Barack Obama, Health Insurance, and My Bottom

I was out on the porch yesterday when the mailman arrived. "Anything good?" I asked.

"Well, it depends on what you mean by good," came the reply.

"Anything but bills."

He sorted a small stack of missives before assuring me, "No bills."

Well, that mailman was a liar because there was a bill; a medical bill - not what I wanted to see. I've seen four doctors this month which is more than I'd seen in the previous 20 years. I recalled that the stock market had just lost 777+ points which means that my 401K plan was down the shitter and that it can't be long before the NYSE sends me a bill saying I owe them money. The last thing I wanted was a medical bill. It was from Dean Health System which was the last clinic I'd been to and I'd not yet gotten bills from the first one that I had the displeasure of going to four times.

I hate hospital bills so much because, somewhere in the back of my mind, I perceive them to be penalties incurred by the living for having a loved one die. After my stepmother passed away, I helped my dad sort through piles of medical bills. If the cancer hadn't killed her, all those letters saying "You owe us $2,500" most certainly would have. Looking through them all, I would have sworn there were some from facilities that didn't even treat her. It was as if some billing drone heard about the case through the grapevine and just piled on hoping to score. $20 for a box of facial tissue, $30 for a few cotton swabs, $50 for each "e" used in a sentence by a nurse or doctor, and so on.



And so I was hesitant to gaze upon my own bill. (Had I died and not known it?) As I opened the envelope, my thoughts turned to my girlfriend who was (and is still) in the hospital and to whose 9-year old son I'd just finished explaining that she was going to be alright. Seeing her in the ER was scary and I was consumed with concern. There were wires running in and out of her gown and expensive-looking machines that went "Bing!" with colorful displays of numbers and line graphs. She was going in and out of consciousness and, when she was in, I joked to her that it looked like she was being turned into a Cyberwoman. A chuckle later, the doors of consciousness shut once again when suddenly one of the green numbers in a friendly typeface started dropping to zero. 93…85…60…30…Red lights flashed and a warning klaxon sounded.

Was she dying? Where are the fucking nurses?

Luckily this was all my fault. I had been leaning on the railing and, unbeknownst to me, also on a cable. So, when she set her hand down, there was no slack and the alligator clip hoolie came off of her finger. This was quickly corrected.

She was eventually moved upstairs to some unit with an acronym I can't recall. Let me tell ya, hospitals are pretty slick these days; the new penthouse floor of Meriter, even slicker than slick. (No doubt my friend Mel's stroke a few years back helped pay for a significant portion of the hospital's expansion. Thanks Mel!) We're long past the days when hospitals were these sterile tiled affairs with iron lungs sitting in the corners. I'm talking a flat panel TV, DVD/VCR combo, mood lighting, wood paneling – the whole nine yards. With my sweet out of the woods, I then became paranoid. How much is going to be tacked onto the bill when I wash my hands? I could just envision a $25 charge on the bill for hand soap. Was the cable TV complimentary? The nurse informed me that the tube of charcoal that my sweet had sipped maybe 4 tablespoons of would be well into the three figure range. Had I known that, I would have grabbed some briquettes from the garage and made my own.

When I looked at my bill, I found it to be for $621. My (level 3!!) consultation with a colorectal surgeon cost $370. This consisted of him taking three minutes to confirm the notes of the doctors at the other clinic and about seven to look at my ass and tell me that the abscess was healing well. For another $251, I paid for about five minutes in which he alternately stuck one of his fingers and a camera in my bum before pronouncing that I had no thingy which I can't even remember the name of and that my anal glands were looking spiffy. Personally, I think I should receive a discount because A) the anoscope was cold and B) he gave me no warning. Seriously, not a hint. You'd think that, if you have designs on a person's sphincter, you'd at least give fair warning. If not verbal, then the slapping sound of a rubber glove being put on at the bare minimum. Afterwards, he had the audacity to remind me that, since my father had colon cancer, that I was near the age of my first colonoscopy.

Now, I'm lucky and have health insurance. I expect to pay none of that $621 out of my pocket. But, if being manhandled like a pretty boy in a prison shower by Mr. Big who's in with the warden cost me that much, it is perfectly understandable how a more serious illness or injury could bankrupt a person or family.

It reminded me of this article - "Curb Your Enthusiasm for Obama" which contains the following quote from Dr. John Geyman, the former chair of family medicine at the University of Washington and author of Do Not Resuscitate: Why the Health Insurance Industry Is Dying, and How We Must Replace It:

Obama offers a false hope…We cannot build on or tweak the present system. Different states have tried this. The problem is the private insurance industry itself. It is not as efficient as a publicly financed system. It fragments risk pools, skimming off the healthier part of the population and leaving the rest uninsured or underinsured. Its administrative and overhead costs are five to eight times higher than public financing through Medicare. It cares more about its shareholders than its enrollees or patients. A family of four now pays about $12,000 a year just in premiums, which have gone up by 87 percent from 2000 to 2006. The insurance industry is pricing itself out of the market for an ever larger part of the population. The industry resists regulation. It is unsustainable by present trends.

Now, I'm no expert in this field but the doctors I've spoken to in the past 10 years all seem to share Geyman's attitude. I've watched my health care premiums go up as well as my copays. I recently had a chat with someone who works at one of the hospitals here in Madison and he expressed surprise at how much they spend on advertising these days. After having read the above article, I had even less hope that a President Obama would help move health coverage into the realm of the commonweal.