Sorry you're going through this.

Government sucks; Obamacare sucks.

And many of the medical professionals I've dealt with in the last decades have been profoundly decent and proficient people.

But looking at medical organizations from below the level of doctors, the worst workers in America seem also to be working in healthcare... Bungling record-keeping, prescriptions, appointments, logistics and every other part of the enterprise. And when you point out their failures, and they feel no shame. They're psychopaths.

There are some truly horrible people in health care, and I sounds from this anecdote like you've met one.

This makes me love Swiss health care even more. I got a mammogram last year and I waited 15 minutes after the mammogram and then sat down with the radiologist who went over it with me, right then.

So, by the time I walked out of the appointment, I new all was good.

Whenever 'the government' mandates anything, from the form of communication of your mammogram results, to mine safety, to banking regulation - anything - the end result will always be worse, for the great majority of people, than it otherwise would, could or should have been.

There are 3 reasons for this a) the ideas of regulators always lag behind current technology b) regulators cannot conceive of a multi-level, multi-answer approach to anything, one size must always fit all and therefore their solution must always capture the wild outliers rather than addressing the vast majority and c) regulation more-often-than-not falls hostage to vested interests, political pressures and the status-quo.

llater,

llamas

The real problem isn't government, it's Kaiser.

"The government allows Kaiser 30 days" doesn't mean that they must take
30 days. It means that they're not in violation of the law unless they
take more. If they gave you the results while you stood there, they'd
also meet the deadline.

"The government says we have to send a letter" does not mean that they
cannot also use other means along with the written confirmation.

Kaiser is using the minimum government standards as their maximum
responsiveness standard. Some other insurance company that has some
actual interest in service would perform better.

Seconding Crid, I must point out that when the techs have paper minimum standards and no rewards for better service, they do as little as possible. Ask the MRI guy what the resolution of his machine is. If he doesn't know, you have yet another minimum-service worker. The ACA will perpetuate this among those in the program.

Ron hit the nail on the head. Hospitals have allowed insurance companies and the government to dictate what they do. They could use other means to disburse information or give better care than government minimums but they choose not to do so.

Years ago I asked my doctor how long I needed to stay in the hospital and he said that he would have to check my insurance, so doctors aren't excluded from greed or giving up their power.

Recently during a hospital stay I just wasn't ready to go home. They didn't look at my insurance, they looked towards my condition as it should be and took care of any paperwork necessary.

I'm not going to say that the latter hospital had it all right though. They talked about keeping me in the hospital when I went back in for complications to force coverage of an expensive medicine if the insurance company would not otherwise pay for it which is a whole mother issue but it all has to do with letting insurance companies dictate care.

Ron wrote

'"The government says we have to send a letter" does not mean that they
cannot also use other means along with the written confirmation.

Kaiser is using the minimum government standards as their maximum
responsiveness standard. Some other insurance company that has some
actual interest in service would perform better.'

and while true, it is not quite complete. Sure, Kaiser could set up a better process - to e-mail you the results, or put them on their website - but they will still have to send you a snail-mail letter, because that's what the Gummint requires. The Gummint cannot conceive of what the great majority of private businesses do these days, which is to offer you a choice - paper, or data? One size must fit all.

You can't really blame Kaiser for matching their standard to Gummint requirements - failing to meet that standard will get them in trouble, while exceeding it merely increase their costs for dubious benefits at best. That's what happens when the whole ethos of regulated businesses focusses on 'not getting into trouble with the regulator' rather than 'trying to do the best for the customer.'

My vet is not regulated by the Feds, and she provides me with answers on-the-spot and does everything by e-mail and website. But she's not going to be slapped with and exty-million dollar fine because she failed to send me a paper print-out within 30 days.

llater,

llamas

Look on the bright side: TSA didn't administer this examination. Just think of the convenience: physical examinations and airline screening at the same time!

Woo hoo! no?

Bungling record-keeping, prescriptions, appointments, logistics and every other part of the enterprise. And when you point out their failures, and they feel no shame. They're psychopaths.

*checks thread* Oh, so you're not talking about the VA?

And yes, we have some socialized medicine in the USofA. It is the VA. How's that working out?

Speaking of the TSA, and not to thread-jack, but I went both ways through London Heathrow last week, first time for several years. Flying Delta.

I was highly-impressed by the way I was mind-frisked, by the UK Border Authority on the way in, and by Delta on the way back to the USA. In each case, I was engaged in easy and non-intrusive conversation, which was obviously designed to figure out very quickly 'Who is this guy? Where has he been/where is he going? Why does he speak with one accent, but was born in a different country, but is a citizen of neither? Does his story have internal consistency?'

It was very well-done, and (I'm bound to say) the fact that the Delta questioner was a pretty young woman made it easy to miss what was happening.

Contrast that with the return to Detroit, a nightmare of yelling, confusion, misdirection and timewasting, all designed solely to fulfill the formulaic process. The only thing worse than the bored and sullen drones manning the CPB stations was the legion of yelling, rude and officious pr*cks in scruffy TSA uniforms harassing the passengers on every side. Welcome to the USA.

Not often I have praise for the Brits, but in this case they seem to have learned some lessons. Wish the TSA would.

llater,

llamas

I had my mammo and ultrasound a couple of months ago and had my results within 15 minutes of the tests. The radiologist came in, went over everything briefly with me and sent me on my way. A few days later, my doctor's office sent me an electronic copy of the radiology report, through the Next MD portal, which all my doctors use. Maybe it's an Orange County thing, or maybe it's just a Hoag physicians thing. Like others have pointed out, Amy it sounds to me like your situation may be a Kaiser thing.

But looking at medical organizations from below the level of doctors, the worst workers in America seem also to be working in healthcare.... Bungling record-keeping, prescriptions, appointments, logistics and every other part of the enterprise. And when you point out their failures, and they feel no shame. ~ Posted by: Crid [CridComment at Gmail] at December 4, 2014 12:50 AM

Any heavily bureaucratized field will attract (and/or create) workers who will perform the task to the minimum standard and no more.

You want a job, but you don't want to work? Get employed in a bureaucracy, preferably a government one.

With the advent of government-directed healthcare, we're seeing what was a huge bureaucratic nightmare get even worse.

==============================

You can't really blame Kaiser for matching their standard to Gummint requirements - failing to meet that standard will get them in trouble, while exceeding it merely increase their costs for dubious benefits at best. That's what happens when the whole ethos of regulated businesses [focuses] on 'not getting into trouble with the regulator' rather than 'trying to do the best for the customer.' ~ Posted by: llamas at December 4, 2014 6:31 AM

You can blame Kaiser for not doing their best for their patients, despite the government-imposed obstacles to doing so.

On the other hand, you also understand their need to comply with government regulation and their fear that exceeding government regulations will bring a lawsuit from lawsuit-happy patients who don't have e-mail claiming that they're not getting the same service and speed of response as the 1%. Social Justice, y'all!

The problem with emailing medical results is that there are HIPAA implications. I live in a pretty tech-savvy town and I don't know of any doctor around here who emails this sort of information, unless it's between providers with encrypted email and secured networks. HIPAA is one of those wonderful government regulatory tools that they used to harass the hell out of medical providers, and you'd better toe the line if you know what's good for you.

The problem with emailing medical results is that there are HIPAA implications. I live in a pretty tech-savvy town and I don't know of any doctor around here who emails this sort of information, unless it's between providers with encrypted email and secured networks. HIPAA is one of those wonderful government regulatory tools that they used to harass the hell out of medical providers, and you'd better toe the line if you know what's good for you.

Posted by: Cousin Dave at December 4, 2014 10:50 AM

The hospital here has an integrated system, where they create an electronic file, for your records with a secure log in.
The email will inform you when you have new test results, in your file, and also when you have an appointment scheduled. Not.....that......difficult.

> This makes me love Swiss health
> care even more.

We'd love your health care too, if we weren't indirectly paying for it.

For you.

Crid, the only way you indirectly pay for it is through pharmaceutical industry subsidies. It's private insurance, not gov't issued like most of Europe.

And judging by the price of my prescription drugs, we're paying the same as US customers, so I doubt you're subsidizing me at all. And, in fact, I subsidize you because I'm a US citizen and, therefore, must pay US taxes, even if didn't so much as set foot on US soil during the calendar year. I get no services from the US gov't and must pay taxes on all my income and report all my banking information to the feds.

"The email will inform you when you have new test results, in your file, and also when you have an appointment scheduled. Not.....that......difficult. "

From a technology standpoint, no. But from what I understand about HIPAA, they're flirting with the edge from a regulatory standpoint.

From a technology standpoint, no. But from what I understand about HIPAA, they're flirting with the edge from a regulatory standpoint.
Posted by: Cousin Dave at December 5, 2014 12:40 PM

I don't think so, because on the other hand parts of the ACA mandate electronic records.

A secure web site, with a personal log in, does not violate HIPPA.

http://www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/privacy-security-electronic-records.pdf

> the only way you indirectly pay for
> it is through pharmaceutical
> industry subsidies

This is grotesque and arrogant delusion. The countries of Western Europe are taking essentially no responsibility for their defense or for the provision of their vital resources. You spend your money on ludicrous servings of socialized medicine and giggle as if you've paid for them.

You have not.

That you would then come to American taxpayers to cluck about the comfort they've provided to you is despicable.

A. I'm an American taxpayer. If you'd like, I can send you a copy of my 2013 tax bill. It's ridiculously high, especially considering that I never set foot on US soil for all of 2013.

B. Switzerland doesn't have socialized medicine. It's all private. I pay for approximately $1200 per month for health insurance, with a $2700 per person deductible.

C. This gives me access to fantastic health care, it is true. Switzerland keeps costs low by 1. having standardized billing and 2. removing doctor's offices from insurance. Patients are billed directly and they submit to the insurance companies themselves. Saves overhead costs for everyone. I, for instance, don't even submit to the insurance unless we're hitting $2700. Therefore, they don't need to pay someone to look at each claim.

D. I have 10 years of working in pharma. I know pharma.

E. I agree with you that the US does provide defense of western Europe. That said, Switzerland has an active military and evey young man has to serve. We're prepared on our own, although if Russia wanted to crush us, I'm sure they could. If you don't like the US protecting Europe, you can speak to your elected representatives. Plenty of people would like them gone. It doesn't have anything to do with my health care costs. The health care costs in socialized medicine countries, yes. Switzerland? No.

Kaiser may be allowed thirty days, but my experience has been that I get test results much sooner than that. I can log on to my account and see blood test results as soon as they're completed by the lab.

Now granted, those aren't x-rays which require a radiologist to eyeball and "interpret" them, but still...

On one occasion when I had a rather nasty infection, hours after I had visited the doctor, I got a phone call telling me not to bother taking the antibiotics I'd been given. Instead, I was to come in and get some that would work on what turned up in the culture.

I have a feeling if the mammogram turns up something important, you will be notified. Your personal physician might even send a message to your Kaiser account.

(You have signed up on the KP.ORG website, haven't you?)

Sorry, I didn't think you'd come back for more:

> A. I'm an American taxpayer. If
> you'd like, I can send you a copy
> of my 2013 tax bill.

Yes, I'd like that very much. Send it to Amy's office here, and she'll pass it to me.

> It's ridiculously high

Renounce your citizenship.

> B. Switzerland doesn't have
> socialized medicine.

When the vast majority of your defense is handled by others, your economy enjoys all sorts of wiggle room not available to others. If you were carrying your weight, things would be different.

> C. This gives me access to
> fantastic health care, it is
> true. Switzerland keeps costs
> low by…

Who knows. Again, in the real world, your economy, and those of your surrounding continent, have little to do with the forces that sustain you.

> D. I have 10 years of working
> in pharma.

Irrelevant, and no one said otherwise.

> E. I agree with you that the US
> does provide defense of western
> Europe.

So maybe your tax bill is a bargain, eh?

> That said, Switzerland has an
> active military and evey young
> man has to serve.

To what purpose? In the next sentence, you admit it means nothing for the strongest international pressure you face yourselves; Vatican Hill notwithstanding, you're supplying no force elsewhere to the benefit of Western Civ. Are we to be impressed?

There's a pretty good chance that the mammograms are being read in India or thereabouts. That's become a common cost-cutting measure in the American medical business.

That makes it impossible to have a radiologist go over the x-rays with you 15 minutes after taking them - or ever, unless the overseas screeners found something that has to be reviewed. But the pictures and results are transmitted electronically, so normally results should be available overnight. If it's more than a few days, that's a bureaucratic blockage, not an essential element of the system.