Let the Circle Be Unbroken

All of us at HomeCare and in our parent company (Penton Media, one of the country’s largest business-to-business publishers) recently had to re-enroll for insurance benefits. The company has overhauled policies, changed carriers and, as a result, there is a vast array of benefits and plans available. I’m grateful, of course, but it took a series of emails, a Webinar with a human resources expert and a giant packet of informational materials to explain our new insurance smorgasbord.

But once armed with all that, when it came down to choosing our individual plans, we were on our own.

Something similar is happening throughout the nation’s health care continuum, if you can actually call it that anymore. Patients in the system — and that includes all of us — are pretty much on our own.

The United States has some of the best medical services available in the world, but as medical capabilities grow, our system grows more complicated with them and the “continuum” becomes increasingly disjointed. There is little coordination among physicians and seemingly less between care settings.

When patients are prescribed medications, for example, no one checks to see whether those prescriptions get filled. An estimated 20 percent of them apparently don’t. Where’s the care there? My veterinarian calls the next day to make sure our family dog is okay after I’ve taken him in for a checkup.

Costs are astronomical. Some children go without the most minimal health attention. Seniors have a drug benefit that we’re all paying for, but they are stymied when it comes to choosing the right Part D plan. After wading through several of those with my mother, I wish we had been lucky enough to have an HR expert to help.

When Jan. 1, 2009, rolls around and the Deficit Reduction Act’s ownership transfer kicks in, Medicare beneficiaries on home oxygen therapy will also be saddled with arranging their own equipment service and repair, not to mention taking care of themselves when the power goes out. Some of the seniors I know have problems figuring out their microwaves (I am carefully not mentioning my mother here), much less maintaining an oxygen device.

We can see the health care circle is broken. I’m sure we all hope the politician who wins the nation’s top job will work to fix it. Those in the running certainly seem to have lots of ideas on the matter.

In the meantime, we know that referral sources depend on HME providers — you — to determine the appropriate equipment for their patients after the prescription has been written. That is a serious responsibility. We know that when your patients are homebound, your technician or therapist may be that person’s only health care contact over a stretch of weeks or longer. That is another huge responsibility, yet you shoulder it willingly. It is you who keep their oxygen tanks filled, you who coach them through CPAP therapy, you who fit their wheelchairs properly, you who assess their homes to make sure PMDs will work with their lives, you who call to check on them during emergencies.

Both your referral sources and your patients are counting on you to explain, to educate, to be there when they need you — to care. Don’t let them down. Fight to stay around.

Contact your federal legislators and let them know what could happen if there are more cuts to oxygen or power mobility. Let them know what will happen to your company and your patients if competitive bidding goes further. Let them know that as our health care system turns to home care for help, there must be a sufficient number of HME providers in every local area to continue the continuum.