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Thursday, March 20, 2008

Musings

I was reading Newsweek letters to the editor, and I was struck by this one letter. The mom says she is a single mom, and her daughter has asthma that requires chronic medications. She starts talking about how the medications are expensive and why she has to pay for them. I start to think about it, and I just don't get why people feel that they shouldn't have to pay for healthcare. You have to pay to go to the dentist, to get glasses or contacts, to take your pet to the vet, to get your haircut. Even in the cases that you have insurance, you still have to pay. Why is that not a crisis and unfair and all of the other things people say about healthcare? Of course, I agree that healthcare costs are out of control, and I think it is absolutely ridiculous that providers still use freaking pen and paper to document their visits or that they record something and pay someone else to type it. However, I do not think that healthcare should be free. It is a service just like others. I do think we need to assist those who need it, but as the woman from Newsweek described herself as middle class I don't think it should be free.

I don't think people realize how complicated healthcare is. When we have new developers, I always kind of chuckle as I watch their reaction when you start explaining some of this stuff. Well, in North Carolina, you have to do it that way, but in South Carolina, they don't accept it that way. If you want to get paid by XYZ, you have to put information in box 19 but ABC carrier doesn't want that information at all. It goes on and on. Plus, add in the hours, the busy offices, the under qualified staff working in most of them, and the providers many times not understanding all of the business and financial side, it is a mess. Yes, healthcare should be affordable. No, it should not be free.

At Bond, we had an HSA option for insurance. It really challenged my thinking. When Morgan fell at cheer, I was less likely to rush off to get an x-ray and more likely to wait a few hours to see how it was. When I got my prescriptions, I was more likely to make sure I asked for a generic than I was when it was a copay. However, once my family spent their $2500 for the year (trust me, one kidney stone is all it takes), the insurance picked up the rest. So, my maximum risk for the year was the premium and the $2500. Also, the premium was about $200 less a month than the standard insurance, so I could put that $200 into an HSA. Of course, the people who don't have kidney stones or any chronic diseases love it. They can just keep all that money that would have been spent on premiums. It also doesn't expire like flex spending. I think HSAs are a start, but I think we need to buck the system faster to see change. When I hear what the candidates are saying, I feel like they are all saying something but it all lacks substance.

The Allscripts Misys deal surely seems to have people in a pickle. It certainly is getting people talking. I loved that John McConnell resigned from the board in disgust. What an interesting story in that he founded one company, sold it, bought a company that was struggling, grew it into a growing company, sold it, and now those companies are all together. CREEPY. I loved the quote where he is saying that he thinks this deal was unneccessary and that it will cause job cuts, and he says that Wall Street calls it synergies but he calls them people. Classic. I have heard many people liken it to two American car companies merging. I have heard "what a mess" from more people than I can remember. It appears that even the people who were positive on Misys (and there are not many) are not positive. That should scare some people. When you lose those people, you are in big trouble. I was trying to count products today, and I can't even realize how many they even have. I know the main ones are Tiger, Vision, and Ntierprise for PM and Misys EMR, Healthmatics, and Touchworks for EMR. Then, you have iMedica's product relabeld as MyWay. Very interesting.

As we are trying to blend Bond and Medinotes, it is a very interesting time. It is like dating in some ways. Everyone is trying to be on their best behavior, and everyone is feeling out the other people. It is going to be one heck of a ride to figure it all out. It is very interesting to see the differences in ideas for some things and to realize how similar others are. I guess in the end, we are not as different from other people as we sometimes think.

As we determine assets and such, I have told the story of the toilet plunger many times. When I was getting divorced, my ex-husband actually put the toilet plungers on the list of assets. He actuallty wanted to discuss who got the "decorative" plunger and who got the "plain" plunger. Sometimes, I can hardly get the story out as it cracks me up so. You see, the funniest part of the whole thing is that the plunger was a GIFT. And then it was an item put in an asset list. A PLUNGER. Since then, I have always tried to ask myself if something was a plunger item to fight for or if it was a more substantial item. So, in honor of the story and to remind me to keep that mentality, here is a picture of the plunger that was listed as the "decorative" plunger. Oh, thank goodness I ended up with it! :)

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