Surgery's Needed, and Obama Prescribes Aspirin

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I know a pediatrician who employs five full-time people and one part-timer. The pediatrician, a woman, offers health insurance to anybody who wants it because she’s very nice that way. For the one lady whose family takes her up on it, she pays—the owner, that is—pays $30,000 per year. The employee pays a reasonable $750 per month or so (I think it is). Doctor or not, that pediatrician can’t afford to do that for everybody, though she would work twice as hard and bend over backwards to do so if she had to. She’s just that nice.

At least, I think so, because I married her.

So when you talk about health care and insurance costs, I do know something about them. And when you start talking about controlling the insurance companies, recognize that they are controlled by math, pure and simple. They are in the business to make money, but they can’t make money if they have to insure every Tom, Dick and Barak for peanuts for premiums. The figures just don’t work out.

But is Obama’s solution the right one? No way in hell. He, and everybody else on Capitol Hill, are missing the elephant in the room: They don’t understand the problem. They understand the symptoms, but not the problem.

I think everybody is missing the point because nobody has studied the root causes of high health care costs. Think about it for a moment. All you hear is how the government has to step in to offer a new form of taxpayer-subsidized insurance, when that won’t do anything to control costs—it’ll just shift them around a bit.

So why are costs so high? Here’s one idea: have you priced medical malpractice insurance recently? For pediatrics, it might be only $25,000 per year. OBGYN? $100,000+ isn’t uncommon, and in ten states at least, it was over $200,000 in 2005 (see this report). If an OBGYN sees 20 patients per day (that’s a 20 minute visit, more or less), five days per week, 52 weeks per year (no vacation), each patient already owes $38 just to cover that doc’s malpractice insurance. God help the OBGYNs (and their patients) who have been sued…

Wonder why malpractice costs are so high? So do I.

Frankly, any healthcare bill that doesn’t mention tort reform is a load of Band-Aids when the patient has cancer…

Solution? Caps are low-hanging fruit, and probably not a good idea. More likely eliminating or limiting contingency fees would be a better start. Limit the lawyer’s take to that of the public defender unless he or she wins. Make the plaintiff take a financial risk. I’m not sure.

But I’m sure that’s only one of the causes. And I’ll say it again, nobody is looking at the root causes for high costs. Not anywhere in that 1000+ page bill is controlling the costs that hospitals, doctors, nurses—everybody—have to pay to merely be a business (adequately protected from lawsuits, frivolous and deserved alike, among other things) mentioned.

Patent reform is part of it, too, I think. Think drug companies charge all they do because they need more money for marketing? Well, yes, they do. It’s because they have to make their money in the very short time left of the life of a 17-year patent after “first offered” (which is before clinical trials, and which starts the 17-year clock) to FDA approval. Since it takes years to bring a drug to market, there’s not a whole lot of time to recoup those costs, hence higher prices for you and me. Ick.

Then let’s also take a look at medical school costs. Guess which medical school in the whoooole country costs the most? Harvard? Yale? Baylor? Duke? Mayo?

Nope. That’d be the Medical University of South Carolina—a public institution—at $70K+, all inclusive for those of you not already paying taxes to the state of South Carolina. (Well-deserving of a “WTF?!” Be sure to look at both public and private schools if you look at the list, and it is worth the look, believe you, me.)

I’m an engineer. We look for the root cause of the problem and fix that cause instead of treating the symptoms. (That sounds vaguely medical!) I’m partial to fixing the problems of our healthcare system with major invasive surgery if necessary instead of telling the patient to take two aspirin and call me in the morning. Or, as the Obama administration proposes it, tell your neighbor to give you the aspirin and call your doctor as many times as you want, whenever you want, because you won’t worry about paying for those calls, now, will you?

Anyway, wonder how those medical school costs get paid? And did you ever wonder why those costs are so damned high? (I still wonder. I really have no clue.) Guess where those costs go? Yup. They eventually get passed on to the patients, seven to ten years after everybody else started earning money if they so chose. Think it’s possible for a UPS driver to earn more in a lifetime than a doctor? No? Think again. (I have checked his numbers. They’re right.)

Again, I’m sure I’ve only identified a few of what I perceive to be the real causes of the problem. And I wish I could do something about it. But our politicians are too short-sighted—all of them, party lines notwithstanding—to see beyond the ends of their noses and past the lobbyists and into the real world where, no, my wife wouldn’t be able to afford to put five families on her health insurance, thereby spoiling it for everybody…

Oh, one other thing: Why do we put so much into the end-of-life care and not into the beginning-of-life care? Who gets paid the most? Yup. Those responsible for fixing wrecks, self-induced and otherwise, instead of those responsible for preventing the wrecks in the first place. It’s the family practitioners and pediatricians who are the least paid, most-worked practitioners. It’s the heart surgeons who take Wednesdays off for a game of golf at the Club with Buffy and Mitch. Go figure. Seven figures, that is.

I hope that if we disagree, we disagree rationally. And I hope that where we agree, we will… will what? Suggestions, anyone? Letters to our representatives? Facebook posts?

And now I’m off to bed. I am going to head to the gym at 6am to exercise to remove some of this excess weight and do my own preventative healthcare.

At my expense, I might add. Obama? You got a grant for that?



Elizabeth Basil said:

Bill For President!!! You make some interesting points.

Why can't we buy insurance in other states? That seems beauracratic and hokey. Probably wouldn't help me but may help the operating expenses for everyone else.

Also, why is it that I can pay $3.75 for one generic pill at Walmart and $1 for the same pill from Why is the US pharmaceutical market charged so much more than the rest of the world?...b/c the pharmaceutical lobby is HUGE? What are the pharmacuetical industry earnings now? They were running in the 40's for at least a decade before I quit keeping up. That's wonderful that they're making a killin'. It's the American way, but it ticks me off if they're gonna sell the drugs to the rest of the world more cheaply than they will to me.

By the way, James Assey and Rudy Barnes are both lobbyists now, maybe they can hook you up with some contacts....

Take Care, E-