Modern Medicine and Let Them Eat Cake Politicians

I finally received a bill for my open heart surgery in April.  See I’m back!

The bill for the initial surgeon’s visit and the operation is $20,280.50.  The five days of hospital stay are not included.  My bill for three-plus hours of surgery after Medicare and supplemental insurance: $50.50!!

What I pay monthly for insurance is $178.90 for Medicare and supplemental insurance plus $83.70 for prescription drugs.  This is deducted from my Social Security.  My wife pays the same amount.

According to https://resources.ehealthinsurance.com/affordable-care-act/much-health-insurance-cost-without-subsidy, individual coverage averaged $321 per month and family plans averaged $833.  The annual deductibles were $4,358 and $7,983.

To pay the individual deductible, a person would have save about $84/week or two dollars an hour.  For the premiums, a person would have to save about $74/week.  Together that is $158/week or $3.95/hour.  At a minimum wage of $9/hour, that doesn’t leave much for food and rent.  Without insurance, a year’s wage of $9/hour would not even cover the above bill.

And lots of politicians and millionaires think these individuals should be happy with what they get.  I don’t wish Marie Antoinette’s fate on these “let them eat cake” thinkers, but someday there will be a widespread realization that the people at the bottom of the economic are being taken advantage of.  Let’s hope they find better “champions” than Donald Trump and his ilk.

Protecting the patient or protecting the doctor?

The cost in "An unnecessary health care cost" was piddling compared to a CYA cost that will be sent to Medicare and Blue Cross on my behalf - $1576 for an echocardiogram and stress test that I saw no need for.

Every so often a doctor hears a noise in my chest that he or she doesn’t like. Years ago a family doctor prescribed an echocardiogram and nothing abnormal was found. About ten years ago I was hospitalized overnight for a "heart attack" that was really strained chest muscles from throwing small logs. Two years ago my current physician didn’t like a whooshing; last year he said I had the “heart of an athlete”; this year he prescribed the echocardiogram and stress test.

My non-running legs got tired before my heart rate got to a level the technicians wanted; additionally, they had me on the stress test longer than most people my age.

I think this was the last time I will walk from downtown to the clinic and up the 68 steps to the doctor’s office for an annual physical. Next time, I’ll sit and meditate 20 minutes before my appointment and do my best to hold my breath completely as he listens.

Why wait for the federal government on health care?

Many people think the only solution to the "health care crisis" is a single-payer, federal system. When we think of a single solution, we often run into political roadblocks put up by others who disagree with that solution, whatever the reason.

One way around is that more and more states are coming up with their own solutions, most of them based on mandated health insurance schemes.

Let's go back to the roots of modern health care. What are the names of many hospitals? Lutheran, Methodist, Brigham and Young, St. Mary's, Our Town Community, and so on. These were local hospitals founded to provide care for people in a region, mostly the poor. The rich had care at home, with doctors sometimes on standby. As our wealth increased, more and more of us were expected to pay a larger share of our health care. By previous standards, almost all of us are wealthy. Do you think everyone had a telephone and a car and ate out at fast food restaurants one hundred years ago?

Medical technology improved dramatically over the decades. Who would have thought to give anybody with heart problems an EKG a hundred years ago? Or open heart surgery, surgery that has saved thousands of lives? Improved technology costs money.

The cost of medical care has spiraled way beyond giving the doctor a chicken for his efforts.

Maybe what we need is more structured tier service. Let's make first-line care more readily available locally. We don't need a facility with MRI and so on to treat broken bones or minor illnesses. And we don't need to rush off to Mayo because we have an easily-treated tumor.

We really need better triage care - those who can do all right with a minimum of care, those who need a high-level care, and those who are beyond care. Our first level of triage is the community clinic or hospital. We can probably make the immediate decisions at far less cost than we could at regional mega-care facilities.

We can provide this first line of medical care with local resources, be it local government, church-based, or foundation-based. These can be put in place in a small fraction of time and cost that all the squabbling over a national health care system has taken.

One model is the Green House Project, a series of senior residences for no more than 10 residents, that was started by Bill Thomas in Tulepo, Mississippi. It is more resident-centered than staff-centered. Dr. Thomas is building Green Houses in every state with the help of the Robert Wood Foundation. See "Rethinking Old Age", Atul Gawande, New York Times, May 24, 2007.

In summary, we need a lot of small, local ideas to solve our "health crisis" rather than some super-duper, bureaucratic, one-size-fits-all solution.