Obamacare Turns Wellness Exam into Dying Discussion

Last Monday I got up early, went to gym, did my cardio and took an hour long Pilates class. Then I had a shower and set off for my annual Wellness Exam. (One of those new mandated benefits of the Affordable Care Act [Obamacare] and/or Medicare).

It was a lovely bright blue summer morning, my first day free from a nine month project I had been managing for one of Silicon Valley’s elite technology companies. I was feeling really wonderful – until I got to Palo Medical Foundation.

The receptionist greeted me promptly and took my co-payment. Then she handed me a clipboard with a form attached.

Welcome to the Most Annoying Form on The Planet

It is legally required to be filled out annually by all of us who have reached a certain age.

I wonder if Hillary Clinton’s doctor or Nancy Pelosi’s doctor has the nerve to tell her the form is the law and she has to fill it out. I’m not as old as they are!

The first question asked if could bathe myself without assistance. It went downhill from there.

No, I am not depressed. At least I wasn’t until I walked into the clinic.

Yes, I live in a house with stairs. I run up and down them countless times every day.

Yes, I dispense my own medications – for allergies – because all native Californians are allergic to something. It’s in the air.

No, I have never accidently overdosed myself. In fact, I read the fine print that comes with the medication and take the pediatric dose because I don’t weight 100 pounds soaking wet. There’s nothing wrong with my reasoning!

Yes, I’ve filled out my Healthcare Directive. No, I don’t discuss it regularly with my son – he knows my wishes.

By The End of the Exam I Did Need Medication to Lower My Blood Pressure!

Not only did I have to fill out the questionnaire but the doctor then asked me all the same questions, again. The actual physical exam plus the laboratory blood draw took a total of 10 minutes. The argument about giving me the required referral to see my true primary doctor – allergy and immunology – took another 10 minutes.

The remaining 30 minutes of the exam had nothing to do with keeping me well, happy, productive and independent. Rather, the focus was on just the opposite – measuring the rate of my decline into Depression, Dementia and Death or as I like to call them – the 3 Ds.

One Size Fits All Government Mindset Taking Over Our Healthcare

It’s nothing personal – I had to remind myself – it’s the one size fits all mentality that pervades the bureaucracy at the Center of Medicare and Medicaid Services (CMS).

It’s a striking example of the outdated thinking that dominates Washington DC.

Today, more than 25 percent of 70 year olds are still in the work force – still paying Medicare taxes every pay period – active, vibrant, engaged and productive.

Any of the leading 2016 Presidential candidates would enter the White House already somewhere along the CMS 3Ds continuum– unless we elect Marco Rubio.

The logic behind the Wellness Exam is management of the four chronic disease conditions that cost the US health care system the most – diabetes, high blood pressure, obesity, and heart disease. The earlier these are identified the more effectively they can be managed – through lifestyle modification and, if necessary, medication – controlling the cost of care.

Put Patient at the Center of Healthcare

If health management is the focus of our modern healthcare system, doesn’t it make sense for the doctor to encourage my active and engaged life-style – maintaining my weight, blood pressure, blood sugar – rather than condescendingly telling me I am in denial?

It’s illogical, but the Federal government is incenting the doctor to focus everyone on preparing to die rather than to live.

They’re just following a basic tenet of modern politics – if you repeat a lie often enough it becomes the truth. Tell me I am in decline until I believe it and obligingly die.

I am a typical Baby Boomer – independent, grabbing the gusto. I’m not likely to return any time soon – unless I am sick or injured – adding rather than reducing the cost of my final care.

In the business world, when a policy or procedure is not customer friendly and may cost either customers or customer wallet share, we change it.

If the Centers for Medicare and Medicaid Services truly wanted to keep Baby Boomers well and productive they’d get the bureaucracy out of the exam room and let doctors and patients decide when and how often to focus on the inevitable questions that surround aging.

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