Patients Behaving Badly and Fixing American Healthcare: Dr. Richard Fogoros Offers Solutions

There's an interesting article in Salon.com by Dr. Rahul Parikh, talking about how Blue Cross of California was sending letters to doctors, asking them to report conditions that their patients may have hidden when they applied for health insurance. The company's purpose was to expose policyholders who failed to disclose "preexisting conditions," so they could cancel their policies. At the same time, we have a study out of the University of Miami that found that among 800 patients in physical rehabilitation for pain, more than 1 in 20 admitted feeling like they truly wanted to murder their physicians! Then you have doctors like orthopedist and Time magazine columnist Scott Haig, MD, who in one infamous column, openly mocked empowered patients who do their own research before a medical appointment, referring to them derisively to as "Googlers" and "brainsuckers."

It's no wonder medicine is a mess, when insurance is out to abandon patients, and doctors are selling out patients to insurance companies, patients want to kill their doctors, and doctors think empowered patients are a pain in the neck!

Shocked? You shouldn't be. These sorts of things are going on every day in America's dysfunctional, discombobulated health care system. And if you're the kind of patient who doesn't know what's really going on, you're going to end up on the wrong end of the medical system, sad to say.

We all know we're facing many challenges in our health care system. Certainly at a national level, we need solutions to deal with the fact that there are 50 million uninsured people in America. (And if you don't hear enough about that, stay tuned to upcoming Presidential campaign debates, because I'm sure we'll all hear more than we ever wanted about health care reform -- or the lack of it!)

But individually, many of us access our health care through a less-than-perfect system of health insurance and HMOs. And we are up against a challenge that is coming to be known as "covert rationing" -- a term coined by cardiologist, author, patient advocate and health care policy strategist Richard Fogoros, MD -- known as "DrRich." With covert rationing, not only do insurance companies do such obvious things as try to cancel policies when we're sick, but behind the scenes, they are doing whatever they can to systematically deny patients access to specific information, experts, specialists, procedures, treatments, and medications we may need.

But how do we learn about these covert tactics? How do we find out exactly what is going on behind the scenes in doctor's offices, hospitals, as well as the offices of drug companies, insurance companies and HMOs around the country? How can we know what the doctors and insurers and HMOs don't tell us -- and don't want us to know?

My suggestion: start by reading DrRich's book, Fixing American Healthcare: Wonkonians, Gekkonians, and the Grand Unification Theory of Healthcare. Full disclosure here: I wrote the foreward for DrRich's book. More disclosure: I happily volunteered to do it, because as a thyroid patient advocate, part of my role for the last decade has been to help expose the many ways our medical system is failing us, as relates to our thyroid disease. I was seeing covert rationing in action -- I just didn't know what it was called until DrRich came along!

There's a bigger picture. Even when we're aware of covert rationing, how it works and the dangers it poses, we need to know what's next. What can we do to protect ourselves and our loved ones from falling victim to it?

That's where DrRich's book shines. Fixing American Healthcare presents what DrRich has called the Grand Unification Theory of Healthcare, GUTH for short. Grand it is, as it explains how doctors, patients, and health care companies all fit together and interact with each other, and how you can navigate that complicated system to make it work better for you, personally. And perhaps most importantly, how you can improve your own odds of getting well, staying well -- even surviving -- in the face of disease or illness. The book also looks forward and lays out a plan to explain how the system could be better if particularly improvements were made.

I know that those of us with chronic diseases can get into our own little worlds of doctors, medications, and treatments specific to our own condition. That makes it harder to step back and take a look at the bigger picture. But I truly recommend that you do, and Fixing American Healthcare is a good place to start.

It's no secret that I'm always urging readers and fellow patients to ask questions, insist on knowing your options, challenge the conventional dogma, and don't believe everything you hear -- whether it's from a doctor, a nurse, a pharmacist, a drug company ad, or a medical journal article. I'm always encouraging people to read, study, learn, and be educated, empowered patients. In Fixing American Healthcare, DrRich refers to people like me as "patients behaving badly." He doesn't intend it as an insult -- actually, it's a compliment. He's talking about patients who ask questions, who do their homework -- those of us who aren't walking around with their heads in the sand.

According to DrRich, if enough of us patients behave badly at the micro level, our grassroots effort will force the system to change at the macro level. So in this way, apart from writing to Congress, or voting for whichever Presidential candidate you think can save America's health care system, we may be able to have an impact on American's health care system.

So the best part is that each and every one of us is part of the solution -- in fact, the solution relies on us.

DrRich -- when he's not out there advocating for patients, and trying to change the world and reform health care -- is also About.com's Guide to Heart Disease. So even though the title may sound a bit imposing, keep in mind: Fixing American Healthcare: Wonkonians, Gekkonians, and the Grand Unification Theory of Healthcare is all about bringing some heart back into health care, and what we, as patients, can do to help make that happen!

Whether you are concerned about the care about the quality of your own health care, or the status of health care in America -- or both -- a wonderful first step in your education is reading Dr. Rich Fogoros' Fixing American Healthcare.

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