Television is often considered a mirror of society, and there's no better reflection of the way health care has changed in this country than in a comparison of an episode from the old "Marcus Welby, M.D." with today's hit "E.R."
In the former, the kindly Dr. Welby, portrayed by Robert Young, had all kinds of time for his patients. Cost was never an issue, and a patient never questioned the doctor's advice, assuming he (one rarely saw a female physician, and never a male nurse) always knew best.
Things are quite the opposite on "E.R." where patient-physician confrontations are a frequent occurrence, cost and method of payment are always factors to be considered in prescribing tests and treatment, and downsizing, layoffs and labor disputes are a way of life.
Some call this new world of medicine "managed care," others would describe it as "managed chaos." In any case, it's important for you, the consumer, to know just how to cope with the array of doctors, hospitals and insurance providers competing for your health care dollar.
While there have been great advances in medical technology in recent years, the great shame of our era is that many people are denied access to the latest techniques or medicines due to lack of insurance or, if they are insured, a lack of knowing how to get the most out of that plan.
Getting the most from your HMO is the purpose of the series that's been running in the Evening News this week: "Surviving managed care." We've explored the pros and cons of the increasingly popular HMOs (health maintenance organizations), provided a guide to some of the jargon you're likely to hear from your doctor or HMO administrator, offered tips on how to select the primary care physician who best fits your needs, and gone to the experts for advice on how to navigate the maze of HMO rules and regulations.
In Dr. Welby's day, no one thought much about the cost of health care. Doctors, hospitals and laboratories simply submitted their bills to the insurance carrier, which passed those costs on to the customer. Since in many cases that customer was an employer or government agency, the actual costs were well hidden within one's paycheck or tax bill.
But as health costs soared out of all proportion to those of other goods and services, and both business and government sought ways to reduce expenses as the economy dipped, the pendulum swung hard in the other direction. The result was the brave new world of utilization reviews, drive-through surgical procedures, and physician gag rules with which we are dealing today.
That's why when you want something out of your doctor or insurance provider you have to yell like crazy. But it also helps if you know your way around the system.
That's our view. What's yours? If you have an opinion about managed care drop us an e-mail at sen@ecnnews.com
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