Harry and Louise are back.
Remember them? They were trotted out during the height of HillaryCare in the 1990s. People who believed that Mrs. Clinton’s purpose was to move us to government-run health care used the ads to stop her in her tracks.
Harry and Louise appear to have mellowed.
You can see it for yourself at http://www.harryandlouisereturn.com/. This is the newest ad, and it is meant to throw resolution of health care into the lap of the next president.
From where I sit, asking the politicians to solve the health care dilemma is a prescription for problems. Every time they step in to help, it gets more complicated and expensive.
The ad, however, takes no explicit sides. But since it prominently mentions access to care and affordability of health insurance, it tries to set the debate.
These are real problems, and they need real solutions. The political arena is the worst place to get this done, although it obviously cannot be ignored.
Political leaders use health care reform to gain votes. Those who are serious, like Mrs. Clinton, are the ones who will advance their government solutions based on the appearance of a groundswell of support.
The answer to what ails U.S. health care lies primarily in two areas: We must become healthier. We must become involved in paying for, and therefore knowing about, the cost of care.
Politicians are building the case to tell us how to live, what to eat, where to go, and what to do. That runs contrary to traditional U.S. culture. Maybe Americans have become passive enough to accept top down directives. What do you think?
Clearly, most top down health reform points toward mandatory coverage, forcing more people to pay more to do more and will end up costing more. For certain, politicians cannot solve the spending problem by managing spending.
Tuesday, August 19, 2008
Monday, August 18, 2008
Why health care costs so much
Greg Dattilo and I are writing a new book. Our working title is “Why health care costs so much.”
I had a practical example on July 31.
Early that afternoon I suffered chest pains. (Since them, I have been calling them chest “aches.”) At the time, all I knew is that they did not stop. Feeling pains in the chest and the accompanying pressure is disconcerting, to say the least.
I called my doctor, planning to go to the clinic. They gave me to a triage nurse.
The triage nurse demanded I call the paramedics. She told my wife absolutely not to drive me to the ER. I felt stupid, because the pains (ache) were higher up in the chest. I had no other symptoms of a heart attack. But she insisted.
At the ER, two EKGs, blood work, and a chest X-ray indicated that whatever I had, it was not my heart. Yet, the ER doctor suggested I say overnight in the hospital and get a stress test.
I went home. Five days later, I had the stress test, but my insurance agent told me I had already spent all my deductible. I had the nuclear stress test, by the way.
The great news: My heart is 100 percent. The not so great news: I still have the achy chest, but it is far less of a problem. Tomorrow, the endoscopy. I told my doctors to look up helicobacter pylori (check it out at www.helico.com). We may be on to something here.
Why do we spend so much on health care? To date, I am guessing we’ve spent $5,000-$6,000 on this incident, although I have only seen the $1,600 charge for the paramedics. And there is more to come.
On July 31, there is no question I needed to see a doctor. Maybe even in the ER. Maybe.
My story, however, does indicate in a small way why health care costs so much.
Defensive medicine played a role. If the triage nurse had agreed with me, and I had suffered a heart attack on the way to the clinic, she fears getting sued. If the ER doctor had not offered the chance for me to be admitted, and I suffered a heart attack at home, he fears being sued (he admitted to me that the number one reason ER doctors get sued are chest pain issues).
Okay. They were all doing their job, and did it professionally. I get it. But I also realize that I spent at least $4,500 that accomplished only two things; it gave me peace of mind about my heart and it ate up my deductible.
So, of course, that means I am now considering other medical irritations that just might need treatment this year, instead of next. I admit it. I am just as human as the other 304 million Americans. The deductible has been met. What is your next question?
Oh, did I mention, I have a high deductible health plan and an HSA. And am I ever glad I have the HSA! And a good heart.
I had a practical example on July 31.
Early that afternoon I suffered chest pains. (Since them, I have been calling them chest “aches.”) At the time, all I knew is that they did not stop. Feeling pains in the chest and the accompanying pressure is disconcerting, to say the least.
I called my doctor, planning to go to the clinic. They gave me to a triage nurse.
The triage nurse demanded I call the paramedics. She told my wife absolutely not to drive me to the ER. I felt stupid, because the pains (ache) were higher up in the chest. I had no other symptoms of a heart attack. But she insisted.
At the ER, two EKGs, blood work, and a chest X-ray indicated that whatever I had, it was not my heart. Yet, the ER doctor suggested I say overnight in the hospital and get a stress test.
I went home. Five days later, I had the stress test, but my insurance agent told me I had already spent all my deductible. I had the nuclear stress test, by the way.
The great news: My heart is 100 percent. The not so great news: I still have the achy chest, but it is far less of a problem. Tomorrow, the endoscopy. I told my doctors to look up helicobacter pylori (check it out at www.helico.com). We may be on to something here.
Why do we spend so much on health care? To date, I am guessing we’ve spent $5,000-$6,000 on this incident, although I have only seen the $1,600 charge for the paramedics. And there is more to come.
On July 31, there is no question I needed to see a doctor. Maybe even in the ER. Maybe.
My story, however, does indicate in a small way why health care costs so much.
Defensive medicine played a role. If the triage nurse had agreed with me, and I had suffered a heart attack on the way to the clinic, she fears getting sued. If the ER doctor had not offered the chance for me to be admitted, and I suffered a heart attack at home, he fears being sued (he admitted to me that the number one reason ER doctors get sued are chest pain issues).
Okay. They were all doing their job, and did it professionally. I get it. But I also realize that I spent at least $4,500 that accomplished only two things; it gave me peace of mind about my heart and it ate up my deductible.
So, of course, that means I am now considering other medical irritations that just might need treatment this year, instead of next. I admit it. I am just as human as the other 304 million Americans. The deductible has been met. What is your next question?
Oh, did I mention, I have a high deductible health plan and an HSA. And am I ever glad I have the HSA! And a good heart.
Sunday, August 10, 2008
Obesity weighs down emergency costs
There is near unanimous agreement that obesity drives health spending higher. We understand this regarding diabetes, heart disease, blood pressure and other diseases.
I was struck by this additional cost that certainly never before crossed my mind. It is an indicator of how interrelated are the hidden costs of health care, and why it is so hard to get the health system under control.
The paragraphs below are lifted from “How To Purchase A Power Cot,” a sales brochure from MonsterMedic, a manufactuer of equipment used by Emergency Medical Technicians on ambulances.
Consider the additional cost for workers’ compensation insurance, heavier duty equipment, lost days to injury, short and long term disability insurance, not to mention pain and suffering of the medic.
“It is widely known that patients in the U.S. on average are getting heavier. Some experts estimate that about two-thirds of American adults are overweight or obese; 3.8 million people are over 300 pounds, over 400,000 carry 400 pounds or more.
“Obesity creates more medical risk factors and consequently, more emergency calls. A heavier patient creates a hardship for the EMT as the amount of weight to lift is more, the risk of cot tipping is higher, and the loss of control of the cot is more prevalent. Of course, this affects the safe transfer of the patient.
“It also presents a risk to the EMT. More weight to lift creates more physical strain on the EMT, especially to their back, shoulders, and knees. The highest percentage of the EMT back injuries occur when they need to bend down over the patient to raise them from the ground. Another common accident is when the EMT has to react unexpectedly to a cot that has become out of control.
“It’s not difficult to connect the dots.
“As patients become bigger, the EMTs face more physical challenges when transporting them. A look at current statistics point out that ambulance cart tipping is increasing and EMT back injuries are on the rise.
“As the general population changes, we must adjust the way we serve them.”
Now that is an understatement.
I was struck by this additional cost that certainly never before crossed my mind. It is an indicator of how interrelated are the hidden costs of health care, and why it is so hard to get the health system under control.
The paragraphs below are lifted from “How To Purchase A Power Cot,” a sales brochure from MonsterMedic, a manufactuer of equipment used by Emergency Medical Technicians on ambulances.
Consider the additional cost for workers’ compensation insurance, heavier duty equipment, lost days to injury, short and long term disability insurance, not to mention pain and suffering of the medic.
“It is widely known that patients in the U.S. on average are getting heavier. Some experts estimate that about two-thirds of American adults are overweight or obese; 3.8 million people are over 300 pounds, over 400,000 carry 400 pounds or more.
“Obesity creates more medical risk factors and consequently, more emergency calls. A heavier patient creates a hardship for the EMT as the amount of weight to lift is more, the risk of cot tipping is higher, and the loss of control of the cot is more prevalent. Of course, this affects the safe transfer of the patient.
“It also presents a risk to the EMT. More weight to lift creates more physical strain on the EMT, especially to their back, shoulders, and knees. The highest percentage of the EMT back injuries occur when they need to bend down over the patient to raise them from the ground. Another common accident is when the EMT has to react unexpectedly to a cot that has become out of control.
“It’s not difficult to connect the dots.
“As patients become bigger, the EMTs face more physical challenges when transporting them. A look at current statistics point out that ambulance cart tipping is increasing and EMT back injuries are on the rise.
“As the general population changes, we must adjust the way we serve them.”
Now that is an understatement.
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