Health Care Rant

A friend was told a few years ago that he was being released from the hospital early despite still needing somewhat advanced care. The doctor told him it was far less risky at home—an infection from a lengthy hospitalization would be almost certain and it could kill him. Another friend is currently undergoing chemotherapy for advanced cancer which was undiagnosed for over 8 years by her trusted physician. Despite her yearly pleading for a mammogram, he just brushed her off because he had her listed mistakenly as a Medicaid patient. Yet now the treatment, costing hundreds of thousands, is still not paid completely by her insurance, notably the one anti-nausea drug that keeps chemo patients able to face life which costs $1000 per pill. A news item in today’s paper told of the coming need for cancer doctors to have serious discussions with their patients about whether or not they can really afford treatment; perhaps they should just decide to die. Yesterday the story was about doctors are refusing to treat oldsters on Medicare because they will not be reimbursed enough for their valuable time.

I should develop this into a full-fledged rant about the sickness of modern society, our seriously dysfunctional food supply, overly-perfectionist definition of good health, unrealistic expectation that we will always be healthy even when modern Life in America is seriously keeping us from being happy. . .but I won’t. I won’t even go past just mentioning, because I never took accounting classes, my suspicion that “costs” are not always figured the same way you and I do in our household budgets. Somehow $800,000 saltwater aquariums in hospital lobbies, carpets custom woven with the hospital logo, and multimillion dollar administrators’ salaries get costed out as “health” care. The only outfit in America with more creative accounting practices is the movie industry.

You are of course familiar with the concept of a valve or a relay. A valve is a device that allows a relatively weak force to control a much stronger flow or force. In effect we as “health care consumers” (no longer patients—we aren’t all that patient anyway) have been reduced to simply fulfilling the function of relays to control the huge transfers of wealth between the insurance industry and the health industry. Neither side really cares if you live or die, they just need you plugged into the system so the level of your health can determine the flow of the dollars. Of course all the dollars came from us in the first place in our fearful support of the health protection racket. The image from those Matrix movies comes to mind—millions of patients on life support, kept alive by hospitals so the insurance which has garnished all their wealth will keep pumping it through the system.

In all this, I have not castigated doctors. That is because, in my little experience, they are still, mostly, caring people who really at some level want to help those they care for. Yet, as all Americans, they are addicted to the toys and the wines, the big houses in safe areas, the golf trips and the nice cars; no one wants to learn to define themselves in terms other than wealth of possessions, no one wants a cut in pay.

What would happen to the system if all health care providers of every sort were legally required to post a current list of their fees and charges on their website? Would we learn to shop like we do for auto repair? I at least ask my mechanics what such and such a repair is going to cost before I sign on the line and they are exemplary about calling me if it looks like an overrun. Try that with your doctor—his blank look is almost comical. The poor man has absolutely no idea of what his 15 minutes of time is going to cost you, and he cannot conceive of why you would undervalue your health so much as to worry about the cost. (He of course gets almost totally free health care through “professional courtesy”). We are out of touch, seriously adrift. Do not get sick! It will either kill you or ruin you. Do not trust this system to have the same interest in your life quality as you do, doubt them, question them, eat healthy food and get plenty of exercise!