Excerpts from Ourselves Growing Older
State Level Action
Changes and proposed changes in state-level programs of financing and delivering health and medical care are under way in many states. These changes will surely affect you since they are designed to either reduce costs, increase coverage, regulate the insurance industry, ration care, or change the rules that determine who is eligible for what kinds of state-supported care.
It is likely that any state that has already enacted a state-level plan in anticipation of a national program will be allowed to keep most of that plan. As a result, the same special interests trying to prevent serious change in Congress are working at the state level as well. Several states have already begun moving to a managed-competition type model of care in anticipation of the federal program. Insurance reforms are badly needed in most states, as we describe elsewhere. Medicaid’s rising costs stimulate cuts that hurt poor women of all ages and children. These cuts should be opposed. Other states are trying to install managed-care programs for all citizens not covered by private insurance, or play-or-pay models to establish employer responsibility. (see Reformspeak box)
If you belong to a women’s organization, urge them to study these issues in your state, and join with other statewide women’s groups to get involved in assessing what your states legislators are doing about changes in the present health-care system. You can get in touch directly and personally with your representatives in the state legislature, asking what position they plan to take, what bills they are supporting, and why. Tell them what position you favor, and why.
Your local group can invite legislators to speak in the community, to explain how they plan to support needed changes that will affect women, especially older women. Have the Older Women’s league or League of Women Voters plan session in your region where all state representatives will be asked to come and explain the basic health-system changes they are proposing or supporting in the different bills—changes in insurance reform, Medicaid benefits affecting the poor elderly, caps in earnings, long-term care, or any other alterations to the existing state system. Your calls and letters do matter!
Many women have felt shut out of the legislative and governmental processes in our state and our nation. Many of us have felt alienated and disempowered by our experiences in the health and medial-care system too. Sometimes we have been treated as if we do not deserve more, and may be given the feeling that we should be grateful for what we have received. Feeling this way alone can be a devastating experience, but knowing you are not alone is one of the most exhilarating experiences women can have. Working with other women to make our vision real is as important as winning. Whether the changes coming will be big or small, women must be part of them, trying to make them happen-- for ourselves, our children, our parents, and all those we care for. We hope you will want to work with us for these changes.
HOW TO BEGIN TO GET BETTER MEDICAL CARE*
Talk to many other women about individual doctors and clinics. In choosing a doctor consider also the hospital at which the doctor practices. Contact women’s groups or consumer groups to get more information about costs, attitudes, and medical competence of a number of practitioners and clinics. See the Directory of Medical Specialists in your local library or at your local medical society for the doctor’s training history and qualifications. Check the medical society or the state board that licenses physicians for complaints against the doctor you are considering. Review your rights as a patient.
During your visit
Know your own and your families medical history. If possible, bring a written record of your own. If you have a problem, write down when it began, symptoms, etc. Write down any questions that you want to ask.
Bring a friend with you.
Firmly ask the practitioner to explain your problem, tests, treatment, and drugs in a clear and understandable fashion.
Take notes or ask your friend to do so. (A tape recorder, if you have or can borrow one, will help in case of long, complicated explanations.) Such record keeping can be invaluable, so try to be assertive even if your doctor reacts defensively.
Ask the doctor to prescribe drugs by their generic rather than their brand names (for example, aspirin, not Bayer). This will save you money.
Talk to nurses and assistants they are often sources of valuable information and support and may explain things better than the doctor.
Ask for a written summary of your visit and any lab tests and x rays.
Remember, you have a right to a second opinion. If a series of expensive tests or surgery is recommended, you can tell the doctor to wait until you consult another doctor. This may prevent unnecessary procedures and treatment.
Don’t forget—it's your body and your life. You have a right to make decisions about tests drugs, and treatments.
After your Visit
After the visit, write down and accurate account of what happened. Be sure you know the name of the doctor and others involved, the date, the place, etc. Discuss your options with someone close to you.
"Shop" drugstores, too. Drugstores in poorer neighborhoods may charge more than those in middle-class neighborhoods. Ask to see the pharmacist’s package inserts listing medical indications and contraindications. Some drugstores will keep track of all your prescriptions and will check for harmful drug interactions.
Have the name of the drug and clear instructions written on the label because of the risk to others who may take it in error and also because when traveling abroad you may be challenged for possession of pills.
If you get poor treatment, if you are given the wrong drugs, if you are not listened to, it is important for your own care and that of other women that you protest. Then write a letter describing the incident to one or several of the following:
- The doctor involved
- The doctor who referred you
- The administrator or director of the clinic or hospital
- The director of community relations of the clinic or hospital
- The local medical society
- The state board that licenses physicians
- The organization that will pay for your visit or treatment (for example, your union, your insurance plan, or Medicare)
- Community agencies, councils, or boards
- The local health department
- Local women’s groups, women’s centers, newspapers
To complain about a hospital or other health-care facility, contact one of the following:
- Joint Commission on Accreditation of Health Care Organizations, One Renaissance Boulevard, Oakbrook, IL 60181
- American Hospital Association, 840 N. Lake Shore Drive, Chicago, IL 60611
It is hard for one woman to work alone; however, health-care consumers can work together to get the treatment and services that they need.
* Adapted from the Boston Women’s Health Book collective, The New Our Bodies, Ourselves. New York: Simon & Schuster, 1992, pp. 678-79, based on material originally from HealthRight, Inc.
END OF CHAPTER.
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