BLOGS: Managed Care Matters is one year old

Joe Paduda’s Managed Care Matters blog is one year old.  If you don’t know it, Joe has short punchy articles on a range of subjects surrounding managed care, insurance and workers comp and it’s well worth checking it out.

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  1. I wrote the following fictional dialog to predict the direction of managed health care.
    Touchstone Healthcare Corporation
    Michael B. Owen
    Customer Service Representative (CSR): Hello. My name is Susan. I am your Touchstone Health Care Customer Service Representative. This call may be recorded to ensure quality and compliance with federal regulations. How may I help you today?
    Ralph: My name is Ralph and I am calling to get an authorization for a medical procedure.
    CSR: Ralph, are you a patient or a medical professional?
    Ralph: Patient.
    CSR: Well, I am sorry, Ralph but, Touchstone only authorizes procedures that are requested by a licensed physician.
    Ralph: But I was told by my doctor that I could directly request an assisted suicide from Touchstone.
    CSR: Yes, sir, that is correct. Assisted suicide is an exempt procedure. We need only an automated order from your physician and your verbal statement requesting the procedure. Please give me your account number, and I can verify your doctor’s automated request.
    Ralph: 217-502-4569.
    CSR: Thank you. The verification will only take a second.
    Ralph: While I am waiting, do you mind if I ask you a few questions?
    CSR: Of course not. I am your Touchstone customer service representative and happy to help in any way I can.
    Ralph: Why is assisted suicide an exempt procedure?
    CSR: Assisted suicide is exempt because it does not require medical intervention from a health care provider. It is an in-home procedure that patients may administer themselves.
    Ralph: You mean there is no medical supervision at all. What part is “assisted”?
    CSR: The term “assisted suicide” was first used around the turn of the century when physicians administered and monitored high-cost, inpatient, suicide procedures. Since that time research has proven that self-administered suicide procedures have identical outcomes to physician-assisted suicide and can be provided at a much lower cost. Although the physician-assisted concept has been obsolete for many years, we still refer to the procedure as assisted suicide.
    Ralph: If I administer the suicide myself, why do I even need to use my health care plan?
    CSR: It is the law, Ralph. Assisted suicide procedures and methods are regulated by both federal and state governments. It is administered under END-A, the Early Need for Death Act that was passed by Congress in 2020. Since that time, unapproved suicides are illegal and punishable by fine and imprisonment.
    Ralph: What’s the reason for that?
    CSR: Unapproved suicides can be highly ineffective and often result in incomplete suicides. One incomplete suicide can leave a patient and his or her family with extremely high, long-term, health care costs. Ten years ago, Unregulated Incomplete Suicides (UIS) were threatening the viability of the entire Managed Universal Care System. On the other hand, Approved Assisted Suicide is the most cost-effective medical procedure in the history of health care. The Administration of END-A has now established best-practice guidelines and inexpensive toolkits that ensure an effective, safe suicide experience for about 98% of patients who are eligible for the procedure.
    Ralph: Well, I have always tried to follow the advice of my personal physician.
    CSR: Very wise, Ralph. Touchstone Healthcare encourages all eligible patients to use Approved Assisted Suicide. Most patients are highly satisfied with the outcome and benefit package. Oh, good, I see your doctor’s order is on my screen. Okay, I can move to the authorization process.
    Ralph: How does that work?
    CSR: I will ask you a series of questions. I will record your answers for privacy and compliance requirements. Ready?
    Ralph: I guess so.
    CSR: Okay. Ralph, state your name, date of birth, and patient account number.
    Ralph: Ralph Craven. Date of birth was 06/27/20. My account number is 217-502-4569.
    CSR: Ralph, what is your physician-approved END?
    Ralph: What?
    CSR: What is your Early Need for Death?
    Ralph: I have Predicted Genetic Terminal Illness.
    CSR: Has your physician explained what that means?
    Ralph: Yes. It means that DNA tests have determined that I definitely will die from something within three to five years. It is not possible to predict what disease will cause my death, but the DNA predictive test results were conclusive. My doctor said the three to five year prognosis makes me eligible for Approved Assisted Suicide.
    CSR: Ralph, did your physician explain the Suicide Benefit Package?
    Ralph: Yes. In fact, the benefit package is what helped me make the decision to go with assisted suicide. The package is just too good to pass up. My family will receive a Suicide Choice Rebate from the Touchstone Healthcare, and they will still collect my life insurance.
    CSR: Right, Ralph. For most people it is a real win-win situation. Well, let me go ahead and email you the Patient Suicide Handbook and Toolkit. The Handbook describes the procedure and tells you how to prepare and what to expect from your assisted suicide. The Toolkit includes your choice of a lethal dose of Endal, or a reusable handgun. If you choose the handgun option, a family member must ship the gun back to Touchstone within thirty days or its cost will be deducted from your Suicide Choice Rebate. The Patient Suicide Handbook also is loaded with other practical information about crematoria and other resources that you might be interested in. Shall I ship your Handbook and Toolkit today?
    Ralph: Okay. And I will take the Endal option.
    CSR: Excellent choice, Ralph. Your Handbook and complete Assisted Suicide Toolkit will arrive by UPS within 24 hours.
    Ralph: Thanks.
    CSR: Is there anything else I can help you with today, Ralph?
    Ralph: No thank you, Susan. You have been very helpful. I’m sure I will be quite satisfied.

  2. Trapper – you need to broaden your narrow perspective. Myblog is about many topics related to managed care; your focus seems to be quite parochial and limited to monologues about the wonders of the free market.
    There is no free market in health care.
    And I’ve been in this business for 20 years; I look forward to your views when they come from a similar perspective.

  3. …and he spits nails whenever you mention anything but a nationalized health care system (sound familiar Matthew?), even if you’re just trying to protect the little guy from being a puppet of the state at his most vulnerable moment: when he’s sick.
    FYI – There’s another blog, http://www.isemmelweis.com, bringing you consumer-driven healthcare newsbites, which is also one year old today.
    Check it out.
    ~Trapier K. Michael