Imagine if Prevention catches on in America how many people will be out of business. The healthcare juggernaut will crumble. A number of job categories will have their ranks decimated like nurse case managers, insurance adjusters, healthcare administrators. Hospitals will close and nurses wages will go south. Doctors will have time to actually see their fewer patients and not worry about lawyers as much.
We have long reached the point in this country where the healthcare system does not exist for the patients but the other way around. The minute you cross a hospital threshold you become a number with a bracelet on your wrist. Have you ever paused at the number of papers they have you sign, and how many people you have to deal with who are NOT YOUR DOCTOR. Your main purpose becomes FEEDING THE HEALTHCARE OGRE.
My notebook is replete of stories of healthcare OVERUSE. How many of you do know somebody who entered a hospital for a right knee pain only to be discharged a couple of weeks later with his liver biopsied, his prostate turped, his left shoulder scoped, his left knee replaced,,,,and STILL complaining of right knee pain! Once you enter the healthcare machine God only knows what you will end up with...or without. EVERY HORSE IS CONSIDERED A ZEBRA UNTIL PROVEN OTHERWISE, meaning that any artifact on an x-ray, any borderline number on a bloodwork, or any EKG misfire will only lead to more tests and more unnecessary procedures.
That is what happened to me after my vespa accident of 1988. I was riding on Flatbush avenue in Brooklyn and a truck cut me off at a green light so I ended up pinned under it saved by my vespa and helmet which got wedged there. The rear wheels pinned my leather jacket and I lost consciousness when I broke most of my right fingers trying to get my right arm away. In a nutshell the brunt of it was in my right hand. Luckily or not, I ended up in a local hospital which just received its trauma designation and was itching to show it. First and foremost, doctor or not, you are the patient so you should just shut up and let them do to you what they wish. It all started with a chest x-ray taken laying down because they had not yet cleared my cervical spine due to a busy CT scanner. Of course anybody knows that you take those x-rays sitting up or standing. Sure enough there was positional distortion in the aortic segment but the attending decreed that it maybe was an aortic dissection and the hell started: an arteriogram was warranted meaning must first do a mini-lap to rule out blood in abdomen and before that of course a Foley catheter you know where. All that was negative. I was so worried about my right hand (my surgical future and all) but nobody cared and I had to literally freeze in the lobby waiting for my cervical spine brain and chest CT scan. Finally it was done and also negative. So now I was ready for my arteriogram, the biggest torture of all, causing me to burn inside and puke my guts out, also negative. After all these negative tests were done, to the tune of about $20,000, some hand surgeon finally addressed my mutilated right hand 7 hours later If they had listened to me in that freshly minted trauma room they could have saved me quite an ordeal and saved my insurance a great deal of money.
The ER is a bottomless pit geared towards heavy-handed defensive doctoring with a dose of high pitched theatricals and disdain for cost.If you can pay the price of waiting for hours, the minute you are admitted it is the TAJ MAHAL of tests, probes and pokes. All bets are off regarding HMO, PPO, precertification, predetermination or any other feeble attempt at cost containment . You are theirs to handle as they please. This plays nicely into the American fast fix and immediate gratification mentality that we discussed in previous blogs.
ERs are by law forced to take everybody, with or without coverage. What ends up happening is a robinhood approach where the insured patients pay for everybody and the prices they are charged are exorbitant. Considering the public fondness for the ER Taj Mahal, no wonder insurance costs are rising.