The Perils of Privatization

 

Now that the Republicans control Congress, you will be hearing a lot about privatization. You will hear that services usually supplied by the government should be turned over to private for-profit interests. The reason cited will be enhanced cost effectiveness.

But, for the past few years, I have had to deal with the privatization of my health care, and it has been anything but efficient.

Back in the Bush era, Congress passed a law to subsidize prescriptions for Medicare patients, and included a provision under which private companies could administer the prescription program. It’s called Medicare Advantage, and in many ways it has been a godsend.

But it has also been a nightmare.

I first joined a Medicare Advantage program provided by United Health Care, but that program didn’t last long before United canceled it. So I switched to Quality Health Care, which went bankrupt, causing a slew of bureaucratic problems. My next choice was Physicians United, and that went belly up, too.

I consulted Medicare.gov and they recommended Coventry, which was an excellent program – while it lasted. A few months ago, I received a letter telling me Aetna had bought Coventry and was canceling my program at year’s end.

I went back to Medicare.gov and came up with CarePlus, a Humana program, as my best bet.

Medicare.gov did not mention that few doctors in my area accept CarePlus. And that was just the beginning of my nightmare.

As the year drew to an end, I was in Lakeland Regional Medical Center undergoing treatment for a severe ear infection, I was discharged with a PICC (Peripherally Inserted Central Catheter, illustration above) in my arm, so I could receive four weeks of daily antibiotic infusions.

But CarePlus doesn’t use the same home care agency as Coventry, and that created a scary dilemma.

I tried to get the new primary care physician assigned by CarePlus to arrange for a change in home care but for reasons that I cannot fathom, the new doctor ended up referring me to Hospice.

I contacted CarePlus and requested a new primary care physician. After numerous phone calls, back and forth between CarePLus, the new doctor’s office, the agency used by CarePlus and Coventry’s home care agency, I finally got a doctor’s appointment for today.

I can only hope that this will finally mean a seamless transfer from Baycare, the home care agency that has been giving me my antibiotic infusion every day – the past week and a half without getting paid – to a new agency that will get paid by CarePlus.

Otherwise, I will have to give myself the IV. And I can’t see very well. I have a cataract in one eye and the other eyelid is paralyzed (I hope temporarily) by the inner ear/mastoid inflammation.

I am not sure what my experience says about privatization. But it looks as if its success is based on a lot of private companies going broke in a dog-eat-dog competition for the government’s business.

And it doesn’t provide anything like efficient service to the taxpayer. Not to this taxpayer, anyway.

More on privatization