Recently I had the opportunity to speak to a Regional Public Health Service Agent at an Opioid Awareness Forum. She spoke upon the changes being made with Medicare and other state insurance policies such as removing required prior authorizations making access to medicated assisted detox recovery treatment for opioid substance users easier as well as a new program that is in the works that will alert the pharmacist if a patient has been on a high dosage of opioids for three months and at which point the pharmacist is to reach out to both the doctor and the patient to see if the medication is still necessary for treatment and suggest other treatment possibilities and will be implemented over the next two-three years like most other government policy changes made to Medicare. Doctors simply don’t want to deal with the hassles of billing nor want to accept a reduced rate for their services. Our western healthcare system has become to expensive for anyone to afford both as insurance companies and individuals.
We had the opportunity to ask her questions. Like in Washington D.C , I went back and forth with the decision whether to speak up or not. I raised my hand half way. After the last presentation, again we had the opportunity to ask all panel members questions. This time I raised my hand higher, if I could speak up at the White House to bring awareness and change then I certainly could do the same thing here.
I asked, “What is being done to fix the lack of healthcare providers that accept Medicare and/or MassHealth. There are very few providers that do accept government insurance and the ones that do there is usually a six month to one year waiting period to make an appointment!” Although she agreed, there really is nothing being done to change this. Medicare doesn’t pay the full amount that healthcare providers charge and then there is a secondary insurance to bill to cover the remaining balance that Medicare didn’t pay.
Another person in attendance expanded on my question and made me aware of available programs that don’t require all the red tape and hoops needed to jump through in order to get treatment. I thanked her and told her it wasn’t for me and shared another piece of what contributed to the fatal loss of my fiance and life partner to a peer influenced relapse which is also another common problem shared that night in the forum by those who also lost a loved one to substance use disorder; dual diagnosis and lack of communication between medical doctors, and the restrictions and limitations by insurance providers.
After the Forum ended, I was able to discuss further with the Public Health Service Agent my concerns with the new pharmacy program being put into place, my own experience with our failing healthcare system after a car accident I was in, lack of equal healthcare to those with government insurance, humanness no longer part of western allopathic healthcare, the injustice, unequal, inhumane practices of the healthcare system and the difficulty of getting proper diagnosis and treatment in a 15 minute appointment with a medical doctor whether it be a primary care physician or specialist as well as preventive care, non-invasive and all natural alternative medicines, bringing humanness back into our healthcare practices and seeing the individual from a holistic perspective of body, mind and spirit.
In response, she said “…. healthcare is seen as a business” as well as thanked me for my valuable input as this is how they find out what our communities need. She also gave me some important advice in how I can continue to bring awareness to the problems to our healthcare system and to share this information with others.
1. FILE GRIEVANCES WITH THE HOSPITALS. Hospitals will pay attention to you as soon as you mention filing a grievance because they don’t want to loose their health care bonus.
2. Continue to GO TO PUBLIC FORUMS and SPEAK UP. This how they know what is needed in our communities.
Please don’t be afraid to speak out and report errors made by hospitals and physicians as well as reach out to State and Federal government representatives and your insurance companies to voice your needs and concerns surrounding your health care, and/or insurance limitations and needs like the Public Health Service Agent said, “It’s the only way we know what our communities need ” and how we can help bring about change to our health care system.
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