I once wrote about his experience with American medicine. Then the internet community has branded me a disgrace, and my claim to the very-very-best and perfect medical system in the world called unfounded. Numerous "experts" from the newly minted Russian patriots of America dubbed me stupid loser who, in their ignorance and stupidity did everything wrong. And I went in the wrong places, and did everything wrong, and generally fool! There is nothing to denigrate the best medicine! I will not make excuses. It makes no sense. Here I would like to tell about one contact with American medicine, also by example. At that time I was a little more prepared and knew in advance and materiel planned many things, unlike the first experiment. But, even though this is my impression of American medicine for some reason has not changed much. On the contrary, many of the shortcomings of the system that were not seen me before, now appeared in full. Well, let's continue unnecessarily vilify the best system in the world, and to slander the democratic medicine, well, you judge for yourself.
It all starts with the selection of
It was time for his wife to give birth. As it was planned cesarean delivery date was scheduled in advance. In the hour of "H" had come to the hospital for a scheduled procedure. The scheme works like this: born in a hospital / hospital, but accepts their gynecologist, who observed a woman. Gynecologist itself typically does not work in the hospital. He / she usually has its own practice. In this case, the hospital / hospital he comes only to take delivery. He there is a contract with the medical establishment, which gives him the space and resources. Typically, the gynecologist can deliver babies only at certain hospitals. Apparently, not all institutions have a contract, or well, the doctor prefers to work with some institutions, and other not. Exactly how this is determined by the gynecologist, I do not know. The fact is that when choosing a gynecologist as soon as you choose and the list of possible maternity hospitals.
In our case, the choice of hospital / maternity home was made very easy. Gynecologist, who observed wife delivered a baby only in a single hospital (the largest in the city). If you want to give birth in a different location, change the gynecologist! For lack of choice, the choice is very easy. In general, Americans are obsessed with the idea of choice, especially in the field of medicine. And then on to you. You can choose any hospital, under the condition that it will only be here this! Somehow, even un-American out. Or vice versa in an American, if you remember, Henry Ford and his famous statement about the color of the car.
The hospital was very modern. The new building, all neat, clean. When you register at the hospital's future woman in childbirth contribute to a computer is assigned an identification number, and put his hand on the bracelet with a bar code. Woman in labor may inform the identification number assigned to their relatives / friends, and they can track it by birth. In the lobby of the hospital is a place to wait, where relatives / friends are sitting on a pretty decent seats, follow what's happening. On the wall hung LCD monitors, which displays information about the whereabouts of a woman in labor and what was happening to her. At each stage of delivery in mothers bracelet is scanned and the information through a computer system hospital immediately displayed on monitors in the lobby. Now do not remember exactly, but, in my opinion, are monitored following stages: preparation for labor, active labor, birth, postpartum / post-operative recovery, post-natal ward. On the monitors, of course, no names and names did not appear for reasons of confidentiality. Show only an identification number and opposite it contains the stage at which the patient is with this number. Who needs to understand. Submission of the information is organized very quickly and accurately. Computer technology at height — very convenient.
At birth itself is allowed to take a small support group. In my opinion, allowed the presence of two people in addition to mothers, if normal delivery. At Caesar's allowed to take one person. And the family connections do not matter. It is possible though the first counter in the street called. Your business. Well, in our case, from the street no one agreed, so I had to go!
Because, as I said, the birth was a cesarean section, then looked more like a standard operation, not as labor. On the operating table is a screen covering an event from the eyes of mothers and support groups. I put a small chair with an end of the table, behind the screen, near the head of his wife and told her to sit and maintain morale. His wife is conscious but half awake from anesthesia. What was my role, I did not understand. As well I could sit up and over door. The whole process took about half an hour. In addition to the doctors, participated in the operation / 2-3 assisted by a nurse. I will not say exactly how many, because the screen is not very visible, and especially obbegat and assume he did not. I can only identify the voices around.
After the baby was born, it was weighed, measured the height and immediately put on both legs and one arm not removable plastic bracelets with credentials. Bracelets manufactured right here in the operating room immediately after birth. On the bracelet contains the mother's name, ID number, child's sex, date of birth, and birth weight. Bracelets with the same data immediately put into the hands of the wife and me. Bracelet hand remains on until until discharged from the hospital. With a bracelet sleep, bathe in the shower, etc. You can not remove it. You can only cut. According to reconcile their identity bracelet child's parents. Unnoticed substitute child with such an approach is difficult.
Immediately after birth, the child was taken away on a gurney in a small procedure. I went along with it, in order for all to watch. In a special incubator baby carefully inspected, crushed for everything is in place, something dripped eyes, and, in my opinion, have been vaccinated. Meanwhile, the newly made mother was transported on a gurney in the postpartum room where she should move away from giving birth. There also after the inspection, which lasted about half an hour, I rolled up on a small child's bed wheelchair. Needless postpartum room — it's just a big room with partitions in the form of curtains, behind which lie the others are the same patient. In this room, nothing happens. The woman is just lying on a gurney. Type rests. Periodically suitable nurses interested in how the patient feels, and ask if everything is OK. All it takes about an hour. After an hour of lying there, lying-in woman transported to a regular room. Why do we need an intermediate step, and why it is not immediately after birth to determine the ward, I do not understand.
More comfort and less restrictions
Permanent Court, which transferred after birth, provides for a stay in it, not only women, but also a husband and / or support groups. The House is single, but it also has a sofa, which can accommodate one more person. Chamber equipped very well. From furniture, besides the bed, in the House there is a sofa, armchair, coffee table, TV. Private toilet with a bathtub. Bed with changing angle of inclination and the multifunctional remote control. By pressing a button on the remote can cause the bed of a lying to a sitting position. Pressing the button, you can contact with the post of nurses on the floor (working on the principle of radio), asked to bring a cure. On the panel there is a button "pain." If you click it, then your request will be displayed on the console to the nurses, and they will know what you need to bring. All in order to make it easier to call a nurse and a nurse already knew in advance what they want from it, and captured what is necessary, and did not go to waste here and there. You can use the remote control to control the light in the House (turn on / off various lighting), and a TV. In general, the control — the dream of a bummer!
In short, the first impression of the hospital is very good: everything is new, modern, comfortable. In fairness, I note that we were in a new hospital building, which was built about a year ago. In many ways, this is why everything is new and modern. On the untrained person can all make a big impression. But it's a beautiful wrap that gradually decreases, and after it starts to appear not so beautiful content.
A newborn child is at all times in the House, together with his mother. Child, however, periodically take on all sorts of tests and procedures, but then (after 30-40 minutes) brought back. In short, the child is with you all the time in the House, from the very beginning. No way to unwind after delivery in women do not. Well when a cesarean birth, as in our case. If natural childbirth, which last a few hours? Immediately after this deal with your child a little difficult.
Here though, it all depends on the particular hospital. Some have a so-called incubator for children, where they can send their children, for example, at night, in others not. Rather incubator, then there is always, always there just is not possible to hand over the child's wishes. In the hospital where we were, the incubator was there but took only children who were born premature, weak or with any disabilities that require attention 24 hours a day. If the child is healthy, he is always with you in the ward.
As far as I know, in Soviet medical practice, a child the first time after birth is in an incubator under the supervision of doctors / nurses. His mother brought only during feeding. But, of course, it's all bloody machinations of totalitarianism. And here, it means freedom. Do not be under the window of his father hospital on duty to look afar on a child when his mother would bring a short while. You can simply take, and come straight to the House immediately after birth. And not only the father can and who you like.
In this regard, the hospital currently passing yard. Right after birth (after 2 hours, once placed in the permanent ward) of a woman can come visitors: relatives, friends and acquaintances. Usually walkers begin to stretch immediately. Visitors must register at the entrance, to name the person to whom go, give the number of wards, provide identification. After all this, visitor pictures, make a temporary pass (on the day) in the form of a label with the name and photo. This label is glued on clothes and go! However, never seen that data is missing someone checked. Theoretically, it is possible most any label with the name on the jersey stick to blend and go wherever you want. Well, I was just in passing. If desired, then, of course, any rules can be circumvented. Another call to report to the House that such and such came to visit, and specify whether you want it to be. You can, of course, refuse, but for some reason it seems to me that this rarely happens. I am sure many will feel uncomfortable, refusing to people when they have already come to the hospital and waiting at the entrance.
As the baby all the time in the House, visitors come mostly to see on him, cuddle. There are no strict rules of hygiene there. People come in off the street in street clothes without removing the shoe. No gowns and shoe covers for visitors not. Who are beetle-crusher was in such and rushing. Visitors are usually recommended to wash your hands before you touch the baby. But none of this is watching. Let this is followed parents. It's their baby. And if the parents do not care, that's their business. Your child, he and decisive. Free people have the right to do what they want! In general, a newborn baby, a few hours old, paw all and sundry. No, it certainly is nice when a child is always with you, and it can be shown to relatives and friends who came. Only I still think that a regime of sterility must be respected, even if the first time after giving birth. From this point of view at totalitarianism somehow more correct.
As already mentioned, the child periodically ukatyvayut on a gurney for all sorts of procedures, tests and checks. When recycled (usually half an hour hour), be sure to compare their child's room on a bracelet with the numbers on the bracelet mother. Asked his mother to read everything that is written on the bracelet on her letters and numbers (mother's name, date of birth, serial number, etc.), and while the offset nurse checks all the data on the bracelet child. The baby 3 bracelet: Wristband on both legs and one arm. Why exactly do not know. Every single numbers and letters on all the bracelets should be the same. As you might guess, all of this is to ensure that children are not changed. Because the procedure is justified. Although, I think, your child will not be confused with anyone. I like my first time I saw so then would have learned from the thousands and, if replaced, would be immediately noticed.
I have already mentioned the wonderful console that enables communication with nurses, who, in theory, should be the first to come to your call for help. This is the ideal. Any technological solution can negate the human factor. When you press the call button on the remote, then on duty at the nurses on your floor lamp lights, and, in my opinion, there is even a beep. But if no one is in the post (which was more than once), then dozvatsya someone hard. Either the people are there, but for some reason they ignore your challenge. This, too, was more than once. After surgery, his wife began to withdraw anesthesia and pain came back. She asked that she brought pain. Called, called, and all to no avail. She is from the remote answer "yes, I'll get" and no one else. After 10 to 15 minutes she called again. The same story. And once again — nothing happens. As a result, strained me so I went to the nurses and asked in person. Technology technologies, and proven effective pendalya old ass has not come up with anything!
A similar situation was observed during a shift change of nurses. Somewhere around 6 pm they change change: change comes new and old leaves. Call the nurses at this time is almost useless. No answer, not a greeting. I thought they just change out old little earlier than comes a new one. But there was all the more interesting. Just like a nurse came to talk to those who leave home. Well, like, long time no see, it is necessary to discuss everything. One day, after 40 minutes of nurse call, went in person to ask for what you need. I went over, and there are two shifts of nurses having tea with cake (apparently someone had a birthday), and cracking of his, about women, not straining. Half of the control-switch on their lights lit office a call, and they could not care less. There are better things to do! Well, of course, turned the personal intervention of the situation. Though reluctantly, but moved. And so that was every day. What would change neither in / out, 40 minutes during a shift change, you can forget about nurses.
I've often heard from many advanced compatriots that such disregard the behavior of health workers is characteristic only of inefficient socialism, which encourages bums and loafers. But under capitalism, where paid medicine, everything, of course, different. After all, a lot of money service is always better! And then, drat. Turns out and paid medicine all the same! How so? Although, maybe in America have built socialism?
Your child's doctor? What is the child's doctor?
But all this stuff. The pinnacle of perfection is the lack of medical thought in the hospital pediatrician! It would seem that it is a medical institution where children in Brazil Pedro. Where else but in this must be a pediatrician? — An, no! It's time to withdraw from the totalitarian thinking. Free people do not need a full-time pediatrician at the hospital. They need a choice of two or more pediatricians! If you want your child after birth examined children's doctor, you must invite your pediatrician, who do you like more. Even before giving birth to yourself to find a pediatrician who agrees to come to the hospital after giving birth for the first examination of the child. Not every doctor can still disagree, especially if the hospital is far away from his office. But even if you agree, then the very fact that the hospital is not a children's doctor, and the doctor on the part should go to the hospital for examination of the child, to me sounds absurd!
I understand that someone may want to after the birth of his child examined precisely the doctor who will be his, and then watch the rest of his life. Personally, I do not see a principled, but I assume that someone can covet it like that. But that's why all the force to do it? You can in fact have a staff and a pediatrician for normal people, and allow your doctor to invite highly principled. Things that are not mutually exclusive. In general, anything-I in the sacred freedom of choice does not understand!
By the way, here is a pediatrician at the hospital there, and the priest is! Moreover, at the request of new mothers in the hospital may invite a clergyman of any denomination, both before birth and after. And rightly so. Why do some stupid children's doctors to rate contain? What kind of sense to them? Another thing — the priest. The priest is clearly more important to be in the hospital! You have to understand.
Others specialists — the path to success
One of the features of professional training in America — a narrow specialization, when a man knows his small work area, and all of that a little bit to the side is outside its purview, and he does not care. This is typical of almost all professions and medical specialties is clearly visible. For each issue, there is a "specialist". Moreover, one skilled in the field can seldom assess the competence of the person skilled in another area. As in the joke, if the doctor said to the morgue — so, in the morgue! Doctor knows best. He is an expert in your field. They asked, for example, a nurse a couple of simple advice about breast-feeding your child breast better take it. Nurse itself can not say it is a "specialist" on lactation. The truth is now occupied by a specialist and will have to wait a few hours, but when it comes, it will explain everything. I now have a feeling that a nurse working at the hospital, it should be able to give some advice on the subject. But no. It is better to lose half a day, but then hear a "specialist." The specialist knows better. And so in all.
I've never realized before how can the hospital mistakenly cut off the wrong leg or arm. For me it has always seemed wild and improbable. How is that possible? And now I understand as well. It's all the fault of the very narrow specialization. Someone can make a stupid mistake in diagnosis or in the documents / records and other health care providers will not check and challenge the conclusion of a "specialist". He is an expert in their field, whereas we in his business does not understand anything. How can we question his findings and directives? Something like that.
Many may think that I am exaggerating and exaggerating, but unfortunately it is not. As an example, one case occurred directly with my wife, which just demonstrates the problem. As a result of cesarean was a great loss of blood, and the doctor-gynecologist specially commissioned medical staff to monitor closely how the wound is healing, especially during the first 48 hours after surgery. In addition to the visual observation of nurses, it is recommended to send his wife to the U.S. about a day after the birth of using ultrasound to see how it heals. At the end of the day the nurses gave the order and he went home (or, in other cases). His wife sent for an ultrasound later in the evening. The technician working on ultrasound, casually made his case, all that is necessary, scanned by ultrasound, done the necessary images to embed your notes and comments, and sent the entire stack of images nurses. Nothing unusual noted. He said that everything looks normal. It was late in the evening. After this change in technique over and he went home to sleep off and was replaced by another.
Early in the morning the doctor uses a wide-eyed and said that his wife had serious problems. He had just made an atonement for change and looked pictures taken last night, and the images show a very large internal bleeding. It is urgent to do surgery! Wife in horror and disbelief. How so? Yesterday ultrasound article did not say, said it all looks like normal. The doctor said that the US-art ultrasound he just does. Not within his competence to diagnose. A doctor on the pictures clearly sees a large internal cavity filled with blood. In short, we must prepare for emergency surgery, to cut and save his wife! While being prepared, you can still try to clarify at the very US-hundred what and how and why it all at once did not say that things are bad? US-hundred was not there. As said, he ended the night shift, and he went home to sleep off. Called him at home — do not respond. A cell — is not responding. In short, the man is resting. Meanwhile begins preparation for surgery.
From the beginning, I had a strong suspicion that there was just a misunderstanding. In the end it turned out. Luckily still managed to get through to the US-hundred, and he made it clear. In the picture he made notes marker for the physician to the fact it was easier to figure out what's pictured. In particular, the picture bladder, he outlined the three-letter abbreviation «BLD» (from the English «bladder»), and the doctor thought that «BLD» means blood (in English «blood»). The doctor saw the picture size of the interior of the bladder is filled (as he thought), and blood began to spawn (not surprisingly). At the same time he somehow did not think that the picture shows the bladder. Well, he's not an expert on ultrasound. Why would he understand himself? Him another "expert" in their field all photographed and noted! Is there any reason to doubt it? And because of this absurd misunderstandings man was under the knife just missed. The advantages of specialization is available!
Another worth noting actively pushing the idea of a blood transfusion. During surgery, the body brought some kind of infection, and the wife got sick. She was prescribed a course of antibiotics, but antibiotics have helped slightly. The doctor said that the problem is in a weakened immunity due to loss of blood. Very highly recommended to give her a blood transfusion. Fresh blood should significantly strengthen the immune system and speed up recovery. At first I did not quite understand why we do all the talking. Well, if it is necessary, so do a transfusion. Do you — what doctors know best what to do. But then it turned out that in order to do a transfusion, you need our written consent. We have to sign a consent and refusal to judge hospital transfusion if something bad will.
On the question of what is a "bad" can get out, we were told that there is always a chance to catch something through someone else's blood! Oh my. How is it infected? What? Well, there's AIDS, Hepatitis "B", etc. responded to us. I almost swallowed tongue. And as it happens? Did not you test your blood for such diseases? I was told that the blood they certainly tested, but completely eliminate the possibility of the presence of such diseases can not. Therefore, there is always a chance to catch. Well, no guys own perspective! Let's give a blood transfusion to help the body recover faster, but AIDS infect it! Just perfect.
"Go you … with his transfusion" — has been answered. Decent words are simply not able to pick up. Most interestingly, the doctor is very surprised that we refused. In the future, it is pouring us some more time actively trying to push through, to convince that this is the best solution. They say that the risk is small, but it will directly benefit. According to the principle or right help or just a complete "kirdyk" and then there will still be! Maybe they give it a premium to those who more people will sign this month for a blood transfusion? For me, so even a small risk of contracting an incurable disease that is not worth it. The proposals were rejected by transfusion in a rigid form. Fortunately everything went without a transfusion.
Announce please list!
In total, in the hospital, we spent 3 nights. At the 4-day discharged home. About a month after discharge from the hospital bills started coming generations. No, the bill is not one, they are many. From all the running. Every expert who participated in the delivery of health care services, sending its separate account. As a result, the individual accounts come from the doctor, who took birth, apart from the anesthesiologist from the hospital / hospital for a hospital, from any specialist who has ever examined or woman giving birth, or a child from each laboratory, where they had been sent to any analyzes (mothers or a child), etc. Almost every cleaning lady who cleaned the house, sends his own expense. Make sense of what was and what is not, is very difficult. Here comes the expense of Dr. Jones, and who he was and what he did (or did not), is not easy to figure out. Sometimes it happens that you are the doctor and did not see it, but he allegedly once, looked at your pictures and gave some instructions to nurses. That is, in fact, involved in your treatment. For this, they say, and score. How can I check the plausibility of such statements, I absolutely do not understand. Not to mention the fact that the accounts are designated specialized medical procedure codes, not just words described. As a common man who does not have specialized knowledge in this one can understand a mystery to me. And why not send one person to account for everything (and then divide among themselves), not 30 different accounts for every little thing?
I foresee some resentment about my unfounded accusations of bad faith in the doctors. I can responsibly say that what they include in the bill, to put it mildly, is not always the case. This is not my speculation. With that, I personally have encountered. I do not know whether by mistake or on purpose (I will not argue here), but the doctors (and hospitals) sometimes on account shall include procedures and actions that were not there. So before you pay your bills should carefully check everything and often disputed. This is not socialism, but an efficient market!
Prices for medicine in America, as you might guess, the roof. In total, deliveries came the following accounts:
For the services of the doctor, who took birth: $ 4,500
Anesthesia: $ 3,650
During a hospital stay of mother: $ 18,000
Child's hospital stay: $ 3,450
Nursing care for the mother: $ 370
Nursing care of a child: $ 25
Laboratory tests (from different laboratories): $ 200
Examination of the child's pediatrician: $ 150
Total: about $ 30,000!
Well, this is a major / large accounts. Even a whole slew of small accounts I have just lost, but they do not make the weather. Incidentally, this is only for deliveries. Observation of pregnancy, I did not include here. We must also clarify that this amount billed. In fact my insurance paid them of course less. After verification of the procedures and prices, insurance paid roughly around $ 17,000. — Also not weak. Well, I had a trump insurance that covered everything. I paid only out of pocket $ 250. And what about those who do not have good insurance, or do not have any? Well, the truth had a couple of times to prove I was not a camel when it was revealed that some tests were sent to a laboratory that insurance does not cover. Insurance announced that they have never agreed that the tests that were sent to the lab, so I have to pay myself. I had to spend 45 minutes on the phone to explain that I have no idea at all where there what tests sent. We were at the hospital did not ask. Anyway, why do I have to know where to and where not? Sort it out for yourself with the hospital. Well, in general disassembly of the sort — it everyday. It seems everything is settled, although the nerves a little shook. Well, it's little things, to be honest.
I will say more about insurance separately. Good insurance — it's almost always a question of money. As a rule, the better the insurance, the more expensive it is, other things being equal. I, for instance, pay $ 200 a month for insurance for the family. In this case, my employer pays an additional $ 1,100 per month. That is, the total cost of insurance is $ 1,300 a month! It is easy to calculate that the $ 17,000 I will pay them for about a year. Not surprisingly, they are so easy to pay. I can definitely say that if the employer did not pay extra bulk of the price, I myself would not be able to buy such insurance. So it turns out, if you work for a big company — will be good insurance. Work for medium-sized company — insurance will be so-so. On small businesses — about insurance you can forget.
Child benefit and maternity leave
Compatriots often ask me what in America Child Benefit. The answer is — no! In America, any child support are not available. Of course, in Russian child benefit is very modest, does not clear up. But it's still better than nothing. In Russia, the state has at least some support. In America, this support in our understanding is not there. Nor for the birth of a child, no matter the content state pays nothing.
Allowance issued only to the needy, and to the birth of a child is irrelevant. To obtain benefits must prove that you are below the poverty line. Of course the poverty line in America is somewhat different from the poverty line in Russia. But do not build illusions. People living below the poverty line in America, deprived of many opportunities that are available to other members of society, and are on the verge of survival in the same way as it is in Russia. The official poverty line in America — it's income of $ 23,000 a year "dirty" (ie before taxes) for a family of 4 persons. In last month's $ 1,917 "dirty." It is VERY small!
In addition to the lack of benefits for the child, in America at all is no such thing as paid maternity leave! Nothing like that at the state level do not. There is a federal law that requires employers to provide unpaid leave for medical purposes (including a baby) for up to 12 weeks. That is, the employer is required to provide unpaid leave, and within 3 months of the employee to keep his place. About any payment-in-law out of the question. There is no such requirement. It's all at the discretion of the employer. If the employer wants, you may pay (either fully or partially). It is not difficult to guess, employers do not want to pay anything. As a rule, people have a baby to take leave or use earned sick leave (who they accumulate), or take unpaid leave. Or a combination of both, and the third at the same time, to somehow extend the care of the child.
As already said, the employer is obliged to provide only 3 months. If you need more time (and it is required), it's all at the discretion of the employer. Want to — give. Do not want to — do not provide. After 3 months, if not show up for work, are free to dismiss. Moreover, the law applies only to companies with a total of 50 employees or more. An employer with a workforce less than 50 employees are not required to provide even these 12 weeks. Citizen Prokhorov would approve!
Such are the rules exist at the state level. Perhaps at the state level, in addition to federal laws, there are state and local laws regarding the requirement for maternity leave, but I have not heard anything. In comparison, the Russian paid maternity leave and 12 months of continued employment of up to 3 years — it's just a utopian paradise!
The shell game in an American
I can not pay attention to spread itself amounts issued and paid bills. The difference is almost 2 times (requested $ 30,000, and the insurance paid $ 17,000). This clearly shows the problem of winding the invisible hand of the market price for the medicine. Doctors and hospitals regularly and unreasonably inflate prices and include the expense of what was not. And that even with insurance, which monitors compliance with the agreement on prices. The insurance company enters into with doctors and medical facilities agreement on the price of services and shall pay for services according to negotiated rates. And yet, the doctors still regularly try to "throw" the insurance and set prices higher than those to which they themselves have agreed to include in the bill, or what was not. Again, this happens even when a person has insurance, the representatives of which are well oriented in medicine and can check every detail before you pay anything. One can only imagine how fool people who do not have insurance, which is not very versed in medical matters and can not check everything thoroughly, as does the insurance. There is, I think, a "scam" include that the sharps just relax.
Many people may accuse me that I was on the basis of a single case has made far-reaching generalizations and conclusions. I can assure you that this overpricing I see all the time, ie, the case is far from isolated. Recently had to go to different doctors: a physician, a pediatrician, to specialists for routine inspection by the disease, different practices / medical facilities, etc. And if any hike to the doctor repeated the same thing. The doctor put up the price is 2-3 times greater than in the contract with the insurance. Insurance then severely notch wrapping and paid as much as was stipulated in the contract. I could never understand why doctors do it? After all, insurance knows what prices should be, and will be checked. Maybe by mistake? But then somehow too systematically wrong, and only in their side! Plus, each facility and each physician has a special employee (and sometimes more than one) who specializes in the relationship with insurance companies on the agreement on pricing and billing. Still, prices are inflated, and the expense involved in the "left" procedure. Or all of these workers are full of mediocrity and klutz, or deliberately inflate prices (as directed by the doctor) in the hope that the insurance may be overlooked and pay an inflated price. The second reason to believe anymore.
Every time it comes to the problems of the health care system in the United States and discussed plans to reform it, the problem is technically hushed up. Prices for medical services in the United States each year are growing by about 10 — 15% and outperform inflation at 2-3. Among the reasons commonly referred to as the aging population, which increases the demand for health services, lack of health care workers (something we were told that the free market deficit did not happen, and then on to you), a conspiracy of evil insurance companies that currently wind the excess profits, rising costs of pharmaceutical companies the development of new drugs in the mounting requirements for testing of drugs, etc. I must say that all of the above listed factors in varying degrees have a place to be. But that's about what the doctors huckster and blatantly overcharge, this one does not speak, as if that was not. It is as though taboos. No one has ever expressed indignation at the unreasonable overpricing doctors, does not offer them somehow rein. But I think it should be.
On the contrary, doctors are always set up as victims of the system. Like, they work hard, and the insurance and pharmaceutical companies, as well as an evil state, they put a spoke in the wheel. In my opinion, everything, to say, not really. Doctors are no better (or worse) than the insurance companies, and had a profit from those who are least protected. Their task is not to treat people (even for money), and make money by all possible and impossible ways. And that, I think, in the long run and is the root of all problems.
Medical reform or socialism?
There have been some hope for Obama's health care reform, that maybe it will change something for the better. What exactly is the proposed reform, it was difficult to understand at once. Tantrums surrounding its adoption were many, but the direct document with all the details have seen a few. The main stated aim of the reform was to ensure access to medicine for all citizens without exception. That sounds good. Given that the opponents of reform are regularly accused Obama of socialism, there were hopes that the reform was discussed on strengthening the role of the state in the provision of health services.
And then, finally, the reform was pushed through with great difficulty. And what is it? Maybe the fact that the state has been actively involved in the provision of health services, has built a state hospital hired doctors in public hospitals to private hospitals to create competition and thus lower prices for medical services? Maybe reform plans to rein in doctors, insurance companies, pharmaceutical companies, to regulate prices for medical services, the prices of medicine and most health insurance was available to the majority? Or maybe there is a plan to create a system of financial incentives to encourage the provision of medical services at affordable prices and punishing speculators making profits out of nowhere? No, no and no again! Anything of the kind in the reform of the question. All of the reform is to make medium and large companies to provide (at least some) insurance to employees, and insurance companies get to sell it even to those who do not want to sell. Plus get all the stupid people who do not provide insurance company (if you are not a full-time, or if the company is small), to buy health insurance for themselves. A little simplistic, but if you omit the details, it is in the whole point. That's the whole reform.
But all still continue to scare Obama's socialism. It is, sorry, not socialism. This — idiocy!