On
Sept. 8, I read a well-written but misleading letter to the editor in the
Durango Telegraph. The letter dismissed ColoradoCare Amendment 69 and went on
to praise the perfection of our current Colorado workers comp arrangement. The
author, a big-time insurance executive, skipped over the many reasons so many
workers feel abandoned, cheated and locked out by what they experience as an
adversarial workers comp insurance bureaucracy.
Too
many workers find themselves forced to deal with insurance representatives,
investigators and regulatory agents who seem to view every claimant as an enemy.
Instead
of being allowed to focus on resolving questions and healing, injured workers
too often find themselves having to struggle for legitimate compensation from a hostile system.
After
reading the letter I felt compelled to give voice to the ignored side of this
story. For my response I did a lot of internet trawling for information and my,
oh, my, the onslaught of ugly stories and sad facts overwhelmed me at times.
First,
revelations of the scandalous health-insurance executive perks, bonuses, golden
parachutes and such that have been paid for by developing a culture dedicated to rejecting claims.
Then
the seemingly inhumane expectations, stress and over-worked conditions doctors
and nurses must endure. At 400 work-related doctor and medical student suicides
a year, it’s a professional crisis. Of course, dealing directly with this
problem would impact the corporate bottom-line, so the problem gets swept under
the carpet, just another costly externality to ignore as much as possible.
Even
more startling was all the evidence that shows “independent medical exams” have
become anything but impartial efforts to arrive at the truth. Patients complain
of feeling like they are up against a stacked deck. The negotiation and appeals
processes are likewise rigged against workers, who are treated more like
bothersome expenses than humans trying to get the health care they need.
In
the middle of all this I learned of the strange ongoing saga of Dr. Tom Horiagon, master of occupational health (also internal medicine, pulmonary, critical
care and sleep medicine) and his non-profit clinic that was summarily shuttered
in a matter of a couple hours. What could the man have done to deserve it?
It
wasn’t patient complaints; there were no professional or medical misconduct charges against this doctor. His sin was
being a vocal advocate for down ’n’ outs and injured workers. His non-profit
clinic had insurance companies on edge because of the precedent he was trying
to establish and they took their gripes to the Colorado Medical Board.
It
appears he took his patient advocacy too far when he agreed to accompany a
couple patients to their IMEs because they didn’t trust the good-faith of the
examiner and desired a knowledgeable witness, something that is legally
permissible.
That
precipitated a bizarre cascade of petty events and bureaucratic moves that
culminated in Dr. Horiagon receiving two-hours’ notice before his practice was
forced to shut down, leaving needy patients without their doctor.
The
drama continued snowballing and within a couple weeks he found his license
suspended with no due process – once again, bureaucratic fiat stomps the
opposition.
It
had me curious so I contacted Dr. Horiagon. He was helpful and informative,
sharing many documents and responding to questions. The more I read, the more
childish this saga felt, which would have been comic if not for its intent to
destroy a good man’s career.
I
asked Dr. Horiagon about independent medical examinations. He responded:
“The process of doing (Independent Medical Exam) IME's, or formal
second opinions, will never be fair to workers if the only second opinion you
can get is from a physician who is paid by the insurer.
“There are companies of physicians, like
Integrated Health Management, that ONLY exist to knock out claims. (Colorado Medical Board) CMB was
well aware of the IME advocacy I did.
“Giving my IMEs away for free was unprecedented in
Colorado, not to mention that I was Level II-certified in DWC/CDLE Level II
full accreditation, and have four board certifications, worked at National Institute for Occupational Safety Health (NIOSH), and
have specialty training in occupational medicine from the Center for Disease Control (CDC) and Harvard
School of Public Health.
“So these exams would have been worth quite
a lot if I worked for the dark side. The (Colorado Physician Health Program) CPHP records I got from a
subpoena document this very clearly.
“The physicians in the current system who do IMEs for
cash are paid to lie for the insurers. It is that plain and
simple. And the level of training they have is minimal compared to my
training.”
Dr.
Horiagon has spent the last year forced to squander his precious time and
resources struggling to regain his rights within a medical regulatory system
that does not want to hear from him. What I found most unsettling was that as I
accumulated more information, it became plain that Dr. Horiagon is but one of
many such instances. Try googling “Physician Health Programs (PHPs) under fire”
or “Pauline Anderson at MedScape.com,” it’s an eye opener.
What
happened to the humanity that used to infuse our health-care system? How can we
recapture some of that? It will never come about with profits-obsessed, amoral corporations who created these conditions
to begin with.
That’s
why I support ColoradoCare Amendment 69 with all its warts and yet-to-be-resolved
details and challenges.
It’s
going to force We The People of Colorado to take some responsibility for
our own health-care system. We will need to become engaged. We will need to
encourage and support integrated professional medical groups, IT resources and
others working together.
It’s
a challenge, but a constructive one. It sure beats constantly banging our heads
against the brick wall of corporate self-interest while nothing changes, or
worse.
Vote for ColoradoCare –
Vote YES on Amendment 69.
https://www.youtube.com/watch?v=81mU0NjTacg
Published on Jan 31, 2016
Senator Irene Aguilar answers questions regarding Colorado Care
No comments:
Post a Comment