Sunday, July 14, 2013

The US Healthcare System - Up Close and Personal.

I'm lucky.  I've been healthy and haven't required medical care.  But my 54 year old younger brother had an extraordinary encounter with the healthcare system.  He is actually quite healthy but about six months ago he experienced severe pain in his neck, back, shoulder and arm.  He's a truck driver who also does manual labor but he's a big strong dude who is used to hard work.  The unrelenting pain triggered a visit to the doctor as well as an ordeal that literally went on for months.  At first the doctor just prescribed muscle relaxants and pain killers.  That didn't work and his condition slowly filtered through the medical insurance quagmire that eventually resulted in a diagnosis of a herniated disc near the neck, after being in agony for 4 months.

It took a long time, including finally scheduling more tests, an MRI and visits to a neurosurgeon, but surgery was finally approved by his insurance company.  Throughout the ordeal, he incurred out of pocket medical expenses, mostly for tests, that totaled in excess of $4,000 which he paid and post op he has unopened medical bills that he's afraid to open.  He called the insurance company to complain about the medical bills and the insurance company practically laughed in his face and informed him that it was paying $38,000 for the surgery alone which didn't include other costs the insurance company had already paid.

Surgery day finally arrived 6 weeks ago.  We got up at 5:30 a.m. to be at the hospital by 7:00 a.m. for a scheduled outpatient 10:30 a.m. 1.5 hour surgery, despite being at the same hospital the day before for more pre-op tests.  Oh well, the medical bureaucracy has its rules. The surgery went as planned and he was wheeled out of the operating room at 12:01 p.m. according to the hospital's electronic status board.  After several hours in recovery, he was wheeled to a regular hospital room because he couldn't walk, could barely talk and wasn't permitted to leave the hospital until he could walk, hold down food and urinate.

I have nothing but the highest praise for the staff, competency and professionalism of the Seton Medical Center in Austin.  If I ever got sick and needed hospitalization, that's where I'd want to go.  It can't be easy working in a medical surgery facility with tons of antsy and neurotic loved ones hovering around and Big Sis can be a bitch.  My brother was well cared for as nurses and technical assistants constantly monitored everything.  Two physical therapists arrived to get him up and walking.  It's no easy task getting a semi-conscious post op patient in severe pain out of bed and walking but that's what they are trained to do and they had him walking the hospital halls on his own with the IV pole in tow.

He was declared well enough to leave the hospital at about 8:00 p.m. and was wheeled to the hospital entrance, gently put in the car and I drove home with my patient.  It would be weeks before we knew if the surgery was a success but 6 weeks later he's back at work and pain free except for some very minor discomfort at the incision site.

He estimates that the entire ordeal cost him and the insurance company at least $45,000 with the insurance company paying most of it - the $38,000 surgery plus a substantial portion of tons of diagnostic testing.  Still, $4,000 out of pocket for a truck driver is painful.

A hospital is a strange place.  From the classless waiting room of the surgery center, the rich and poor alike waited for word on their loved ones.  You can only sit for so long so walking the halls of the hospital is common.  I met a guy who appeared to be in his late 30's or early 40's.  He was really down on his luck, out of work and was just diagnosed with a late stage cancer.  He was incredibly grateful that the healthcare system was treating him despite the fact that he had no money.  I met an incredibly distraught man whose father was brain dead from a stroke and he had to make the decision to pull the plug.  He felt like he was murdering his father and wondered if the hospital tests were wrong.

Few folks in America have the resources to pay for healthcare because it's so expensive.  How a 1.5 hour out patient surgical procedure can cost $45,000 is beyond anything that I can comprehend.  It literally boggles the mind.  Obamacare, whose official name is the Patient Protection and Affordable Care Act, has only increased the cost of medical care.

Yeah, America has great healthcare but the cost.......

Zero Hedge had a map on the cost of an appendectomy in America and other countries.

USA             $11,997
Canada             2,436
Germany           2,506
France              2,700
Netherlands      2,700
Spain                2,959
UK                   2,634 

US healthcare procedures cost at least 4 times what they cost in other developed nations so I'm guessing that my brother's $45,000 surgery would have cost $10-12,000 outside the US.  

In 2011, USA Today published a report saying that Medicaid and Medicare costs, both entitlements, were $992 billion and expected to rise substantially.  Federal tax receipts in 2011 totaled $2.3 trillion, here.   The US government reported that "U.S. health care spending reached $2.7 trillion in 2011, or $8,680 per person", here.  

Our healthcare system isn't working and I don't have the answers.  What is clear is that America spends more on a per person healthcare basis than any nation on earth and by a very wide margin.  PBS reports that the US spends 2.5 times the OECD average.

Progressives will argue that the government must takeover the entire US healthcare system and churn it into single payer system.  Well, we're practically there anyway and it hasn't worked.  The more government intervenes, the worse the healthcare nightmare gets.  Libertarians and conservatives will argue that the government just needs to end its entitlements and interventions.  What are we going to do?  Just let folks die because they can't afford medical care?

America has managed to engineer and build the most expensive healthcare system in human history and that's not something to be proud of because eventually healthcare rationing will become a necessity and a reality, at which point we all lose and suffer.


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