What a Great System

As anyone who has been listening here knows, both Lisa and I have had nasty colds. I got mine in Chicago, and it was so bad that Lisa took me to the emergency room. We were out of town, after all, and in downtown Chicago. It’s not like we had a lot of medical options. This is a major, major mistake, though, and it describes exactly what is wrong with the health care environment in this country.

I’ll start by noting the people in Chicago’s emergency room were all very nice, and seemed good at their job. I felt miserable, and they were great. I left feeling better than when I came in. Kudos.

But let’s face it, my diagnosis was a probable virus (for which they could do nothing), and a possible sinus infection, for which the doctor prescribed an antibiotic. While there, I received an IV bag of sugar water, two Tylenol, and a chest X-ray to ensure I didn’t have pneumonia. The bill, not counting doctors’ time was $3,200.

You read that right. $3200.

I believe three doctors stopped by my room to give me the once over and arrive at this diagnosis, and their charges are not included in that number. We’re expecting more bills, and I’ll not be surprised if the overall cost of having my probable virus looked at will approach $5K.

My first thought upon getting the bill was “Crap, I shouldn’t have gone to get this looked at. I should have just toughed it out.”

When you stop and look at things you’ll see that this is a really dumb way of thinking. I mean, when you’re sick, you should go to get it taken care of. It’s the right thing to do for both yourself and the rest of the world. But, $5K? Seriously?

Yes, I have insurance, and the company came riding to the rescue. That $3200 bill was reduced to $1200. Oh, joy. Now I’m supposed to be happy to pay $1200 for two Tylenol, an X-ray, and a bag of sugar water. Call me cheap, but wow. The incredible thing here is that for a very few moments I actually felt good about this. After all, I was getting a 62.5% discount! But then reality hit. The Tylenol (which I assume was the $28 pharmaceutical charge itemized on the bill) is worth about a buck, and I had some in my hotel room. The X-ray was a couple hundred dollars as itemized on the bill. Unless a bag of sugar water is valued at something nearing $1K, someone here is getting jobbed.

You can guess who it is.

Back in July, I wrote that “The more I learn about the various systems of the world, and the more I think about us here in the little old US, the more I think that it just really doesn’t matter what system we have insofar as who pays for it. It costs X dollars to fund healthcare, and those X dollars are coming from the folks who have dollars in some form or another. That seems to be the base process. The question of who pays for it is the wrong question.”

I sugar coated what the right question was. The right question is “Why is our basic health care so expensive that the average person can’t afford it on their own?”

Quite honestly, this trip of mine should have been a $600 expense–maybe $800 if I stretch things a bit. Actually, who am I kidding. Even those numbers are a bit mind-boggling. A person with a cold should be able to walk into a medical facility anywhere in the country and for a couple hundred bucks walk out either (a) knowing there’s nothing they can do about it, or (b) with a prescription to fix it. In the case of (c) it’s something worse, then that person gets the “Go to Hospital” card, and things change at that point. Anyway, I digress.

Neither ObamaCare nor RomneyCare nor WhateverCare is going to solve this problem–all they do is make one group of people (or companies) pay more so the others can get something cheaper. So my trip to the ER for my Probably Virus might cost $7K next year or the year after or whenever. I’m not saying that’s the wrong thing to do or the right thing to do. What I’m saying is that neither system is actually attacking the X dollars that our health care costs. All they are focusing on is spreading that X dollars among everyone in some way that they can basically “afford” it. Our health care system lobbyists have successfully kept the focus on the “who pays” question rather than “how much?”

So I’ll need to plan to pay $7K next time. Except, of course, next time it won’t cost that much because there won’t be a next time. I’ll not go to the doctor in that situation. ObamaCare? RomneyCare? TodayCare? Doesn’t matter. I’ll suffer instead. I’ll save the $7K (bargained down to $2800), and just ride out the sonuvagun.

With any luck, it’ll just be a virus.

Great system, eh?

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  1. Interestingly, Tammy had almost the exact OPPOSITE experience just this week — our oldest (S.) had an earache, so rather than bother with making an appointment with the pediatrician and pulling her out of school, she took her to a Walgreen’s “Take Care Clinic” after picking the girls up from school. Things were apparently slow and the doctor on call (nurse-practitioner, to be precise) came out while Tammy was filling out the preliminary paperwork to see what they were there for. When Tammy told him that S. had an earache, he said, “Well, let’s take a look first to see if there’s anything worth seeing the doctor for before you fill out all that paperwork.” He (she?) proceeded to look at S.’s ear, and noted that she had a large was build-up, which was most likely the cause given that she had no fever or any other symptoms. He recommended an over-the-counter ear wash and some wax removal tools (which we keep on-hand anyway), and sent them on their way WITHOUT having to pay a cent for “seeing” the doctor.

    So, Walgreen’s benefitted from our over-the-counter purchases, even though they made nothing off of our “visit” to the clinic. When capitalism WORKS like that and there’s a positive outcome for EVERYBODY, that warms my cockles.

    With a privately-run “clinic” structure in-place nationwide like Walgreen’s “Take Care Clinics” and the CVS “Minute Clinics,” along with whatever places like Wal-Mart and Target have in-place (and I’m sure they have their own equivalents, since their pharmacy operations are pretty substantial), I was HUGELY surprised that the “Affordable Care Act” did NOTHING to put in place a similar clinic system, or to commission and/or subsidize the pre-existing private clinics like these to serve those who DON’T have health insurance, to use as an alternative to using emergency rooms as your “primary care provider” (which is something done by many people without healthcare coverage, because they can’t be turned away).

    Seems like the “affordable” part of the “Affordable Care Act” was completely overlooked, unfortunately. 🙁

  2. Er, that should say “large WAX build-up” up there, NOT “large was build-up.”

    Rasen frasen typos.

    There’s never an editor around when you REALLY need one!


  3. That’s a great story/example of how things can work and should work. But it misses a point. In your case, the nurse-practicioner bypassed the actual system to diagnose and prescribe a simple fix. Certainly the right thing.

    But that’s not really the system. And the question at hand is how would you feel about the price/system had she had to be seen by the doctor and been diagnosed. In may case, there appeared only two options–suffer or go to the emergency room.

    Either way, the “affordable” care act is no better or worse than the existing system. Which is my point, really. Romney’s “plan” is not any different. Neither stop these Walgreens/Target/whatever “capitalistic” approaches from existing. But neither is focused on using them either. So I find riding the affordable health care plan out for this is not overly valuable until some politician of merit proposes a fundamental plan geared to controlling cost instead of merely arguing who should pay for it.

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