Rules and laws and health care

2013

Consider this real life scenario.

A patient in one state requiring wound care will be in another state for a couple of months. To make life easier she wants to visit a wound center in the state she is visiting. Unfortunately, the out of state center won’t see patients to change a dressing and check equipment unless they are in charge of the case … one door closed.

The visiting nurse association will change the dressing, but they can’t do so because a state law requires a referral from a physician licensed in that state … another door closed.

Why in the world can’t a patient engage a visiting nurse to change a dressing without a referral? And why can’t a referral from the attending physician regardless of where he practices suffice in any case?

The answer is simple, we have a disjointed, uncoordinated, unintegrated health care system … and one obsessed with protecting itself from liability and violation of scores of laws. In effect we have fifty-one health care systems, one for each state and another federal system.

And you thought we solved the health care problem!