It is time for the empowered patient  to have a standard of care for the medical profession.  It is not just a patient's rights concept.  I don't need someone to give me the right to be cared for, be treated with dignity, receive care in a timely manner or have a doctor.  I believe I have that inherent right.  Standards of care are what I expect and want from a provider and hospital.  The medical profession has standards of care of how to treat or not treat my illness, my time and my follow up.  If I believe I am an equal partner in my healthcare, then I need to have a standard by which I measure my providers.  For so long patients have been like baseball players before free agency.  We are not involved or maybe peripherally involved with decision making.  We are often limited by our insurance options and are grateful we have a payer source.  We have come to expect the 15 minute visit, the wait for specialty appointments and procedures, and the slow response to follow up questions.  

The empowered patient's standards of care offers a way for the consumer to be a participatory member of the healthcare team.  All things being equal, the consumer is a vital piece of the puzzle. A standard of care could address medical relationships, expectations,  communications, team participation while being respectful and supportive.  What it is not, is a list of demands.  It is a guideline for the manner in which I expect my healthcare needs to be considered and managed.

What would be in a patients standard of care?   Here is one idea.  Questions answered whether in the office , by phone or email in a timely fashion.  Here's another idea.  I expect the provider/ hospital to listen to the information I have gathered in regards to treatment options and work with me.  These are just two ideas and there are many more.  

I have started telling my advocacy clients, believe in yourself as the empowered patient.    The threshold has been crossed as to the changing role of the patient.  Knowledge, information and technology have facilitated that  change.   Many, but not enough, in the medical profession have embraced the change.  Just like free agency, there is no looking back.

No one has addressed whether or not  buying healthcare insurance in another state, eliminate "out of network" doctors or hospitals.  I can only hope it would mean, I could go anywhere in the country and my health insurance would cover it.   Will contracted or reasonable and customary fees be the same across the board nationally for providers and hospitals?  Will the doctor in New York  get the same reimbursement as the doctor in Jackson Hole, Wyoming?  Or will there be a sliding scale based on regional economic levels?  This all sounds "socialistic "to me.  

If an interstate plan is now considered out of network, then the cost to the consumer will rise.  Out of network per cent of payment is higher for the consumer usually 40-50% of cost.  Some plans won't even pay out of network cost. If all your medical bills are now out of network,  your cost per visit and hospitalization will rise.  It sounds good to have lower premiums but it won't help if out of pocket costs are higher.

Another issue is the credential process  of the doctors and hospitals for all the plans nationally. Currently individual plans control their own credential process.  There is a central clearing house for documents but each company has their own contracts and specific needs.  Large practices and hospitals have departments that handle this process but smaller and rural practices will suffer if multiple credential processes are going to be necessary.  It is time consuming and labor intensive.  The government would have to mandate by law a central credential center.  More big government and this is a Republican idea!

Overall, I don't see this idea as a viable concept.  The insurance companies would have to be made to change much of the way the offer plans and make money.  I don't think the Republicans intend to ask the insurance companies to make such major changes.  Plus it would take multiple laws to control the interstate commerce of health plans.  There would need to be oversight and control.  Again, not a basic Republican calling card.  

                                                                                The Second Opinion

If there is a new diagnosis, chronic illness, need for a radiological tests, surgery or procedure, get a second opinion.   Medical professionals do not always agree on the diagnosis or treatment.  A new set of eyes can read a report, lab or radiological films differently.  In order for you to make an informed decision about your healthcare, you will need to know all your options.  Insurance companies generally pay for a second opinion and even a third or fourth opinion.  Your doctor will not drop you for getting a second opinion. Many doctors appreciate a second opinion.

The article stated the  American Legislative Exchange Council (ALEC) was driving this movement.  I read the information on their website and found it well presented yet inaccurate in places.  One of the premises for an amendment is to stop any single payer system.  Their premise reads:

                                            Protecting the Doctor-Patient Relationship

"ALEC's Freedom of Choice in Health Care Act ensures a person's right to pay directly for medical care.  Single-payer systems, like in Canada, make it illegal for citizens to go outside the government's health care plan and contract for their own medical services.  Cost overruns require most single-payer plans to restrict patient choices, and instead mandate an "evidence-based" treatment schedule that standardizes care."  (taken from ALEC website)

I am not going to discuss the single payer system but the premise that evidence based medicine already controls our health care.

This process already exists and it is called the insurance companies. One of the reasons I left private practice was because it was being controlled by the myth of evidence based medicine.  Our care already is dictated by what the insurance companies deem medically necessary based on cost and evidence based medicine.  It is an illusion to think that most doctors haven't bought into this.  It is the standard in medical care now.  Evidence based medicine translates into : thinking outside the box means no reimbursement and patient pays.  There is always a third person in the room with the doctor and patient , the insurance company.  How many people can afford a treatment not covered by health insurance?  Very few and many die because the treatment is unreachable financially.

ALEC also wants states to allow citizens to buy healthcare across state lines.  Great idea and  would agree if ALEC could guarantee it was not considered out of network.  Yes let's have more  insurance options with lower premiums.  The problem is all the options allow insurance companies to exclude for pre existing conditions and drop people if costs are too high.  Why can't ALEC get on board with no pre existing conditions?  Perhaps there would be less uninsured if insurance companies couldn't deny people coverage because they had been sick.

I would like ALEC to do the research or talk to  people like myself who daily are trying to secure health insurance or negotiate medical bills or get an insurance company to pay for a much needed procedure that every doctor agrees is necessary.    What relief will an  amendment give to any American to relieve increasing premiums or being denied for pre existing conditions or have thousands of dollars of medical bills?  I want an amendment that reads NO PRE EXISTING CONDITIONS and NO DROPPING PEOPLE FOR BEING SICK!