In case you didn’t know, becoming a health care provider isn’t cheap. The six to fifteen years of school and/or supervised practice isn’t cheap. The professional organization memberships aren’t cheap. The malpractice insurance isn’t cheap. The equipment isn’t cheap. Continuing education and the reading and travel that go along with it aren’t cheap. And that’s just talking direct economic costs.
I wish we could talk health care without having to talk about money. I wish we could all offer our services for free. Unfortunately, if all health care providers offered their services for free, we’d soon have no health care providers. It costs too much to become a health professional and to maintain professional standards as a health professional to not get paid. So somehow, we’ve got to get paid.
The majority of payments that come to health professionals come through insurance companies. They decide what they’re willing to pay for and how much they’re willing to pay for it–sort of. The sort of is because most insurance companies use Medicare and Medicaid as the basis for making their decisions regarding payment. If Medicare or Medicaid covers it, private insurance is sure to follow.
If Medicare/Medicaid covers Medical Nutrition Therapy (MNT) for a disease, then dietitians get paid. If the government isn’t willing to pay a dietitian for Medical Nutrition Therapy–neither will the private sector. So if dietitians want to get paid, they have to convince the government to foot the bill. It’s bad enough that money makes the world go ’round–even worse, too often it’s government money that makes the world go ’round.
I sat through Community Nutrition tonight biting my tongue and swinging my legs and wondering why it felt like I was being told to sell out. Contribute to the ADA-PAC. Sell your vote for support for nutrition-related legislation. Campaign for somebody on the basis of dietetics. Bribe your congressman. Join the lobby. Sell out.
I want dietitians to get paid for what they do. Why? Because they provide an invaluable service to health care. Dietitians have the knowledge and skills to prevent disease rather than just managing it. Medical Nutrition Therapy is incredibly cost effective from a medical standpoint. It prevents the occurence of disease in the well and prevents the development of complications in the diseased. Medical Nutrition Therapy means fewer drugs, fewer diseases, fewer costly medical interventions, and ultimately fewer deaths. That’s a lot of bang for a little buck.
The problem is that if dietitians are going to get paid for what they do, the government is going to have to pay it. Congress is going to have to approve MNT for Medicare/Medicaid patients if MNT providers are going to get paid by anyone for any of the work they do. Which puts me in a very difficult situation.
I’m a fiscal conservative. I’m a true believer in free market. I much prefer the invisible hand to the “Wonderful Wizard of Washington”. I don’t believe that throwing government money around solves anything. The Robin Hood complex is a mental illness, not benevolence. Stealing from the citizen to support the system isn’t my way of going about things.
So what am I to do about dietetics? I want to get paid. I want my profession to get paid for its legitimate work. I just don’t want the government to be doing the paying.
Our economic system depresses me. We’ve messed it up so much that it’ll take a MASSIVE restructuring to return us to free market principles. Unfortunately, when even the conservatives start throwing government money around in an attempt to “save” the economy, how can we hope to ever have a stable economy?
I almost think it’d be best to just never mind the short-term consequences. Knock off all government intervention in the economy and wait for things to equalize. Then, once we’re dealing with a free economy, we can rebuild the way the American economy was first built–on hard work, civic responsibility, and innovation.
