You are currently browsing the category archive for the ‘Healthcare’ category.

I’ll admit it. I like firing people too, especially if they suck at what they do. So Mitt Romney, your comments¬†don’t bother me.

Indeed, I agree that Romney’s comments–about enjoying the act of firing people–were¬†taken out of context. But it’s really quite a stroke of luck for the GOP front-runner that few people are trying to square those comments with the actual context.

Yes, it is pink.

As everyone knows by now, Romney was talking about health insurance when he made his now-famous remarks.

The problem with health insurers is not that their customers can’t fire them (i.e., find better coverage at better prices). It’s that the insurers can simply refuse to do business with you in the first place, for example, if you are sick and urgently need an insurance company’s services. Or if you have been sick in the past and might need the company’s services again.

As a result, I doubt that a sick person who has a problem with an insurance company can realistically fire that company and hire a new one in its place.

Romney probably knows this. As governor of Massachusetts, he signed health care legislation designed to spare people from this problem. As president, Barack Obama did the same. Insurers agreed to cover all comers in return for the requirement that all people buy coverage–not just buy it when they’re sick.

I guess at some point in this contest we’ll get to that debate. But I’m not going to hold my breath. It might make me sick–and then I’d be the one on the firing line.

Advertisements

We are very focused on pinpointing the tiniest flaws in our physical selves, and the fate they may portend. What if we spent half as much energy searching for the signs in our souls and on our planet?

I usually complain about healthcare, so let me report a positive experience with the system. It’s rather an unlikely one, considering it inv0lves a New Year’s Eve visit to the ER at a hospital in West Philadephia with a crying toddler. But there you have it.

We were staying with my aunt, who lives near Broad Street in South Philly. Around 6:30pm, I was swinging our younger son, Jack (19 mos. old), by his arms when I heard a pop, kind of like the crack your knuckles make but with more bass. I put him down and he started to cry. I picked him up and eventually figured out his left arm was the source of his pain. Any poke or movement made him cry more. He was just letting it hang. I feared I had dislocated his shoulder.

So off we went to Children’s Hospital of Philadelphia, or CHOP, which is near Franklin Field. I pulled up to the ER and dropped off Jack and my wife. By the time I parked the car and made it back — I took no more than 10 minutes — they were already in triage.

The nurse finished taking his blood pressure — and making him cry more by sealing him in one of those hospital ID wristbands — and told us to wait. Which we did for about 5 minutes. At which point, a nurse came out to bring us back to an exam room.

The docs came and then within 30 minutes, Jack’s arm was back to normal. A simple snap back into place was all it took. Within five seconds he was using his arm as if nothing at all had happened. Turns out he had nursemaid’s elbow, a fairly common thing in toddlers.

We were back at my Aunt’s house within 90 minutes of leaving. Let’s hope the bill is as pleasant as the visit. The doctors said there’s usually a several-hours wait in the ER. So, if you must take your child to a hospital, do it on New Year’s Eve.

So I’m in the bathroom of a convenience store in Gettysburg, Pa., when I notice the condom dispenser. Only it’s not labeled as such. The sign reads: “Health Care Convenience Center.” Alas, my camera phone was in the car so I can’t provide visual evidence.

Nonetheless, it’s good to see that people outside Washington and Manhattan have been polishing their euphemisms. Lord knows we’ll be seeing plenty today as the House takes up a financial bailout and vice presidential candidates clash in St. Louis

Health care is the new weather. Everyone likes to talk about it (especially in an election year), but no one wants to do anything about it. Except talk some more.

I’m glad that a lot of people see a need for change. But I imagine if you took a poll about the weather on any given day, you’d get similar results.

At least the weather has a chance of changing for the better if you just wait. Not so with health care. Someone has to be benefiting from the current situation and its progressive worsening (my premiums are going up nearly 30% this year and I already pay a ton out of pocket as it is). And I doubt those someones will green-light reform without putting up a huge fight.

It’ll all come down to who pays. People will be stirred up against higher taxes, not realizing that a heavier financial burden will be taken off their backs. But maybe that paradigm is shifting. People may be realizing they get something for their taxes, whether it’s war, health care or clean roads.

If you don’t want to pay for it, stop complaining. Save your gripes for the weather.

It’s too bad the healthcare system isn’t given to the same booms and busts as our financial system. Then people might actually be talking a bit more about real reform.

Indeed, if I were paranoid, I would say the credit crisis is just a way to divert attention from more serious, long-term issues. After all, banks make money by making loans. They’ll start doing it again someday. And, as I’m sure every mortgage broker never tires of shouting (even today): Interest rates are low by historical standards! Now’s the time to buy!

But alas, people tend to get sick on a fairly regular basis no matter the state of the underlying economy, so business for doctors, hospitals, etc is pretty steady. Kind of like the forward progress the Titanic was making after it bumped into the iceberg. Too big to sink?

I tend to harp on the perils and pitfalls of free-market medicine. But there’s one area where it seems to work, at least in my own life. So I figured I should give dentistry some due.

Last November, my dentist told me I needed $300 worth of work based, essentially, on readings given by a laser beam that a dental assistant shined through my teeth. This red beam allegedly showed the existence of unseen cavities caused by pinhole cracks. I balked. After all, my teeth felt fine (my gum line is another story). But the dentist insisted on the additional work. I told him I would get a second opinion. He graciously allowed that such a move was “my prerogative.” Thanks.

So this month, I went to a second dentist who doesn’t use the laser-pointer and said my teeth looked fine. He even said he would refrain from drilling unless really necessary. After all, dental procedures don’t always turn out as planned. And he told me what I could do on my own to arrest — and even reverse — any problems that might be stirring behind the enamel. The old dentist did no such thing.

As you can imagine, I now have a new dentist. He costs more per visit, $78 versus $55. But there are several key differences that make the extra cash worthwhile, even if it comes from my own pocket — which it does.

My new dentist does the cleaning himself rather than assigning it to an assistant. Second, he doesn’t push expensive procedures. The old dentist had TVs in the treatment rooms showing crooked and yellowed teeth turning white, shiny and straight, kind of like those ads showing Democratic candidates morphing into Osama bin Laden. I’m willing to pay more if I don’t have to resist that kind of marketing pressure every six months.

Dental care is unique in that regular care is relatively affordable and necessary, at least on a middle-class income. It also feels good to have a nice clean mouth for a day or two. And the more expensive-but-routine procedures are relatively limited. For the most part, it’s easy to compare.

Nonetheless, it was a fairly wrenching decision to change dentists. It wasn’t easy to disagree with a medical professional. They have a certain authority that’s hard to reject. I happen to be stubborn enough and didn’t have a long history with my first dentist. It would be tougher to reject a dentist or doctor I’d been seeing since childhood.

Some dentists certainly push what could be unnecessary care, and that could happen in the wider medical market. Maybe we could learn something from dentists, though. Where the sales tactics are too heavy-handed, it could encourage more people to get second opinions. It’s nice to see that where choice is available and exercised, there’s often a better one.

Give John McCain credit for a healthcare plan that goes beyond the traditional conservative mantra of “tort reform.” It’s actually a decent plan if you agree a free market is a good prescription for our healthcare woes. I for one would love a tax credit for buying my own health insurance, which I have to do because I’m self-employed. Too bad the market fails in reality.

It’s fun to dream of consumer power over healthcare decisions. But it’s ultimately a fantasy. I know this firsthand. My second son — who’s looked perfectly healthy on the outside during his 11 months so far — has a suspicious heartbeat that requires occasional and expensive tests to make sure it’s still not a problem.

We have a health-savings account, so we pay most of this stuff out-of-pocket. We could decide to forgo these tests, considering there appears to be little wrong with our son and he’s otherwise perfectly healthy. But, the doctors tell us there’s an outside chance of something bad cropping up. Do we really have a choice in spending the money? I guess. I do often suspect the doctors are being overly cautious and the tests may not really be necessary.

I could get a second opinion — for another couple hundred dollars. Or I could decide I’d rather spend all the money on iTunes and Amazon. What if I spurned the tests simply because I didn’t have the extra couple hundred dollars to spare? What’s good for the bank account may not always be good for the heart.

I know money should play a role somewhere in the healthcare equation, and something has to happen to rein in spending. But I can’t imagine complicating already-excruciating decisions for parents by forcing them to weigh family finances against a child’s health. Maybe the advocates of free-market healthcare think that’s a good thing, and they may even have a rational argument to support it. But the argument needs to be at or near the center of debate.

That’s the unspoken straight talk about consumer-driven healthcare.

The free market in health care will probably work a lot like the free market in college tuition and CEO salaries. But that probably doesn’t matter to ideologues who learn about the market from a textbook rather than the real world. I expect to see many people touting a free-market solution to health care between now and November.

In theory, the free market should work, of course. But one reason the free market works reasonably well in the field of, say, televisions, is that you can return one you don’t like and get a better one. The penalty for a bad decision is all on the seller (and could explain why store return policies are becoming stricter – returns are just one more place to control costs).

However, it is far more difficult to return a college education or a hip replacement. In fact, when it comes to the hip replacement, a botched job will only add to the costs, not to mention the pain.

Information will help the health-care consumer? I suppose, but consider all the sites ranking various televisions. There’s a ton of information, yet some people still end up disliking whatever set they buy.

Let’s take the absurdity a step further. Say I wake up in the middle of the night with chest pains. Are my first words going to be, “Honey, log onto the Internet and see which local hospital has the best record of dealing with heart attacks”? I’ll let you decide.