.

1 test report still has not been received in any form, and this was
done in November 2011. We have documentation of faxes requesting the
result, and I called the pulmonary department directly myself while the
patient was in the room–and nothing came over the next 48 hours.

BTW, these tests were done at two different hospitals, and one of them
now has a system where all requests for results must go through their
main medical records, an understaffed department full of people who
have no idea of the relative importance of the various requests they
get, so how can they prioritize which to respond to when?

Even if we can get the right tests done, when they’re not done in our own center, we don’t always get meaningful results.

Last night spoke with good friend who had heart surgery last month – hospital bill alone was over $100K. Hasn’t seen bills from surgeon, anesthetist, etc., yet. He was in the hospital less than 30 hours. Last year I was in the hospital less than 48 hours, no surgery, just observation: over $20,000. I keep thinking: what if we didn’t happen to be lucky enough to have health insurance?

When I was unemployed, I got a copper IUD (a non-hormonal form of birth control) from Planned Parenthood. Fortunately, they were able to secure funding for me to get it for free. After its insertion, I started to have extremely severe outbreaks of hives that would each keep me in bed for a week at a time with swelling bad enough to constrict my airways. After finding similar stories online, I went back to Planned Parenthood to see if the hives were related to my IUD, but the terms of my funding made it so that I would only find out whether or not my tests would be covered after the results were back. Because of my age and a few other factors, I didn’t qualify for aid from any other health plan. There was no way that I could afford the tests on my own, and I couldn’t risk the gamble. Seeing my frustration, the staff told me that it was just as difficult for the clinicians to be unable to provide care to low-income or unemployed patients because of such technicalities. I was only grateful that my brush with medical miseries did not saddle me with the expense of something like an MRI or with a worse condition to tolerate until I could afford the exams on my own.

‎$93,000 for my stents, including 3 days in a for-profit (HCA) hospital. I still had (COBRA) health insurance, but we had to declare bankruptcy soon after that, anyway.

I have been following Joe Flower’s thoughts in this field for some years now, and they are one of the few gleams of hope in the murky waters of our time–Joe Flowers’ ideas, writing, and suggestions are clear, partisanship-free, concrete thinking, usable now, by all who have a stake in the healthcare system in this country (and in the world)–which means, us all.

The 20 minutes I just spent talking with you were the most useful 20 minutes ever.

I am so looking forward to the Project promoting these ideas!