October 2016
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Our health-care system lacks heart

By Peter Miesler

On Sept. 8, I read a well-written but misleading letter to the editor in the Durango Telegraph. The letter dismissed ColoradoCare Amendment 69 and praised the perfection of our current Colorado workers comp arrangement. The author, a big-time insurance executive, skipped over the many reasons so many workers feel abandoned, cheated and locked out by what they experience as an adversarial workers comp insurance bureaucracy.

Too many workers find themselves forced to deal with insurance representatives, investigators and regulatory agents who seem to view every claimant as an enemy. Instead of being allowed to focus on resolving questions and healing, injured workers too often find themselves having to struggle for legitimate compensation from a hostile system.

I felt compelled to give voice to the ignored side of this story. For my response I did a lot of internet trawling for information and my, oh, my, the onslaught of ugly stories and sad facts overwhelmed me at times.

First, revelations of the scandalous health-insurance executive perks, bonuses, golden parachutes and such that have been paid for by developing a culture dedicated to rejecting claims.

Then the seemingly inhumane expectations, stress and over-orked conditions doctors and nurses must endure. At 400 work-related doctor and medical-student suicides a year in the United States, it’s a professional crisis. Of course, dealing directly with this problem would impact the corporate bottom-line, so the problem gets swept under the carpet, just another costly externality to ignore as much as possible.

Even more startling was all the evidence that shows “independent medical exams” have become anything but impartial efforts to arrive at the truth. Patients complain of feeling like they are up against a stacked deck. The negotiation and appeals processes are likewise rigged against workers, who are treated more like bothersome expenses than humans trying to get the health care they need.

In the middle of all this I learned of the strange ongoing saga of Dr. Tom Horiagon of Denver, master of occupational health (also internal medicine, pulmonary, critical care and sleep medicine) and his non-profit clinic that was summarily shuttered in a couple hours. What could the man have done to deserve it?

It wasn’t patient complaints; there were no professional or medical misconduct charges against this doctor. His sin was being a vocal advocate for down ’n’ outs and injured workers. His non-profit clinic had insurance companies on edge because of the precedent he was trying to establish and they took their gripes to the Colorado Medical Board.

It appears he took his patient advocacy too far when he agreed to accompany a couple patients to their IMEs because they didn’t trust the good faith of the examiner and desired a knowledgeable witness, which is legally permissible.

That precipitated a bizarre cascade of events and bureaucratic moves that culminated in Dr. Horiagon receiving two-hours’ notice before his practice was forced to shut down, leaving needy patients without their doctor. The drama continued snowballing and within a couple weeks he found his license suspended without due process – once again, bureaucratic fiat stomps the opposition.

I contacted Dr. Horiagon. He was helpful and informative, sharing many documents and responding to questions. The more I read, the more childish this saga felt, which would have been comic if not for its intent to destroy a good man’s career.

I asked him about independent medical examinations. He responded: “The process of doing IME’s, or formal second opinions, will never be fair to workers if the only second opinion you can get is from a physician who is paid by the insurer.

“There are companies of physicians, like Integrated Health Management, that only exist to knock out claims. CMB was well aware of the IME advocacy I did.

“Giving my IMEs away for free was unprecedented in Colorado, not to mention that I was Level II-certified in DWC/CDLE Level II full accreditation, and have four board certifications, worked at NIOSH, and have specialty training in occupational medicine from the CDC and Harvard School of Public Health.

“So these exams would have been worth quite a lot if I worked for the dark side. The CPHP records I got from a subpoena document this very clearly.

“The physicians in the current system who do IMEs for cash are paid to lie for the insurers. It is that plain and simple. And the level of training they have is minimal compared to my training.”

Dr. Horiagon has spent the last year forced to squander his precious time and resources struggling to regain his rights within a medical regulatory system that does not want to hear from him. What I found most unsettling was that as I accumulated more information, it became plain that Dr. Horiagon is but one of many such instances. Try googling “Physician Health Programs (PHPs) under fire” or “Pauline Anderson at MedScape. com,” it’s an eye opener.

What happened to the humanity that used to infuse our health-care system? How can we recapture some of that? It will never come about with profits-obsessed, amoral corporations who created these conditions to begin with. That’s why I support ColoradoCare Amendment 69 with all its warts and yet-to-be-resolved details and challenges.

It’s going to force We the People of Colorado to take some responsibility for our own health-care system. We will need to become engaged. We will need to encourage and support integrous professional medical groups, IT resources and others working together.

It’s a challenge, but a constructive one. It sure beats constantly banging our heads against the brick wall of corporate self-interest while nothing changes, or worse. Vote for ColoradoCare – vote YES on Amendment 69.

Peter Miesler writes from near Durango, Colo., and has started a blog dedicated to sharing information that supports these claims — Amendment69-info-kiosk.blogspot.com.


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