Last week I spoke to a group of payers — health insurance executives, Medicare and Medicaid representatives — and shared with them the many ways in which we patients feel the American healthcare system is failing us.
The points I made came from you — my readers — from the many stories you have shared with me through email. Your frustrations, your debilitations, the loved ones you have lost… your substandard care or battles with your insurance companies…. your bankruptcies, your denials of care and more….
Of course, at first they couldn’t fathom why a “mere patient” would be addressing them at all. With one exception (Morton Kondrake, commentator from Fox News) the other speakers were all just like them — health insurers who were sharing the many tactics they were using to manage business, save money and cut costs.
I’ll give them credit for one thing — I was pleasantly surprised to hear them talking about improvement in care, what they call disease management, as one way they had attempted to keep costs lower. The idea being that if they could teach patients to manage their health problems, then those problems wouldn’t become so expensive to them. Unfortunately, what they were reporting was that disease management doesn’t seem to work for cutting costs. I don’t remember that anyone commented on whether it was improving the patients’ health….. but I digress….
So then this patient with credentials unknown (me!) steps up to the podium and explains why she had been asked to speak…. Many were uncomfortable (to their credit.) Some didn’t care. Most listened. No one asked questions. But a few did approach me afterward to thank me for being their conscience. That was a pleasant surprise, too.
I’ll share with you two of my main points. First, I explained to them that I’ve been teaching all of you — my readers — “guerrilla patienting.” I define guerrilla patienting as a way we patients can find workarounds to the system that is failing us so we can find better healthcare success for ourselves. If it sounds a little warfare-ish — well — aren’t we fighting for our lives?
And second, I suggested a dozen ways that patients, providers and payers could collaborate to find solutions to improve the system. That was my original assignment, by the way. I’ll be curious to see if any of the folks who heard me speak will come back for more ideas.
Today I have an invitation for you. Do you know of workarounds? Ways to get the healthcare help you need despite the system? Tactics you have used that you would be willing to share with others?
Soon I will begin a new page on this blog called “guerrilla patienting” that will address specific ideas and tactics. We’ll categorize them and make them known to others. If you have ideas you’d like to share, please email them to me (blog (at) epadvocate (dot) com) and I will give you the credit for the idea.
Each one teach one. Patients — our time has come.
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As a patient advocate my first line of defense is to never take “no” as an answer without making sure that it’s the right answer. Too often, especially when dealing with insurance companies, the “easy” answer is to say something is not covered – it gets the caller off the phone and keeps their numbers on track. But, too often that “no” is not the correct answer – there are many instances where there are specific circumstances where coverage is available and a little knowledge can go a long way to getting the correct answer.