JUNE 2009 - Comparing Health Care

May's column dealt with the frustration of dealing with unfathomable delays in medical testing and treatment for patients requiring more immediate attention. Readers were invited to comment:

" . . . when you see what our health care system looks like from the inside, you’re outraged—enormous inefficiency and waste, with a couple people even in a small outfit . . . just to deal with the billing. Also stupid [stuff], like which therapist you can have depending on whether you have Medicaid or Medicare or neither or both. It’s the worst possible system—in the old days when it was pure capitalism, it was cheaper because people wouldn’t pay what they couldn’t afford, and might shop around.

Now we are about to get some kind of "reform," distorted by the conflict between the fact that the public is demanding change and the corporations which control Congress are forbidding it. So we’ll get yet another layer of tax-paid coverage for another group, another set of rules for health care providers to learn, and even more expensive health care costs."

Which brings to mind patient #4 from last month's column, waiting since February to complete tests to determine a diagnosis. The insurance company insists that the only place the patient is 'allowed' to have MRI testing done is out of state at a group facility. I find that outrageous.

". . .our system . . . (is) too focused on drugs, and the drugs are advertised directly to a public entirely ill-equipped to assess drug choices—this is illegal in nearly all other countries. . . Meanwhile, our country doesn’t bother with advertising campaigns to influence the lifestyle choices behind half of all illness at least—smoking, a sedentary lifestyle, lousy diet, unresolved stress. But there is endless advertisement for the elements of that lousy diet, and the TV shows people watch while getting no exercise…a government that pays for the health care of its citizens has the duty and the right to find ways to lower costs."

Very good point – how many readers have read or watched an ad touting some miracle pill and then questioned the physician about the drug on their next visit? What interests me even more: how many people actually succeed in receiving a prescription for that particular drug?

"Ontario, Canada decided to phase out coal-fired power plants because of the associated health care costs .. . . and they feel free to step in and put limits on the costs of drugs, while our government has more than once brought a drug all the way through clinical trials, and then handed it to one of the drug companies, allowing them to patent it and then charge cancer patients ten times the cost of manufacture."

"As Dr. Mendelsohn said, 'Malpractice is the only kind we have.'"

"My sister was diagnosed with liposarcoma (fat cancer-- I had never heard of it before her diagnosis). She went to the Cleveland Clinic, they were supposed to be the best. (She was a physical therapist, so she was very medically oriented, and got right in.) Two years later, she was dead. The cancer didn't kill her, the doctors did."

After eight long years of hearing, "Tests are fine, nothing is wrong," a woman finally discovered that her cardiac function was diminished by two-thirds. Her medical card allowed her one cardiologist visit per month. An hour and a half ride to the city resulted in the doctor whizzing in with her chart, "How are you today, Mrs. Smith? You look great, see you next month," and whizzing out. No conversation, no exam, nothing. She and her husband recently sold their farm and most of their personal belongings, packed the rest and moved to Germany, near family members – and medical care.

"If you are delayed getting the health torture the AMA recommends, consider yourself blessed. It is that much less torture you have to endure. When he was president, Ronald Reagan was diagnosed with cancer. He did not go to the AMA but to Germany where he got an intelligent treatment. He died many years later, and not of cancer. That treatment is still available--in Germany."

Meanwhile, Chew on This: "Taxation is very much like dairy farming. The task is to extract the maximum amount of milk with the minimum amount of moo. And I am afraid to say that these days all I get is moo."

– Terry Pratchett