Dear Doctor

Dear Doctor
Am I correct?
That you are less interested in my health problem
Than before?
Is it me or is it you?
Your 10:05 AM Patient.

Dear 10:05 AM Patient
My 9:55 AM patient was much
more medically engaging than you.
My scheduler controls my day
Not me, not you.

Chocolates, Brownies, Fudge and Emotional Depression

The Christmas season is a time when doctors' offices are deluged with chocolates, brownies, fudge and lots of other goodies which staff and professionals enjoy, though with some guilt.

But there is another side to the holiday season which is more troubling then extra calories and saturated fat.  It is the distress of many women we would see with serious holiday depressions because they were exhausting themselves physically, spiritually and financially, trying to make the holidays "perfect" for their families and other loved ones.  To the women who read this blog - I wish you well and hope that you will do what you can reasonably do and recognize that perfection is not a human characteristic. To the men who read this blog and pay attention to what their spouses are going through, I suggest you make it a point to notice what is going on around you, support your loved ones and help set family holidays goals which will leave everyone refreshed, rather than exhausted physically, spiritually and financially.

Truly happy holidays depend on the strength and joy of family relationships.  What ever holiday is yours, I wish you and yours holiday happiness.

Texas Health Insurance Maternity Benefit Unavailability - Response to Comment

I don't know whether the commenter is correct that passage of the Affordable Care Act was responsible for strategic actions taken by Texas health insurers to raise rates or make unavailable maternity benefits (2 sides of the same coin). Was the decision by insurers to raise their rates for individuals seeking maternity benefits as part of their insurance package solely due to health care reform or was it a response to actuarial experience (increases in the range of 10-15% have not been unusual in the health insurance business in many states, even before health reform),  to the extraordinarily high costs of  Texas health care (as documented in 2010 journal articles and federal government discussions),  was it a business strategy to mobilize public opinion against health reform, or was it a non-publicized highly selective business or political strategy?

I don't know.  Do any of my readers have other insights?

Silence - Not A Winning Strategy

Last week I spoke to lawyers, retired judges and others at a local bar association meeting about the "Patient Protection and Affordable Care Act" (the "ACA").  As I spoke about the availability of high risk insurance coverage, the Elder Justice Act, parents' health insurance for children up to age 26,  Long-Term Care insurance, the support for young families (including college students),  and the ultimate effect that supporting and encouraging young families to have children by removing financial and health insurance barriers through  providing health insurance and other benefits, it was clear that my audience was hearing this material for the first time.  WHY?

It wasn't their fault. Congress passed and President Obama signed a comprehensive health care reform act and the only thing the public heard were a few words from the administration about its benefits and a lot of words from the right about its high costs.  The administration spent a lot of time demonizing insurers, provider groups and our existing system but failed to support champions out in the field explaining to groups of citizens why the ACA was specifically in their interests.

In visiting with my Texas family this past week, I heard that a member who has a vital interest in maternity coverage, could not find an insurer who would provide it at a reasonable affordable cost.  Thus, her entire concept of health reform is that it has resulted in escalating costs and insurance unavailability. She was right in her observation that her interest in health insurance with maternity benefits is important for her and her family and for our country.  So it's time for the Administration to address her issue and at the same time champion provisions of the ACA which are good for American businesses and individuals.

Health care is not a game of golf- 18 holes and a visit to the clubhouse for lunch and drinks.  American lives and security  are at stake. Mr. Obama, treat health care as a continuing important subject. Commit the resources to champion the benefits that each American will - at some point in his or her life -  experience in the ACA.

Otherwise, Americans will face the bleak prospect of unaffordable health care while the lobbyists celebrate victory at their clubhouses.