If you read these letters regularly you are aware that I have commented on healthcare costs many times, but in the past, I have always been focused on statistics and general principles. Today I have something more specific on my mind.
On December 7, 2015--I remember the date because...well, we all do--I was up at about 4:00 a.m. because I had been experiencing a right of passage for late, middle-aged men who don't pay particular attention to what they eat and drink; the passage to which I refer is kidney stones. I didn't know this until I spoke to my female doctor in the ER and my father-in-law's girlfriend, but apparently many women who've had both experiences say that they'd rather have another baby than pass a kidney stone. The pain is intense, and it doesn't vary from when the stone first lodges until it passes, which is why after about twenty four hours of passing stones, one after another with nothing but a few hours between for a respite, I relented and asked my wife to take me to the hospital. Never having experienced kidney stones before, I thought I was dieing. When I got there, the first step in my treatment was waiting, which I did for an excruciating forty five minutes, after which, step two was taken. I was outfitted with a saline drip bag that had a dose of pain medication in it, which was unhelpful, by the way. About an hour after that was plugged into my arm, I was taken for a CT Scan, during which I apparently passed a stone and felt relief that lasted for a few hours, by which point I was home with my diagnosis of kidney stones...no ruptured arteries or tumors. That's all they did at the hospital: make me wait on a gurney, give me one dose of pain medication that didn't work and take a CT Scan, oh, and then talk to me about it for a minute or two. The doctor spent a total of perhaps six or seven minutes with me during all this, and one nurse was involved in the hanging of the saline solution. Otherwise, I might just as well have stayed home as I passed another stone later in the day...just as painfully, I might add...and got as much relief with acetaminophen as I did from whatever the hospital gave me, that is, I grinned and bore it. But the episode passed, as did the pain, until I got the explanation of benefits from my insurance company. That four hour event in which I didn't even get to lie in a real bed cost $7,902, and that is what I'm on about today.
Since the advent of the Affordable Care Act, Obamacare if you are a Republican who disdains Democratic successes, there has been an ongoing controversy about the benefits we will derive as a society from the law. First there was the website itself, then how many would actually sign up, then the Republican inspired lawsuits about subsidies, Medicaid expansion and constitutionality in general, and the tens of bills passed by John Boehner in The House to repeal the ACA, none of which was anything but a flailing gesture intended to keep the attention of those already on his side regarding the ACA. And somehow, those partisan, arbitrarily contrary efforts yielded legislative hegemony for the Republican Party in the form of majorities, and hence "control," in both houses. (I say control with the qualification that as long as the Speaker of the House can pass special rules to prevent the opposition from calling a vote on a particular bill and The Senate continues to honor that now-decades-old tradition of filibustering by taking a vote, rather than taking the floor and speaking, as long as you have a 41 vote minority behind you, no one has control except for the purpose of ensuring that nothing happens in Congress.) And during all this sturm und drang over healthcare there has been some lip service paid to the issue of the cost of healthcare, but the primary issue has been the effort by President Obama and his party to make sure that, whatever the cost, everyone has access to healthcare, which is a good thing considering the size of the bills that healthcare generates, as in the case of my kidney stones. But consider this. If we paid for our medical care as taxpayers rather than as insured individuals, none of this would be an issue. Healthcare represents 20% of our gross domestic product. That's a total of about $3 trillion a year--at least one and a half times the cost in the next most expensive country, Germany, and two or more times what it costs in the other twenty five or so of the most industrialized countries in the world. That is the problem. Healthcare is too expensive, and it has thus become a privilege rather than a right.
In my final analysis, while the ACA was a good first step, it includes a middleman, the insurance industry, which makes more money the higher costs are because that is how they justify higher insurance premiums, a percentage of which is profit. The proof I need to the effect that we need a single-payer system is in my own experience with kidney stones if nowhere else, and I am beginning to think that the only way for us to solve the problem of healthcare being rationed by financial status is for everyone to get kidney stones...and to have to pay the bill himself. Of course, I don't wish the experience of kidney stones or the bills on other people, given what I went through...except perhaps John Boehner, and you can throw Mitch McConnell in there too.
Your friend,
Mike
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