[villalobos]

I was reading about Obama's plan to make all all health care digital, and how it would cost a lot of money, and could have some privacy issues involved. This reminded of my sister-in-law, who has arrived recently in the US as a visiting scholar. She was vacationing at my place over the holidays and got struck with a severe tooth ache. I'll pass the details about trying to find a dentist who would take her dental insurance ("you are out of area", a whole 200 miles away from where she lives... This alone should be a reason for universal coverage, but I digress). She finally found a dentist who accepted to take her. She had x-rays and it turned out she needed a root canal. The dentist would not do it since she is "out of area" and would only prescribe ibuprofen as palliative care. She then called near where she lives and got an appointment, explaining that she was needing a root canal. At this appointment, another round of X-rays, same diagnosis : " well we don't do root canal I am going to refer you to a "root canal specialist" (WTF?). They have no appointment for the next 2 weeks but sometimes there are cancellations, so let's put you on the waiting list..." Needless to say she called another dentist, who took her in, had her go to a 3rd round of X-rays, diagnosed the exact same problem, and finally did the root canal...

So within one week, her insurance was billed for 3 X-rays for the exact same problem... Had her record been available this would not have happened. I know X-rays are not that expensive, but these are the small things that line up doctor pockets (which more so than drug cost accounts for high healthcare costs) and make healthcare so expensive. So there I think digital health care records would be a good thing.

[ghporter]

There is almost no profit in dental X-rays. Those dental practices may have actually taken a small loss on seeing her. The only profit involved is in the pockets of the insurance company.

And the issue your sister-in-law ran into isn't really lacking digital health records (though this could have simplified things). It's the fact that, in spite of having decent insurance, she couldn't find a practitioner who would see her where she was-due to some artificial construct of the insurance company's making. "Out of area" just means that the insurance company doesn't have a solid contract with providers outside of some geographic area. Which means that, instead of taking care of their customer by providing care wherever the customer is, they forced her to wait (in pain) while they spent more of her money on X-rays. Fixing health care is going to take a lot of things, but one of the biggest is ACCESS to health care wherever you are. And most insurance companies act like we're tied to the ol' farm and never go more than 15 miles from home ever. Dumb.

[mduell]

Why didn't she take the X-rays from the first dentist to the second and third?

You can buy insurance with nationwide coverage (I've never had a problem with being out of area with BCBS or Aetna PPOs); the current system gives you the option of how much you want to pay instead of forcing you into one option like the so-called "universal" schemes.

[Doofy]

Originally Posted by villalobos 

arrived recently in the US as a visiting scholar

Chances are, she wouldn't be in the system anyway so the exact same thing would happen after The Messiah™ has fixed everything.

[OreoCookie]

I didn't know that. I'm glad I never needed health insurance while I was in the US (although I think I would have had to pay for the treatment in advance and then would have gotten reimbursed by the insurance afterwards).

[villalobos]

Originally Posted by mduell 

Why didn't she take the X-rays from the first dentist to the second and third?

You can buy insurance with nationwide coverage (I've never had a problem with being out of area with BCBS or Aetna PPOs); the current system gives you the option of how much you want to pay instead of forcing you into one option like the so-called "universal" schemes.

Not sure that she was given the X-rays. My experience with X-rays is that you have to pay to get a copy. Why would she do that instead of letting the system pay for more X-rays... Heck our child pediatrician makes us pay to fill a travel insurance form...
My point was that had this be digitized somewhere, it would have been accessible readily. And I think that would make perfect sense. Save time, save money. That by the way is irrelevant to universal healthcare.

[villalobos]

Originally Posted by ghporter 

There is almost no profit in dental X-rays. Those dental practices may have actually taken a small loss on seeing her. The only profit involved is in the pockets of the insurance company.

So you are saying the second dentist who knew she needed a root canal and knew she WAS NOT going to perform a root canal on her saw her just for the sake of losing money??

[ghporter]

No, the second dentist needed to do an actual exam, which would include X-rays. You can't diagnose someone without an exam. It may have been that the first dentist got it wrong. When #2 concurred with #1's diagnosis, that was it for him. And as I said, it could have wound up being a small loss in terms of the dentist's time spent on someone the practice couldn't bill anyone for treating.

Oh, and in the U.S., your medical records are YOURS. If you request them, you should be given them, or at least a copy. If the two dentists that were never going to see this person again were asked, it should have been no skin off their noses to give her the films.

[villalobos]

Originally Posted by ghporter 

No, the second dentist needed to do an actual exam, which would include X-rays. You can't diagnose someone without an exam. It may have been that the first dentist got it wrong. When #2 concurred with #1's diagnosis, that was it for him. And as I said, it could have wound up being a small loss in terms of the dentist's time spent on someone the practice couldn't bill anyone for treating.

Oh, and in the U.S., your medical records are YOURS. If you request them, you should be given them, or at least a copy. If the two dentists that were never going to see this person again were asked, it should have been no skin off their noses to give her the films.

But then if the X-rays had been digitized, she could have told the dentist #2 to look at them and decide for herself whether this was right or not, instead of having her to come in, run another set of X-rays. That's where I think that a digital health record would be a very nice advantage.
On a sidenote, how many dentists get it "wrong" on the diagnosis of a root canal...

My records might be mine, but I still HAD to pay to get a copy of my X-rays when I broke my ankle. They would not give it to me for free.

[OreoCookie]

That's strange: here, it's your property, they have to hand them out to you. In the digital age, they even burn you a CD (which is a *lot* more handy than those huge physical x-rays that you don't know where to store ).