Scott A. Edmonds, OD, FAAO, focuses his blog on the role of the optometrist in health care reform – moving from primary eye care to primary health care. He is the chief medical officer of MARCH Vision Care, the co-director of the Low Vision/Contact Lens Service at Wills Eye Institute in Philadelphia and a member of the Primary Care Optometry News Editorial Board. 

Disclosure: Edmonds is a consultant for March Vision.

BLOG: Government frustrations

The new year is off to a rough start. Mother Nature has swept the country with a series of disabling storms.

The last week of January promises a visit from the dreaded Polar Vortex, with record cold temperatures for much of the country. If that’s not enough, our cherished democracy is showing us the worst-case scenario of a system of checks and balances. How a petty argument over border security can cripple our government services and punish 800,000 unrelated government employees is beyond comprehension. The founding brothers are turning over in their collective graves.

To optometrists and many other health care providers in private practice waiting for payment for services rendered in good faith is not a new concept. How many times have you rendered services or supplied ophthalmic materials to a patient with some type of government-sponsored health care plan like Medicare, Medicaid, Tricare (formerly CHAMPUS) or the Veteran’s Administration and had your claim delayed or rejected? After many phone calls, resubmissions and delays, your payment finally shows up with no explanation or apology. Welcome to life in America.

Unlike our government workers however, health care providers have other lines of revenue to float us over the inept government plans and allow savvy business operators to continue to care for these people. But that doesn’t make it right or fair. The Internet and new automated systems should have made this better or more efficient but, alas, it has made it worse. Now when we attempt to call and resolve a problem, there is no human being that even understands the problem let alone being able to make an attempt to rectify things. Is it any wonder that doctors are experiencing physician burnout in record numbers?

Unfortunately, it is this same government that is responsible for creating, negotiating and legislating meaningful laws to support health care reform. Given the nonsense witnessed by all of us in the last month, there is little hope that these same people can lead us to any type of reasonable solution for a workable health care system. Please follow this three-ring circus closely, watch how your elected officials operate and perform, then remember what you learn about these folks come election time. These people are only there because we elected them.

In the meantime, we must rely on the health insurance industry to develop meaningful reforms. Fortunately, we continue with a hybrid system that depends on a balance between government and health plans to develop and execute our programs. It is times like these that demonstrate the dangers of a single payor system.