In that long office visit, how much face time did you spend with a family practice doc, or with the endocrinologist though? I'll bet that an RN took you back, performed a weight, blood pressure check, asked you some screening questions, and then you sat in the exam room waiting for the doc to show up. Maybe he/she appears and disappears based upon the complexity of your case, and the nurse comes back with a script or change, instructions, and then you pay the bill/sign forms.
In all of that, the average face time is nine minutes due to Managed Care, not 30. If you get thirty, you're very fortunate. This study found 8 minutes was the norm.
http://well.blogs.nytimes.com/2013/05/30/for-new-doctors-8-minutes-per-patient/?_r=0
Due to the high amounts of endocrine issues like Diabetes (1 and 2) and the amount of out of control blood sugar, then it then begins to affect many systems of the body (occular, circulation, immune) and so forth.
Under Obamacare, you're likely to have a wellness check, determine that you're at risk of Diabetes in various forms and intensity, but then will be given milestones to shoot for regarding the control of your blood sugar. If you don't meet these wellness goals, then an increase in premium costs. As Diabetes always ends up with a poor outcome as we age, then an increase in services due to these other systems, and so rising prices as more than an average amount of services are concentrated in that Diabetic patient.
Traditionally due to very low reimbursement and complex economic issues, Medicaid Diabetics had poor outcomes. If money is tight, then acquiring an insulin pump is a major problem. No one is guaranteeding an equitable amount of healthcare services, but a level of healthcare services, right?
As a decline in a Diabetic patient's life occurs, then it directly affects their ability to work, and so it behooves whatever medical system to keep the patient healthy. Otherwise a system could be regionally hammered by many ailing Diabetic patients, dramatically driving up the cost, for they might no longer be working, and so end up on Medicaid.
It's a cruel disease. CDC statistics estimate 29 million of 9.3% of the US population has Diabetes of some form, with only 20 million diagnosed. It's a significant part of American healthcare. Earlier diagnosis would help as type 1 manifest in the teen years but Diabetes 2 is largely preventable unless there is a genetic component.
Note that a Diabetics compliance can be measured or estimated and so wellness checks might monitor this and again raise health insurance premiums based upon the patient's actions. It could knock a patient from being considered for certain procedures.
Type 2 is largely preventable, it's that our diet and moderation is so out-of-sync, slamming the body with sugar substances and so placing too much demand on the pancreas. As such, wellness counselors might really raise rates if milestones are not achieved.
Don't think patients are getting a free ride. They're not with Obamacare versus standard health insurance.
EDIT:
This is not an unsolvable problem. One tactic that has been suggested is the focused patient meeting versus the standard patient meeting. To do a patient history means hunting around to watch body language and tone to see what the patient is feeling and experiencing versus what they verbalize. It's very hit-and-miss.
Writing down things help stay on target. If you do this as the patient, then the physician can more quickly assess your illness and not just look at symptoms.
http://www.foxbusiness.com/personal...utes-face-time-with-your-doctor-make-it-work/
Another better suggestion is the patient journal. When you have a chronic condition, then you have a specific journal with say ten measurements, and then show it to the doc with a synopsis of your findings.
http://familydoctor.org/familydocto...th-your-doctor/creating-a-health-journal.html
Example: "I noticed that my blood sugar was ill controlled on these days when I ate these foods. My exercise regiment has been irregular but when it was maintained through Yoga and two days per week of cardio, then I managed to do much better."
You write down your weight, your mood on a scale of one to ten, medications, brief diet, strange incidents, etc and then working in partnership with the RN and the Doc and yourself, then come to some conclusions. It sounds simplistic, but many ailments have lots of components that cause them, and it's unclear what the root cause is.
Say it's abdominal pain. Well any number of things could cause it, but it might be as simple as too many caffinated drinks resulting in overstimulating the intestines, and not a sign of something more serious. You could end up having unnecessary tests that are intrusive and very unpleasant, and an incorrect diagnosis like Irritable Bowel Syndrome, when it was too much Mountain Dew or very strong coffee.
