Sunday, July 5, 2009

"The Fix" Is On. NOT.

Once again, I’ve been too busy and too exhausted to properly follow a national news story. So I suppose, in the interests of responsible journalism, I shouldn’t even be writing this. But since responsible journalism is a commodity that evidently went out of style a couple of decades ago, I’ve decided to write this anyway…

I have to admit, I’m disappointed with the Obama Administration’s inability—and, indeed, unwillingness—to consider any kind of meaningful change to the health care/health insurance system in this country. The fact is, our medical culture has degraded to where it has nothing to do with “care;” like everything else in America, It’s About The Money. Along about twenty-five years ago, Medicine jumped into bed with Big Business. And though that relationship may be golden for them, it’s completely toxic to the rest of the human race.

I have entertained several theories about why medicine has become business. I’ve wondered if it’s the fault of my problematic generation—the Boomers. Like everything else we do, we’ve consumed medical services on a grand scale. Since we were old enough to discover our first gray hairs in the mirror, we’ve been looking for ways to turn back the clock and live forever. And we’re willing to spend billions of dollars on the search. I suppose it was just a matter of time before somebody turned our quest into an unending source of positive cash flow.

Then again, perhaps it’s the fault of runaway technology. The medical community insists upon being on the cutting edge of every technological breakthrough. If a new gadget or widget comes out, every hospital, clinic and doctor’s office has to scramble to have one. It’s common knowledge, now, that the price of any given technology goes down with time. Smart consumers have learned to hang back and wait—both to see how a new gadget performs (and let other people discover the bugs that then have to be programmed out of the thing) and to wait for the cost to go down. But not our stolid medical community. “You just invented this? And it does what? And it costs three billion dollars? Send us one on the next truck…!”

Or could it be the fault of the doctors, who think that just because they emerge from medical school and internship with multi-thousand-dollar debts, they need to make enough money to satisfy that debt five times over in their first decade of private practice. After all, they are entitled to a certain lifestyle…are they not?

And then there is the ever-expanding system, growing like a cancer, feeding on whatever fiscal resources it can attach its tentacles to. Where there used to be doctors and nurses, there are now med techs, and EMT’s, and paramedics, and certified nurse aids, and physician assistants, and phlebotomists and dieticians and…and…AND… Each of these many layers of “care-givers" caters to its little piece of your medical problem, and each of them has to make a living wage. So where we were once paying doctors and nurses and lab techs, we’re now paying a whole host of practitioners to do essentially the same job.

I know…I sound like a cranky old fart whining, once again, about how much better things were in the “good ole days.” But, once again, I have to assert—things WERE better. You went to a doctor. One you knew and who knew you, and your history, and your family, and probably delivered you and your siblings and your kids. If you had a problem, the doctor slapped you in the hospital, they ran a bunch of tests, and they found out what was wrong with you. And then they treated it. How many of us, these days, are confident that our doctors--one of the half dozen or so you are sent to in order to diagnose any given complaint-- would recognize us if they tripped over us in the hallway outside the exam room?

Okay, maybe it wasn’t that simple, and maybe it was more hit and miss than I remember. But these days, everyone I talk to or hear about who is trying to deal with a medical problem, has to go through weeks or months of protracted diagnostics, running from doctor to hospital to specialist and back again, hearing differing and often conflicting opinions from every quarter, becoming more confused and more rattled by the day. There is no such thing as diagnostic urgency anymore. I guess the current thinking is that if you die of your problem before they get around to diagnosing it, they probably couldn’t have helped you anyway.

Americans can expect to spend 25% of their incomes on medical treatments and health insurance. Oh, yeah…let’s not forget health insurance. That essential commodity for which we pay an arm and a leg, but which then proceeds to find any possible way to avoid paying to maintain or repair the parts of our bodies we have left. That is an entire rant in itself, too long to go into here.

In any case, whatever the root cause, we now have this massive behemoth of a medical culture basically sucking our society dry. And yet, the question Congress insists upon asking is, “Who’s going to foot the bill?”

When they should be investigating: “How can we reduce/control the runaway costs?”

I really have to ask…why is no one asking that question????

I can only believe that the medical lobby(ies) are so influential that they have the power to utterly subvert that line of questioning before it can be fully formed. Someone, somewhere—or rather a lot of someones all over the place—have convinced the “powers that be” that medical costs are what they are; and not only is there no changing them, but there is no chance of even slowing the upward spiral. A tremendous amount of money and power depend upon controlling the flow of information just enough to assure that the public, including legislators, believe what a certain group of players wants them to believe.

Where have we seen THAT before....?

Helllooooo Congress! Helllllooooo President Obama!

The question isn’t “Who’s gonna pay for this?” It’s “Who’s gonna FIX this.”

It’s broken. Fix it.

Get a clue.


Anne said...

It's too easy to blame the medical community. Sure there are exceptions but by and large they are dictated by everybodys insurance on HOW to treat and HOW MUCH to treat. I know you will find it hard to believe but every physican I know goes above and beyond their duty in taking care of patients and so many times for FREE or at a reduced price for those who have no insurance. Did you know if a physican does not submit a bill to a patients medical insurance it is considered ins. fraud on the physicans part?Your co-pay is an agreement YOU have with your ins. company. We have to pay for our insurance also. It is indeed very expensive. People need to investigate different plans or HSA's. Consider a high deductable. Those that can't afford it can also write a letter to a physican for treatment and many times the DR will even help write a letter to a drug company for free medications. There are several organizations who offer free meds to many. is one.
Also I want to agree with you that this system is in great need of being fixed. The costs that are being cut currently are for the ones who need it the most (aged, metally ill and children) These are the people with no voice. It is up to us to write our congressmen to keep up with what is being introducted and voice our opinions.
As boomers, we live longer and thus need more tests to diagnose and a multitude of DRs to help us get to the right one. It is a fragmented spectrum. BUT (and there is always a but) IF you need it, we live in the best country to be treated. Always remember, the squeeky wheel gets the grease. May there be more input on HOW to fix this dire situation. Anne

JACKIE said...

We have the highest per capita medical costs in the world, but lag behind the countries with "socialized" medicine when it comes to infant mortality and life span. My source......Overdosed in America. The author is a doctor who also knows his way around statistics. A good if frustrating read.

I'm reminded the poet Simonides in The Praise Singer. He's over eight when he's remembering his career. What he never told the local physicians who inquired about his long life that when he felt ill, he took to his bed and sent for the local wise woman.

One of the marvels of modern advertising is the idea that modern medicine is traditional and the herbs and plants that gave us many of our magic bullets is not. When it should be the other way around.

Kathy said...

"I guess the current thinking is that if you die of your problem before they get around to diagnosing it, they probably couldn’t have helped you anyway."

And they've made plenty on you while you've been waiting...

Years ago I managed a medical practise. A very busy neurological practise. We were old fashioned. If a patient made an urgent call in ... they were treated as urgent. As were the requests for tests. There was no, 'go home and call here' we made the appointments for the patients.

I loathe going to the doctors myself these days as much as I loved that particular job and physicians group. My recent dental fiasco has me shaking my head over just trying to find, nevermind get an appointment with,a decent ENT's office.

IT is broken. And it needs fixing, but I don't think this president or congress is going to do the job right.

Another damn shame.

"But, once again, I have to assert—things WERE better"

You're not a cranky old fart whining. Things WERE better. But I laughed out loud ... how like MY PARENTS you sound.