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I was cooking my son his dinner, and thinking back about how HMOs made the primary provider into the gatekeeper with financial incentives to keep people from accessing specialty care unless absolutely necessary and as we saw many times, the lure of the money was such that for some PCPs, there was no threshold at which they would allow you through that gate. It was and is immoral. I never, until this week, imagined that the health insurance companies could come up with something even more immoral. Silly me. I call that a serious lack of imagination on my part.
Hyperbole alert: It feels like they are putting me in the position of Sophie's Choice. It was bad enough when the doctor was blocking my child's care, now it becomes my job!
Now, as a RN who has worked in an ER, I have a lot of evaluation skills that laypeople don't necessarily have (and if necessary, can even do certain care that might be a bit out of my scope of practice but not outside my ability. I would rather not fragment my family's care that way nor jeopardize my license, but we'll just have to see) and I have already been very conservative with basic care with my kiddo, but since he has autism, there are some really high dollar items that allow him to have a bit more of a reasonable life. The HMO doctors might have tried to block that care (once, only, I assure you. I am not someone to be messed around with and have no problem reading the riot act to a doctor behaving badly), but I'm never going to do that. That's my "Sophie's Choice". I'll go into bankruptcy before I will allow my child to go without his necessary medical care. What astonishes me is that there are thousands of laypeople out there getting transferred to these kinds of "insurance" programs and they aren't going to have the knowledge or the savvy to navigate them without getting severely screwed over. Hell, even with all of my expertise, we will likely get screwed over pretty badly.
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