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Doris' Blog

How do you choose your healthcare?

Doris' Blog
By: dorisjdickson

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Posted: Nov 24, 2008 14:31
  • How do you choose your healthcare?


    This Boston Globe article discusses, among other things, the discrepancy in the costs from one hospital to the next, specifically, in the Boston health care market and even more specifically with Partners Health Care.  I would venture to guess, this occurs in other large cities where there are teaching hospitals and regional hospital from which to choose.

    I had to laugh.  The article says the issue with Partners Health Care is Boston's best secret.  Funny ... I discuss it all the time. 

    However, as a person with a pre-existing chronic condition I have repeatedly given my mate specific instructions to never, ever allow me to be admitted to the local hospital in my area or several others on my "I'd rather die first" list.  He has specific instructions to drag me to either of two hospitals and to immediately contact my endocrinologist. Why is that?

    Well, the area hospitals I have experience dealing with left an undiagnosed diabetic friend of mine with ever rising blood sugar sitting in their waiting room and then sent him home with, in essence, nothing but a referral and maybe a script for some insulin.  I sat and watched his blood sugar rise by a few hundred points in 30-60 minutes.  He should have been 1) admitted, treated and given instruction or 2) given insulin and an IV and sent to another hospital capable of treating him.

    A second local hospital in essence improperly diagnosed and treated a family member who has now died in part due to their mistakes.  When he finally went to a major hospital, they did their best.  But it was too late and he was too weak to fight.

    A third local hospital doesn't like to give insulin (in this case to an elderly insulin dependent diabetic) unless blood sugar is >200.  They couldn't imagine why he wasn't healing in a prompt and efficient manner, was depressed and was in la-la land.  Golly, I can't imagine why.  I also specifically pointed out to the "lung doctor" that the IV with antibiotics was full of glucose and it was inordinately raising his blood sugar.  Couldn't they mix an IV without glucose I asked.   Well, he's almost done ... was the answer I got. 

    So, my point you ask?  My point is though I believe Partners Health Care charges a relatively very high fee for services versus the local and regional hospitals, I wouldn't go anywhere else for may services.  I have my blood tests drawn at a less expensive lab than the hospital to which my endo admits ... I've done my homework.  It's a big difference for the same A1Cs, cholesterol, thyroid, etc. labs. 

    However, for anything that is "important" there is no way I am going to entrust my life to the local/regional hospitals that I already know have come up VERY short in treating other friends and family members.  

    That does leave us with the "what to do about costs" question.  What do we do?  What can patients do? 

    1) We can tell our insurers to better negotiate with the teaching hospitals.

    2) We can talk with our feet and not pay for horrific services. 

    3) We can do our homework and have less important tests done at secondary, less expensive labs ... in my case the secondary lab is much easier to deal with, much more pleasant, equally as accurate and much less expensive. 

    Even if you have an HMO or a PPO and you don't pay directly for health care costs (i.e. you have copays), you still get an Explanation of Benefits (EOB) to see the charges.  You can compare and make decisions about which services are important to have where. 

    We want good care but we have to be equally as responsible for taking note and affecting charges as much as we can.  Every time we or someone else over pay, it is eventually going to be reflected in our premiums or our neighbors premiums.  And I do think that we as diabetics 1) should have the best care that we can get but 2) are equally as responsible to be cost effective to the best of our abilities ... and the insurers should step up and do some better negotiating.  We should not have to choose lesser care just because it is cheaper.

    Doris J. Dickson

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