Saturday, December 27, 2003

American Justice Part 1

They're lined up around the block." LaVerne looked out the window. The guests attending the Grand Opening of the Starzinsky Elder Lifestyle Improvement Center were dressed to the nines, despite the black puddles of slush on the sidewalk. The only flaw in this picture was the man sprawled out in a pile of wet cardboard across the street. He had been there for as long as she could remember. The crusted blood and his broken face marked him as something to avoid.

LaVerne still couldn't believe how smoothly things had gone during this year, transforming the Star Ortho-Surg Clinic into this welcoming home of an innovative program for the community. The federal auditors had taken most everything, except the lease on this prime real estate right across from the Verizon headquarters. It was LaVerne's quick thinking that had brought the Verizon Retirees Assoc. together with the community leaders to fund the project.

Dr. Tony Star took a fast look in the back seat of his classic Mercedes. "The Russians won't miss a couple of hip replacements here, a few knee repairs there." He paid them plenty for the referrals their No-Fault scam provided. He knew he'd be basking in the sun, spending the cash that was now stashed in the Mercede's boot, long before the Courier News caught wind of the Attorney General's investigation into fraud at the clinic.

Dr. Star was lost in a fantasy where an ice cold Mohita was being brought to him by a nubile young native girl. No more Russian Mule Sweat for him, after he collected on this last procedure. Lieutenant Dan had great insurance.  The seconds pins, Dr. Star used on the Lieutenant's son, wouldn't hold up for any fancy footwork, but the savings were paying for Dr. Star's Cessna. He thought he remembered something about the kid going to college next year anyway.     

Author; Caryn Isaacs

American Justice Part 2

PLEASE READ American Justice Part 1 FIRST!

He heard, more than felt the fist that broke his jaw. Dr. Star couldn't see where the blows were coming from because his eyes were rapidly filling with blood from a cracked skull. He couldn't breath through his broken nose. The cold on his crumbled teeth brought him to his knees and he scraped his face against the bumper of the gleaming classic Mercedes. He struggled to stand. He thought he could make it to his office across the street, but this was the 15th. The 15th was the one day of the month that garbage was still collected. The brakes on the city garbage trucks were also a victim of Dr. Star's hand picked Mayor's budget cuts.

Dr. Star was catapulted against the pile of cardboard boxes leaning against the Verizon headquarters.  He didn't know how long he had been sitting there. From time to time he could see someone in a uniform would come by to bring a cup of coffee or some soup. Dr. Star alternately yelled obscenities and pleaded for recognition. He was sure someone from the clinic would be looking for him soon.  

LaVerne turned from the window. " Dan, can't you get that guy to move somewhere else. I'm giving my speech in front of this window and I don't want the guests to be reminded of the rest of the city's problems."

"Sure, I'll get my son to call a few friends from the Precinct. He loves to help out here. It will be good practice for him when he is a doctor, himself.  Mike's really grateful for the The Anatoly Starzinsky scholarship. After his legs were ruined by that quack, he didn't think he'd get to go to college.    

LaVerne agreed, "If  you and your son hadn't been here, on the same day that Dr. Star disappeared, we may never have found all that money in Dr. Star's car. Your being a policeman must have scared him into leaving the car behind."

"Yea, I call that real American Justice."  

Author; Caryn Isaacs


Monday, December 1, 2003

The Perfect Partner

Here are some American health system partnership arrangements that have changed the way we receive and pay for care. 

1960     The patient and the doctor are partners in health.

You feel sick, you call the doctor's home. His wife says he'll be right over.  He leaves you some medicine and you give him a check. If you don't get well, it was just your time to go.

1970     The patient and the employer are partners in health.

You feel sick, you go down to medical. The staff gives you some medicine and tells you to go back to work and enroll in the company exercise class.  If you don't get well, you can always go on disability or collect on your pension.

1980     The patient,  the clinic and the insurance company are partners in health.

You feel sick, you stop at the clinic in the mall. They do some tests. The secretary gives you a prescription. You wait for your pills to come in the mail. It's all billed to your insurance plan. If you don't get well, you can pursue the options up to the maximum of your plan allowance. Then you can pay the bills from your pocket or claim bankruptcy.

1990     The patient, the provider and the payer are partners in health.

You feel sick, you call your primary care facility. A nurse practitioner discusses your symptoms. She says they will call in a prescription to your pharmacy plan.  If the medicine doesn't work , you can come in next week for an approval form to see a specialist. Your HMO pays the bill. If you don't get well, you can change HMO's or your heirs can sue for malpractice.

2000    The Consumer, the Supplier and the Provider are partners in health.

You feel sick, you go on the Internet to upload your symptoms to the Provider Benefit Manager's web site. You wait for EMail competitive bids for alternative treatment options from Suppliers. Enter your card number to have the amount deducted from your health savings account. Print out a receipt and bring it to any Super Store for Self-Directed Healthcare.  If you don't get well, call the consumer health partner support group.

Author; Caryn Isaacs