It's not just a question of rural versus urban: there's a difference between countries. On the scary night in 2000 when my husband had to have emergency surgery, I had to stand at the desk and check him in, show the insurance card, fill out forms., a process that took 20-30 minutes - he was in too much pain to stand. (This was in a small town in Iowa where he'd worked for 30 years). Years later, he collapsed when we were on a trip to Winnipeg, Manitoba; I took him to the closest ER where he spent the day, had tests, saw a doctor twice, and was finally discharged at night when they knew he was able to walk with the help of a walker. They did not demand I.D. or proof of insurance before admitting him. Weeks later we finally received a bill for $800; even back then it would have cost more than that to cross the threshold of the local ER. There is something to be said for a single payer universal healthcare system.
I'm in central Illinois, and navigating health care here is much the same. The doctor and nurse may be "in network", but surprise - the anesthesiologist and her staff are not. X-ray is in, but other imaging is not. Pathology was "in" last year, but now it is "out". It is up to the patient to figure all this out before even a routine procedure.
With cutbacks in Medicaid and Medicare -- which rural health systems depend on -- this will only get much, much worse. For many older Americans, finding or getting medical help will require a long road trip many will be unable to make, and it all might now be "out of network".
With the current expertise at the helm of American health care, the rotating red and white pole outside the barber shop may regress to its old significance.
Take good care Art, and many thanks as always for sharing your commentary!
I love that you make me laugh as you take me through the tragedies we’re in, Art. Good luck to you. I’m running through these mazes too, and we’ll probably meet along the way. . I’ll wave.
First, I wish you wellness, Art! We become experts on a particular issue only after it visits upon us, or a loved one. Now, a suggestion for all who are listening. Almost twenty years ago, I grew tired of filling out the forms, for the growing number of members of my Medical Team. I created a document, which is now four pages. Page 1: My vital info, name, address, phone number, email, DOB, SS #, insurance, license # (you'd be surprised!), pharmacy; all medical services/doctors under the headings of their specialty, including addresses, phone numbers; also hospital information. Page 2: Surgeries/Procedures/Injuries, listing year, issue, results/treatment, doctor. Page 2: Illnesses/Conditions, year, issue, results/treatment. Page 4: Supplements; Medications, dose, purpose; Allergies, results; Adverse Reactions, medication, results; Immunizations, name of vaccine, dates; Blood Type; Emergency, family names, primary physician, phone numbers. I update this document when necessary, keeping all information ready for any emergency. I arrive at my routine checkups...primary, ENT, chiropractic, dental, optometry, dermatology...and any other necessary visits such as emergency room...with this document in hand. THEY LOVE IT!!! I write my name at the top of a new form and sprawl "SEE ATTACHED" after that. At almost eighty, I have a long history to share!!! I am grateful for the Team I have, and cost coverage as well!! But there was a time, as a single working mother, when I had no medical coverage. I know the fear; getting through days too ill to function; hoping that nothing serious happens. If we cannot at least care for the health of the least fortunate among us...who are we? If healthcare is not a basic need and right, as a human being...what is? Again, Art, you have brought us into conversation by sharing your most personal journey. Thank you...
Healthcare in this country is a nightmare. It all completely fell apart when Harry and Louise became so afraid of what would happen if everyone had health care. It was the beginning of the end of the proposal for universal health care in the Clinton administration and the beginning of the for profit health care model. (For Profit Health Care, really?!!) This country is broken when it comes to providing safe, affordable health care to everyone. The ACA was a good start, but with republicans in charge I am afraid we may be looking at the end of that model as well.
You're in the system now. They'll poke, prod and scan every part of you. At least you have the choice--I promise you that the MRI at Mercy is preferrable (it's quieter and the contrast is gently administered, not blowing out your blood vessels ike in Miami).
Life in the system is exhausting. But it's better than getting knifed and pushed in the a grave, like our Congressional delegation is proposing for us.
your columns always make my day! I know you will persevere and you will take us along for education and entertainment. I fear the health care system in more populated areas is no more coordinated or effective than in rural Iowa. I long for the day when elected people seemed to care about vulnerable citizens and saw legislation as a way to protect or improve their lives.
From your keyboard to the politicians. Unfortunately it’s hard for people to understand the difficulties with our healthcare system until they experience them firsthand. Take care Art. Wishing you the best possible outcome.
My late husband went thru the same here, there. Spirit Lake, Spencer, Sioux City back and forth. Last chance Mayo. Once in the system there all went smoothly. It is amazing the amount of tests and specialties they can do in one day. When you get there, get a nice hotel and enjoy some good meals.
- Neal Patterson, founder of Cerner a healthcare software company, every year for at least 30 years.
When Patterson's wife got cancer, he realized that his transforming software ignored one critical part: the patient. He was CEO of one of the leading electronic health records companies in the world, and his wife was hauling a folder of paper records around to her doctors
"I am one of the few people that should be able to fix this," he said. "I'm frustrated that we're not moving faster."
Neal Patterson, CEO Cerner Corp. 2015
Patterson died of cancer in 2017. His wife died 2 months after him.
It's 2025 and I'm still hauling paper records to doctors, although I've learned to record those paper records on my smartphone. Not surprisingly, the doctor offices have no way to ingest that info and few rarely allow you to send a copy to their printers.
Larry Ellison, the chairman and CTO of Oracle, had a vision for the acquisition of Cerner, a leading electronic health record company, that was driven by a desire to revolutionize healthcare delivery. The vision? AI.
How do you carry AI in a paper folder?
(Full disclosure: I was managing editor of Cerner's intranet from 2003-2008)
Just starting my journey Professor. Had a bad cough in Texas, couldn't sleep and stopped by an Urgent Care. They didn't like my pulse or BP, one too low, the other too high. Being a lifelong owner of 110/70 on my barometer and pulse of a typical non-athletic 66 year old; I popped a 150/80 and 44 pulse. Gave me a steroid for the cough, and check in with my Doc when I get back to The Moines. Similar #'s at home and I got to meet a cardiologist and pharmacist for the 1st time in my life. There is still debate whether its tpo many bithday candles or too much birthday cake, but the professionals are on it. I trust 'em, but if I don't get a follow up within 48 hours on something I'm calling some body. My inlaws and my own parents left lessons in advocacy. That and a rabbits foot, a couple amulets and the Serenity Prayer* keep me going.....
Continue kickin’ ass, Art. It will make your own feel better. And the rest of us always feel better reading you.
Wow, this is a powerful summation of the difficulties rural folks face with health care. My best to you, Art Cullen.
Especially the immigrant working man
It's not just a question of rural versus urban: there's a difference between countries. On the scary night in 2000 when my husband had to have emergency surgery, I had to stand at the desk and check him in, show the insurance card, fill out forms., a process that took 20-30 minutes - he was in too much pain to stand. (This was in a small town in Iowa where he'd worked for 30 years). Years later, he collapsed when we were on a trip to Winnipeg, Manitoba; I took him to the closest ER where he spent the day, had tests, saw a doctor twice, and was finally discharged at night when they knew he was able to walk with the help of a walker. They did not demand I.D. or proof of insurance before admitting him. Weeks later we finally received a bill for $800; even back then it would have cost more than that to cross the threshold of the local ER. There is something to be said for a single payer universal healthcare system.
I'm in central Illinois, and navigating health care here is much the same. The doctor and nurse may be "in network", but surprise - the anesthesiologist and her staff are not. X-ray is in, but other imaging is not. Pathology was "in" last year, but now it is "out". It is up to the patient to figure all this out before even a routine procedure.
With cutbacks in Medicaid and Medicare -- which rural health systems depend on -- this will only get much, much worse. For many older Americans, finding or getting medical help will require a long road trip many will be unable to make, and it all might now be "out of network".
With the current expertise at the helm of American health care, the rotating red and white pole outside the barber shop may regress to its old significance.
Take good care Art, and many thanks as always for sharing your commentary!
I love that you make me laugh as you take me through the tragedies we’re in, Art. Good luck to you. I’m running through these mazes too, and we’ll probably meet along the way. . I’ll wave.
First, I wish you wellness, Art! We become experts on a particular issue only after it visits upon us, or a loved one. Now, a suggestion for all who are listening. Almost twenty years ago, I grew tired of filling out the forms, for the growing number of members of my Medical Team. I created a document, which is now four pages. Page 1: My vital info, name, address, phone number, email, DOB, SS #, insurance, license # (you'd be surprised!), pharmacy; all medical services/doctors under the headings of their specialty, including addresses, phone numbers; also hospital information. Page 2: Surgeries/Procedures/Injuries, listing year, issue, results/treatment, doctor. Page 2: Illnesses/Conditions, year, issue, results/treatment. Page 4: Supplements; Medications, dose, purpose; Allergies, results; Adverse Reactions, medication, results; Immunizations, name of vaccine, dates; Blood Type; Emergency, family names, primary physician, phone numbers. I update this document when necessary, keeping all information ready for any emergency. I arrive at my routine checkups...primary, ENT, chiropractic, dental, optometry, dermatology...and any other necessary visits such as emergency room...with this document in hand. THEY LOVE IT!!! I write my name at the top of a new form and sprawl "SEE ATTACHED" after that. At almost eighty, I have a long history to share!!! I am grateful for the Team I have, and cost coverage as well!! But there was a time, as a single working mother, when I had no medical coverage. I know the fear; getting through days too ill to function; hoping that nothing serious happens. If we cannot at least care for the health of the least fortunate among us...who are we? If healthcare is not a basic need and right, as a human being...what is? Again, Art, you have brought us into conversation by sharing your most personal journey. Thank you...
Healthcare in this country is a nightmare. It all completely fell apart when Harry and Louise became so afraid of what would happen if everyone had health care. It was the beginning of the end of the proposal for universal health care in the Clinton administration and the beginning of the for profit health care model. (For Profit Health Care, really?!!) This country is broken when it comes to providing safe, affordable health care to everyone. The ACA was a good start, but with republicans in charge I am afraid we may be looking at the end of that model as well.
You're in the system now. They'll poke, prod and scan every part of you. At least you have the choice--I promise you that the MRI at Mercy is preferrable (it's quieter and the contrast is gently administered, not blowing out your blood vessels ike in Miami).
Life in the system is exhausting. But it's better than getting knifed and pushed in the a grave, like our Congressional delegation is proposing for us.
your columns always make my day! I know you will persevere and you will take us along for education and entertainment. I fear the health care system in more populated areas is no more coordinated or effective than in rural Iowa. I long for the day when elected people seemed to care about vulnerable citizens and saw legislation as a way to protect or improve their lives.
From your keyboard to the politicians. Unfortunately it’s hard for people to understand the difficulties with our healthcare system until they experience them firsthand. Take care Art. Wishing you the best possible outcome.
My late husband went thru the same here, there. Spirit Lake, Spencer, Sioux City back and forth. Last chance Mayo. Once in the system there all went smoothly. It is amazing the amount of tests and specialties they can do in one day. When you get there, get a nice hotel and enjoy some good meals.
Hang in there, Art. We’re all just pilgrims on the road, witnessing people who don’t care cause further damage to an already shaky medical system.
"We are transforming healthcare."
- Neal Patterson, founder of Cerner a healthcare software company, every year for at least 30 years.
When Patterson's wife got cancer, he realized that his transforming software ignored one critical part: the patient. He was CEO of one of the leading electronic health records companies in the world, and his wife was hauling a folder of paper records around to her doctors
"I am one of the few people that should be able to fix this," he said. "I'm frustrated that we're not moving faster."
Neal Patterson, CEO Cerner Corp. 2015
Patterson died of cancer in 2017. His wife died 2 months after him.
It's 2025 and I'm still hauling paper records to doctors, although I've learned to record those paper records on my smartphone. Not surprisingly, the doctor offices have no way to ingest that info and few rarely allow you to send a copy to their printers.
Larry Ellison, the chairman and CTO of Oracle, had a vision for the acquisition of Cerner, a leading electronic health record company, that was driven by a desire to revolutionize healthcare delivery. The vision? AI.
How do you carry AI in a paper folder?
(Full disclosure: I was managing editor of Cerner's intranet from 2003-2008)
Jeesh. Go get 'em, Art.
Just starting my journey Professor. Had a bad cough in Texas, couldn't sleep and stopped by an Urgent Care. They didn't like my pulse or BP, one too low, the other too high. Being a lifelong owner of 110/70 on my barometer and pulse of a typical non-athletic 66 year old; I popped a 150/80 and 44 pulse. Gave me a steroid for the cough, and check in with my Doc when I get back to The Moines. Similar #'s at home and I got to meet a cardiologist and pharmacist for the 1st time in my life. There is still debate whether its tpo many bithday candles or too much birthday cake, but the professionals are on it. I trust 'em, but if I don't get a follow up within 48 hours on something I'm calling some body. My inlaws and my own parents left lessons in advocacy. That and a rabbits foot, a couple amulets and the Serenity Prayer* keep me going.....
*for my dad, for my daughter