| 5/18/08 09:31 am - Doctors
One thing I'm grateful for in the current political election/zoo climate is that the state of our health care has finally taken a front seat in public discourse. However, one thing that keeps coming up over and over is, to paraphrase, "the U.S. has the best medical professionals in the world... there's a reason why people fly in to the U.S. when they have an obscure or difficult procedure that needs doing."
I have to admit, for a long time, I had accepted this notion, and my beef with U.S. healthcare wasn't the care, per se, but the insurance and costs.
Recent health issues involving people I love have me second-guessing the assumption.
First off, my sister recently had her second child and started suffering a host of health problems, beginning when she got pregnant and persisting in the nearly two years afterwards. Some of it was chalked up to being in her later 30s, and I don't know the details of most of what she went through, all I know is that she was feeling miserable and the doctors couldn't seem to solve what was going on.
A few months back I heard the words "Fibromyalgia" tossed out there as a possible culprit for some of the symptoms she'd been having, constant pain and fatigue. The name sounded familiar due to some drug company ads for treatment, and as I looked up information on the internet, I was pretty horrified my poor baby sister might be afflicted with this. What was screwy though was that the doctors couldn't conclusively say this was the cause for her symptoms, and kept ordering a bevy of tests, each of which didn't seem to tell them anything.
The pattern seemed to be: order a test, go get the test, wait to hear the results, the results were inconclusive, order another test. Each cycle took 2 months or so with zero progress on helping Rachel get over her constant pain and exhaustion. This went on for like a year!!
Eventually, our mother started spending her days on the internet researching Rachel's symptoms trying to figure out what was going on. One thing she stumbled across was "aspartame poisoning," overdosing on the artificial sweetener found in many sugar-free products. Rachel drank Diet Cokes like water, and often chose sugar-free products over sugared products to save on caloric intake. Mom pointed Rachel to some of the articles on the topic, so Rachel asked her doctor about it. Her doctor dismissed it, but Rachel decided to cut out aspartame, switching to products sweetened with Splenda instead to see what happened. Nothing seemed to change for a while... but after two and a half weeks the pain and fatigue dramatically decreased to almost nothing.
Her doctor remains unconvinced that aspartame was involved and keeps asking her to get more tests, but she says she feels great and cancelled her last appointment.
My mother-in-law has had numerous health issues over the past few years, and a recurring theme is "bafflement" as to the root cause. Things recently got bad enough that she's spent most of the past two-months in the hospital, with about a two week stint at a nursing home for physical therapy before she landed back in the hospital. Just recently they've nailed down a few culprits for some of the issues, but there remains a disturbing number of unknowns.
All of which has me wondering-- if this is representative of the best health care service in the world, just why the hell is it so damn expensive? Why are there so many times when the doctors just seem to shrug and say, "hm, I'm at a loss"? I would think that, if I were a doctor, and I had a patient for whom I could not diagnose the root cause, I wouldn't rest until I came up with an answer. I would think there would be forums you could go to, lists of your peers in the medical field, you could post your delimma and see if anyone else ran across something similar and perhaps found the answer by going down a different path of reasoning. You know, network. Like with my sister, I'm sure there are doctors who have found that overdosing on aspartame can produce symptoms similar to Fibromyalgia, why didn't her doctor run down that possibility instead of spending a year of shoulder shrugging? I would be embarassed that a patient's mother researched the internet to find the root cause of something my patient was suffering from.
I do have a theory though; I don't necessarily think that doctors are a bunch of uncaring slackers who don't want to go the extra mile to help their patients. I think that the insurance companies are giving them a huge squeeze financially, paying them only a fraction of what they charge for their services. Ever noticed on the "this is not a bill" statement you get mailed after going to the doctor, and it shows such-and-such procedure, the bill amount and the amount that the insurance pays, which is always considerably less? Then there may or may not be some amount that you owe, but if you add that (a lot of times its zero) and the amount the insurance pays, it's always considerably less than what the doctor's office notes as what it costs. My theory is that there is so much business that doesn't get paid by the insurance companies, that the doctors have to overbook on patients, pushing them in and out, spending as little time as possible with each patient so they can cram enough in the day to pay the costs of running their business. They literally can't afford to spend extra time digging into mysteries, so if your malady isn't something obvious then you're fucked.
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