Lesson: You need help, but your helper cannot help because s/he did not have the right “papers.” You were not ready for an emergency medical situation.
One thing we learned from the pandemic is that you can get seriously ill and you will need help. We’re not talking about dying Many, many people got so sick they could not do anything but work on getting better. What treatment does the doctor recommend? “What about something I heard?” “Can’t I get any help in home?” These are just the types of questions that came up and for most people there was no help for them to get real answers. When they were sick they needed help!
One of the hallmarks of the corona virus experience is that we did not know what treatments worked best. There was information available from everywhere. If we step back from the national “political” debate about the covid virus, and look more broadly at many conditions of aging, we can see this is not a unique experience. Consider chronic back pain. Many people have surgery on their spine while others report similar complaints but resolve them through therapy and exercise. What about swollen ankles and on and on. Many medical conditions have treatments we don’t know about. It seems that our medical system is pill and hospital centered. “If a pill won’t fix you, go to the hospital” seems to be the rule. But for many chronic conditions there is an alternative treatment and here we can run into the problem that the insurance company will not authorize the treatment. Here we go with appeals!!
How do I get help?
The takeaway is that when you are suddenly very ill you or you have a condition that pills have not solved, you need a pre-authorized healthcare agent. As they used to say “your papers must be in order.”
Not a Living Will: We’re not talking about a “living will” or a Designation of Patient Advocate. Those refer to end of life decision making, like when to “pull the plug.” We’re not talking about dying. We’re talking about getting better the best way possible! And sooner the better!
The Healthcare System Requires Legal Documents
Why do you need a legal form? A number of reasons. Perhaps the first is healthcare is a system. It is no longer “you and your doctor.” It’s you and “the physicians in your network” Your healthcare insurance program, public or private, is a huge entity. It is either a part of national government or a national corporation with headquarters who knows where. But that’s not the only reason you need legal form.
Healthcare “science” is really complex. It’s more than the dozens of pills we see advertisements for. It is a variety of medical treatments and not all doctors offer all treatments. When you want to know what is the best for you it calls for “researching:” find the options your insurance covers.
Michigan Mental Health Code Has Separate Requirements
Don’t forget “mental health.” That is covered under separate laws that not only cover psychiatrists, but also psychologists and medications that affect mood. Mood medications, such as pills for anxiety or depression, are common treatments covered under the Michigan Mental Health Code. Your agent may be denied access to information without specific authorization.
A HIPAA Release Is Not Enough
Healthcare is legally complex. Everybody has heard of “HIPAA.” That refers only to authority to talk to the doctor and receive specific information. That may not be enough for some corporate providers. You may need specific authorization to see medical records under the Michigan Medical Records Act.
So your “agent” can see records and discuss options with your doctor. Can they make decisions on your behalf? No, you must give them authority to go further.
What Can Your Authorized Agent Do?
Your agents must have authority to make decisions. An example: your doctor says you have two options: surgery or physical therapy. You lean toward the therapy but have questions about the chances of success and the recovery time with the surgery option. You discuss it with your daughter and decide that you would like to try therapy first depending on the answers the doctor gives. With the above authority your agent can receive information but cannot relay your decisions. With a full healthcare power your agent could get the answer to your questions and then say “Doctor, we’re going to try therapy first.” The referral process would begin immediately and not have to wait until you can speak with the doctor.
Let’s go further with the example. You are making progress with therapy but then the agency says they have reached the limit of the authorization. Unfortunately most people nowadays get no further help. But, with your agent helping you can “fight” for more in-home treatment. And, you will get it, if you get your “ducks in a row.” For example: the therapy record must show benefit; your doctor must recommend; etc. etc.
Finally, you must give legal authority to each person who will help you during emergency. Family relation is NOT sufficient. Without specific authority your spouse has no capacity to help. Your children have no authority to help. You must expressly authorize each of them.
Answer: A Complete Healthcare Power of Attorney
All of the above is what a complete healthcare power of attorney accomplishes. It names your agents and states what authority you gave them. They can do anything you need them to do.
In short? Get a comprehensive, immediately effective, healthcare power of attorney for your “team” so their ready to spring into action right now!