Should I be able to read what my doctors write in their notes?

Of course. Legally, the records belong to me, and I can request copies any time.

After Mike died, I got the chance to read his records from Dr. Patrick Hammen in Savannah. That's where I discovered his doctors knew he was succeptible to cancer and needed a colonoscopy, but they didn't do it because he couldn't pay for it up front.

A former doctor of mine tried to tell me my records were his property. I relayed the legal information and threatened to report him to the state medical board and I got the copies. Turns out he was more than a little sexist (which I why I fired him in the first place), and the records made for fun reading.

Anything that makes patients' records more open to them is a good thing as far as I'm concerned, and a study just announced could help make it easier for patients to get at their records.

Researchers led by a team at Beth Israel Deaconess Medical Center in Massachusetts have launched a pilot program called the OpenNotes Initiative. The program will allow about 25,000 patients in Massachusetts, Pennsylvania and Washington to read their doctors' notes on a secure Internet portal.At the end of the study, participants will fill out questionnaires about the effectiveness of the program.

Some physicians argue that the records are for them, and things they write could upset patients.

Perhaps they need to be more diplomatic in their writing.

If I read that a doctor doesn't believe me when I complain of pain, that makes me furious. If I read something the doctor didn't tell me during my appointment, I'm ready to do battle.

This is about better communications between patients and physicians.

If I have easy access to my records, I don't have to call the doctor's office if I've forgotten something she told me. I can check the dates of immuniations and procedures. I can look again at the advice she has given me.

As it is, I can e-mail my family doctor and some information is available on the Web site. Doctors may have to learn to self-edit as they write their notes, but  I want the convenience of access to my records.

I was at a party over the weekend with a young woman from France. The talk turned to health care, and she said she never has to worry about it at home.

"I get sick and I get taken care of," she said. "It's as easy as that."

She admitted she probably pays more in taxes than we do, but if you add our taxes and the cost of health insurance, she pays less. She has never been denied treatment and she doesn't know of anyone who has. People don't die there because they can't get medical care. In fact, she said, the care is excellent.

One of the people at the party has been very critical of "Obamacare" all along, and it was delightful to have someone with first-hand knowledge to say the French don't hate their health care system.

"What would happen if I got sick in France?" my naysayer friend asked. "

"You would be taken care of, of course," she said.

Bit by bit, as portions of the health care bill take effect, it becomes more popular. My naysayer friend's 24-year-old daughter is living at home and looking for a job. The law allows her to remain on his insurance plan for another two years if she needs it. That means if she gets sick, she'll get treatment instead of die. That's, as Joe Biden would say, a big effing deal.

The Obama Administration announced this week that many preventive care services will be free for people whose  insurance plans are covered under the new rules. Initially, that means about 41 milion Americans; iIn 2013, some 88 million will be covered.

Even those of us with insurance usually pay for checkups (my co-pay has gone from $10 to $25 in the last few years; $50 for a "specialist" (anyone who isn't my primary care doc).

Under the  new requirements, though, health insurance policies will have to cover four sets of preventive services at no additional charge to their members:

• Screenings strongly recommended with a grade of "A" or "B" by the U.S. Preventive Services Task Force, an independent advisory panel. Among them are breast and colon cancer tests, screening of pregnant women for vitamin deficiencies, tests for diabetes, high cholesterol and high blood pressure, plus counseling to help smokers quit.

• Routine vaccines from childhood immunizations to tetanus boosters for adults.

• Well-baby visits to a pediatrician, vision and hearing tests for kids, and counseling to help youngsters maintain a healthy weight. These and other services are recommended under guidelines developed by the government and the American Academy of Pediatrics.

• Women's health screenings, also to include test called for under guidelines that are still in development and not expected to be be announced until Aug., 2011.

For a lot of people, co-pays and other charges are prohibitive, so they don't get the screening tests they need to discover chronic conditions before they become serious. That's a very costly way to do health care.  Conditions like high blood pressure, diabetes and high cholesterol are a lot less expensive when caught early and managed -- before they beome debilitating strokes, heart attacks or kidney failure.

This is a big step in health reform.


We're still not quite to 50 percent approval, but a Kaiser Family Foundation report finds that 48 percent of Americans now approve of the legislation, up from 41 percent a month ago. (see the report at

We're about evenly divided on whether a legislator's vote will affect how we vote in November. Roughly one-third of voters said it won't affect their voter and the other two-thirds are evenly split on whether it will cause them to vote for or against a candidate.

So, reform is gaining in popularity. But if the insurance companies' ability to raise their rates at will isn't reined in, reform could become a total mess.

Wellpoint, which wanted to raise its rates 39 percent in California, then withdrew the hike after public outrage, has announced it will raise rates 20 percent instead.

Several states have passed laws to put some oversight into health insurance rate hikes, but not all states are willing to do this. It's up to the federal government to review rate increases and make sure they are reasonable.

Call me a socialist, but this free-market crap is nothing more than a gift to big corporations that allows them to rape the rest of us.