Thu, May

Health Care Costs Are UP, Coverage is DOWN...What Do We DO?


THE DOCTOR IS IN - As someone who thinks outside the box (or certainly tries to), I am extraordinarily concerned about (and scared for) all of us...because medical needs are going up and are being unmet, but there are fewer health plans or options available to most of us. 

And the burnout rate, and an accompanying dropout rate, of physicians is as high as it’s ever been. 

So, what do we all do? 

The immediate goal is for us all to find care anywhere we can, and get our medications anywhere we can: 

1) Get over any closed-minded or backwards-thinking attitudes about nurse practitioners and physician assistants being a bunch of uneducated idiots. The main metric should be how long out of their training a health care provider is...because the more years outside of their training there is, the greater the risk of doctors' knowledge and compassion going down. 

And the greater the opportunity there is for a nurse practitioner (NP) or physician assistant (PA) to become more knowledgeable, more savvy, and better for you. 

If a primary care clinic is run by NPs, and there's good MD oversight, then they probably can see you sooner, and may just give a hoot about your health and well-being, to boot. 

2) Nurse practitioners are trained to be PRACTITIONERS and take command of your health, just like medical doctors (MDs or DOs). Physician assistants range from being poorly educated or skilled, to being someone who patients have learned to trust more than most doctors. 

And I remind you again that doctors are burning out and are being overwhelmed at historical levels. Find someone who OVERBOOKS and find someone who CARES. 

3) Ditto for pharmacies and pharmacists.  

Do you know about GoodRx, which is a cheaper and alternative form of getting your prescriptions that your pharmacist or provider can print out for you? 

Does your pharmacist offer you all options to save you money and keep you healthy?  

Do they care? Find out someone who DOES, and maybe check out smaller, non-chain, private pharmacies for the service that we've known in years or decades past. 

4) The perfect is the enemy of the good!  

Get a cheaper generic if it gets the job done for now, and tomorrow is another day to fix any immediate problems. Go online to reputable sources (such as WebMD, Medscape, specialty websites, Mayo Clinic, etc.) to get an idea of what's going on... 

...but while you should be your own advocate, don't be your own doctor. 

5) Get a second job!  

One for your rent and utilities and clothing, and the second for your health and other needs. This may require more than a 40-hour work week, but until something better comes along, the "fairness" of it all is less important than your survival. 

6) Finally, we need to advocate for: 

a) More medical schools to train physicians and other providers (as in, we need to DOUBLE the number of providers, and ditto for nurses).  

b) The medical profession has an army of retiring and resigning physicians, and at the least they're "quiet quitting" and not sticking their neck out for patients because they're horribly burnt out. Find one who's available, and try to be supportive and gracious about their help (and do you GET IT that COVID-19 has beaten the daylights out of them)? 

c) A refocus of our medical resources and overall funding--we're bending over backwards to the huge swarm of illegal immigrants and to the homeless, but how about those of us paying for it all? Can we even ask this question without being told to shut up because we're racist and heartless? 

The middle class is drowning, and health care costs have gone up so much faster than the level of inflation (which itself is pretty horrible) that we must all learn to fend for ourselves.  

None of this is fair! 

But we need to do whatever we can for ourselves, our families, our friends and neighbors, and for our overall American society and nation. 


(Kenneth S. Alpern, M.D, is a dermatologist who has served in clinics in Los Angeles, Orange, and Riverside Counties, and is a proud husband and father to two cherished children and a wonderful wife. He was termed out of the Mar Vista Community Council (MVCC) twice after two stints as a Board member for 9, years and is also a Board member of the Westside Village Homeowners Association. He previously co-chaired the MVCC Outreach, Planning, and Transportation/Infrastructure Committees for 10 years. He was previously co-chair of the CD11 Transportation Advisory Committee, the grassroots Friends of the Green Line (which focused on a Green Line/LAX connection), and the nonprofit Transit Coalition His latest project is his fictional online book entitled The Unforgotten Tales of Middle-Earth and can be reached at [email protected]. The views expressed in this article are solely those of Dr. Alpern.)

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