I think freedom is critical in optimizing people's health care. For patients to be able to choose their own pharmacist, their own hospital and their own physician is as important as it is rare.
Unfortunately by relying so heavily on health insurance and the inflated prices related to that, most patients are financially pressured into using a mail-order pharmacy service. From personal experience I can tell you, many of the operators for these places lie.
When I called to check on the status of a prescription I mailed in for my son I was told that I had not received it because they had called the doctor's office and the doctor personally canceled it. I was never given an answer on how that was possible since I was the ordering doctor and didn't remember that phone call.
My office has been called by these mail order pharmacies on several occasions to notify me that a patient specifically requested that I change a medication to one which would save the patient (and more importantly, the pharmacy) a lot of money. When my nurse would call the patient to confirm this, the patient would not be able to remember that phone call.
Either both I and my patients have extremely poor memories or these mail order pharmacy employees could give lawyers a run for the money ethically. If you have an insurance that provides prescription benefits, you should be able to use those discounts at the pharmacy of your choice.
A local pharmacist can be an important member of a patient's health care team. They establish a relationship with their customers and can provide important advice on appropriate over the counter products to take with an individual's prescription drugs, they can advise your physician on possible drug interactions, and they can provide education on the best and safest ways to use the medications.
Only having one local hospital, the choice of hospitals is not a large issue for most of the residents of Henry County. It can come into play when your doctor needs to transfer you from Henry County Memorial Hospital to one in Indianapolis. Due to the large expenses incurred from a hospitalization, a patient that is not independently wealthy will go to a hospital where the insurance will cover the expense.
Your primary care doctor may have a preferred hospital to send you to based on where he trained or based on previous good experiences. Overall I do not see this as a big problem as my experience has been good in dealing with doctors at all the major hospitals in Indianapolis.
The biggest obstacle to optimal health care is the restrictions placed by insurance companies on which doctor the patient is allowed to see. In the "good old days" this decision was left entirely up to the patient and it worked well from everyone's perspective. That is until the insurance companies realized they could make more money by changing the status quo.
The health insurance companies reasoned that since they paid the bills, they could control which doctors the patients went to see. Just as they do with pharmacies, the choices are based almost entirely on the cost to the insurance companies. The doctors who were willing to discount their prices were "preferred providers" to them. Quality of care didn't enter into it. This meant that instead of allowing the patient complete freedom to choose their doctor, choosing a "non-preferred" doctor was now a more expensive option than a "preferred one.
While with most insurance the customer has certain rights in choosing who repairs their car or house after an insurance claim, not so with health insurance. The insurance company can elect to not pay anything if you exercise your freedom in choosing a pharmacist, or hospital, or even a doctor who is not a "preferred provider".
Some might argue that such is the prerogative of the health insurer since they are paying the bill. I would suggest that health care is different, that there is an intimate relationship between a patient and a doctor and that to be able to receive optimal health care it is necessary to have a trusting, ongoing relationship with a "patient preferred" physician.
I believe that health insurance policies should of necessity be required to offer the same benefits and services to whomever the patient prefers in regards to their choice of pharmacy, hospital and especially physician. The patient's freedom in choosing their health care providers should supersede the insurance company's right to dictate who they will provide benefits to on behalf of the patient.
