American Healthcare Issues

First off, let me say this isn't an argument for why we should leave health care in America the way it is, or pushing for universal coverage. I'm just doing a little nit-picking and general complaining over a few things.

One of the things I intend to bitch about came up on a blog by Renaissance Guy about a guy with an infected tooth who ended up dying. He went to the local emergency room and they gave him a prescription for some pain meds and an antibiotic and told to go get his tooth pulled. He was uninsured.

The big thing I wondered is why they couldn't have had some doctor come on in and just yank the infected tooth out and go from there with the pain meds and prescription.

One commenter, who goes by the moniker Plainly Spoken, said:

I would suspect that is because ER’s are not equipped for dental work and do not have dentists on staff. I would further think this is because there are not significant numbers of people going to ER’s for dental issues. Also, I would suspect that the large majority of dental emergencies occur because so many people ignore dental issues until forced to deal with them (which may well come from a lack of dental insurance and/or ability to afford dental care).

Fair enough opinion, but still I have to disagree that the people who work in the hospital aren't capable of pulling out a friggin tooth. They have local anesthetics, they have scalpels to cut away the gum if necessary, they have clamps to hold things out the way, and I'm sure something resembling a pair of pliers. Add some gauze to the hole when your done and give the guy some pain meds.

To which another commenter going by Spherical Time replied to my solution:

I think doctors are unlikely to attempt surgery that they haven’t trained for, especially with as few preparations as getting a scalpel, clamps, and a pair of pliers (and the gauze and painkiller).

That’s a good way to kill a patient

As to ST's first paragraph I agree. Although one caveat I might add is how many ER doctors got formal training treating gunshot wounds? Sooner or later it has to be figured out. As for removing a tooth, it isn't exactly rocket science. Yes, it is better to be trained in the professional manner, however, its still pulling a tooth. Take an X-ray to see what the tooth looks like altogether, then yank that puppy out of the guy's mouth. I would assume the reluctance of a doctor in an ER to do such a thing would be more insurance/malpractice/lawsuit related than the ability to do minor in house surgery.

As to removing the tooth killing a patient, I disagree. I've had a few teeth forcibly removed without the help of a trained professional, and I never died from it. I felt like I'd rather have died than deal with that kind of pain, since when it comes to my mouth I'm a big wimp, but somehow I survived it okay.

The stories we were given as kids, and some people may have actually experienced, about tying string to a loose tooth and a doorknob, or pulling a bad tooth out with pliers, they aren't just stories. That kind of thing actually happened... in one's own home, by the babysitter, or whomever.

Heck, for decades, if not centuries, both dental and medical care were administered where ever it was needed. They didn't require a big fancy building and a staff of specialists for every possible scenario in order to do the job. If a guy needed a big gash cleaned and stitched, the old saw bones (doctor) would do it right in his own house which sometimes doubled as his office, or at the patients place. If a guy needed a tooth removed, they removed the dag-blamed tooth.

Who needs big fancy buildings, a board of directors, insurance executives and legal departments to fix minor issues before they become major ones that might require all of the above? Hell, I have known quite a few elderly people who made a trip to the hospital for some reason or another and refused to stay, after the doctor made the decision to keep them, because they knew damn good and well that staying in the constantly sterilized environment might actually be more dangerous in the form of getting a bad antibiotic-resistant staph infection or pneumonia, than going home to heal up from whatever ailment they suffered from. They can check in by phone, or visit the clinic to be followed up with or monitored, and only choosing to stay in the hospital if things get really really bad that they actually physically REQUIRE hospitalization.

But then again, thanks to lawyers, if the doctors don't toe the line and something goes wrong, the patients family can sue the pants off of them. Whether it happened in the hospital or because the doctor didn't make them stay. I do argue for tort reform in the medical field. Not a full on "you can't sue the doctors for shit" kind of tort reform, but for putting a little common sense back into the system. If the doctor fucks something up, sure sue him. Get the cost of the medical requirements covered by the doctor, hospital, and/or their insurance companies. Get the lost wages to the family in the event of death or permanent disability. Even get your mental anguish and pain and suffering payments if you want...not $10 million dollars worth of pain and suffering by any means, but some smaller, more reasonable figure would be fine in my eyes.

I know life is precious and priceless, especially if it is yours or a loved one's, but some of these lawsuits that award millions in damages on top of the economic scope are ludicrous. I don't care if the guy is a $5 million dollar a year CEO of some corporation or some barely making handyman. Cover the health care costs for life for screwing him up, a reasonable wage recovery amount (in the event of the little guy, give him his last 20 years of work he would have done if it hadn't been for this medical "mistake"; as for the CEO, he can do with less than 20 years at $5 million per), and some capped compensation for your pain and suffering.

I'm not a big fan of lawyers and their ability to make a ton of money from your lawsuit while you get a pittance when something goes wrong in the medical business. I'm not a big fan of the insurance and hospital execs who get big pay for essentially "running" a corporation already tracking to succeed regardless of him being a member of the board. I'm not a big fan of the big pharmaceutical companies who insist on pushing their drugs onto everyone at a steep price, and working their damnedest to keep the generic versions from being available, or their working with insurance companies to keep erectile dysfunction drugs covered while not covering other types of more relevant lifesaving drugs and forcing the customer to pony up every penny for them.

I mean look, I'm not anti-regulation. I believe there has to be some regulations to protect all parties involved, but often times we over regulate things, and use too broad of a brush with those that exist that actually stymie the process in some instances.

I Need An Indestructible Mechanical Head

So, I went back to the dentist today. Now some of you know that I have only two whole real teeth left in my mouth. Well today was x-rays and cleaning, in preparation for even more work.

I once had my mouth to the point of being almost completely taken care of. Then a wisdom tooth comes out of nowhere, and due to finances at the time I couldn't afford to have it pulled so that I could re-insert my bottom partial. That was a couple years back. A few months ago I had the deteriorated wisdom tooth pulled. And now I wanted to get refitted for a new set of bottom teeth.

So I went to the dentist who insisted on checking the integrity of my two teeth. As usual, there had been some deterioration underneath where the crown had been placed. It is my opinion that the previous dentist put the crowns on too soon before allowing my mouth to heal up properly, so the crown didn't go all the way down into my gum line the way it should. The dentist didn't come out and say it, but I think she agreed.

With the current crowns, a lot of the tooth is blocked from the view of the x-rays, and they found a slight cavity, but they have no idea how big it may be underneath the crown. Lovely. Just friggin lovely. this is of course after being subjected to a long time in the torture chamber, err, dentists chair to get scraped, poked, and all cleaned up. I swear the work on those two teeth took longer to get cleaned up than any dentist in my life had taken on me when I had a full set. I've never LIKED going to the dentist, but it was never an excruciatingly dreadful experience that I freaked out about going, like some people do. But after this session, I think I'm not liking them so much anymore. The sound of them scraping my teeth reminded me of fingernails on a chalkboard, or dragging a coffee mug across a rough counter top tile. The mere thought of which makes the teeth I no longer have hurt like hell. I hate that friggin noise!

Well, I go in on Thursday to get my upper relined for a better snugger fit. Then we go to work on the two bottom teeth. One needs to have some buildup work done on it to protect the tooth underneath that crown better. Then there is the left one, the one with the cavity. They will be cutting the old crown off to inspect the extent of the cavity damage. Then we'll proceed to either fill it in and cap it, root canal it and cap it, or insert a post to hold the remainder of the tooth and new crown in place. Then we go on the partial to clip in.

I do want to thank my wife for taking a job that covers my dental needs in her benefits package, without also having to charge me for the health insurance itself as a costly prerequisite that I won't use anyways. My company offers benefits, but they cost a bit too much and aren't nearly as good as her insurance. And quite frankly I'd like to have something resembling a paycheck rather than forfeit it all for substandard insurance.

I have an immune system that I would put up against any one's at anytime. but for some reason, no matter what I do for my teeth, no matter how many thousands of dollars I put into them, they just SUCK!

I think that while we're at it, I just have them lop this head off, sculpt a desirable face and make me a new one out of titanium or some other almost impossible to destroy alloy. Then I could have razor sharp shark teeth put in, so I could just walk into a field along any number of our Iowa roads and get my beef straight from the source with a simple biting. No need for all those middle men involved in rendering, distributing, cooking and serving my beef at a marked up cost. Of course, if I ever bite my tongue, that might prove disastrous. Maybe we'll go with dull-razor sharp teeth? But then I would also never have to worry about shaving anymore. And they could insert my eyes with x-ray and infrared capabilities, telescopic sighting, and maybe even a smart weapon technology that would allow me to aim any piece of my arsenal just by moving my eyes to the target. Now THAT would be cool! And of course, entertaining the family by installing a laser pointer in there to make the cat chase it around the floor and up the walls. That's always a good time for all who get to see it. Cats are psychotically driven to chase those things. And right now, the only thing my cat goes after with that sudden movement capability is a fly. He ate one yesterday after chasing it around the apartment for about 5 or 6 minutes yesterday.



Of course once I get that installed, I'm sure there'd be someone like Sarah or John Connors coming to destroy me since I would be too much like one of the terminator machines. But, at least I wouldn't have any teeth issues anymore, and life would be grand. And, I could just pull back my facial skin at Halloween to freak the kids out!

Anyways, hopefully within the next month to month and a half, this will be all done, and then I can just go in for 6 month cleanings/check-ups and not worry so much...except for that incessant scraping noise!

Government and/or Insurance Companies Directly Driving Costs Of Healthcare UP?!?!

Below is an interview done by Glenn Beck from his show on Tuesday, March 17, 2009
It really is an interesting case. Is it the case just there in New York, everywhere, limited places, or where? I'd be rather interested in who is behind the decision of the State of New York to say how the doctor operates his private practice when it comes to how he charges his fees for his work. Is it just the state being power hungry, or maybe an insurance lobbyist who saw what was ging on and made the push to keep the insurance industry from losing some of its relevance, power, and all that GLORIOUS MONEY? Read below, and let me know what you think!




GLENN: When it comes to healthcare, do they want to fix the problem? Dr. Muney is a doctor here in the New York area. John Muney is his name. You are originally from Turkey, aren't you, Doctor?


DR. MUNEY: Yes, I'm from Turkey.


GLENN: How long have you lived here in the United States?


DR. MUNEY: Since 1975.


GLENN: Since 1975, you've been a doctor here since 1975?


DR. MUNEY: Yes.


GLENN: And you have a regular practice, and it's a thriving practice.


DR. MUNEY: Yes.


GLENN: How many patients do you have?


DR. MUNEY: Well, in our practice now we have about 7,000 to 8,000 patients.


GLENN: Okay, 7,000 to 8,000 patients, and you decided that there's too much waste, it cost too much money, just in your overhead. Tell me a little about the frustration of being a doctor in America today.


DR. MUNEY: Well, the system, it's the wrong system. That's what we have here. It really is mostly to paperwork, waste, bureaucracy, fraud, abuse and that's why we're paying about 50% increase in our healthcare premiums.


GLENN: Say that again. What do you mean we're paying 50% in healthcare premiums?


DR. MUNEY: I mean, the system, the way it's set up, it lends itself to abuse, waste, bureaucracy. And if we were paying $2.4 trillion in healthcare, I think $1.2 trillion is waste. It can be reduced. It can be eliminated.


GLENN: And how is that?


DR. MUNEY: Well, I mean, you know, the way the system's set up, the patient/doctor relationship is broken. People are trying to make as much as possible the way -- for example, the doctors are seeing the patients as a cash cow now, some of them. So they try to do as much, as many tests as possible, as many surgeries as possible. The hospital bills are enormous. $100,000, $200,000, $300,000 bills are common now. And this goes on and on.


GLENN: Okay. How come they can do this?


DR. MUNEY: Well, the regulations, the system itself allows them to do it.


GLENN: In what way? The insurance companies because it's a third party payor?


DR. MUNEY: The insurance company, it's a third party system and, you know, they are trying to do some job but because of the -- it takes certain amount of money to run the system and plus, the patients come to you, they say, "Doc, I have this insurance, do as many tests as possible." And the doctor said, "Well, okay, I'll do it because I'm getting paid. And the hospital does the same thing. And the cost keeps escalating.


GLENN: So in other words, this is -- and I've had this happen a million times. The doctor will say, "Does your insurance cover X, Y, and Z?" You'll say no. Then they will sit there and think for about 30 seconds and they will say, okay, we'll use this instead. That's where the waste comes in. They don't have to do some of the things that they --


DR. MUNEY: No, they don't have to.


GLENN: And would you include some of that waste in the paperwork, you know, to guard against litigation, et cetera, et cetera, and the insurance for the doctors on litigation?


DR. MUNEY: Oh, definitely, there's no question about it. I think in my estimation is the cost of our practice to our healthcare system's about 10% minimum.


GLENN: Okay. So you're talking now about 60% of what we all pay for healthcare is between waste and guarding against litigation?


DR. MUNEY: That's true. I strongly believe it. I believe that we can reduce our healthcare costs by 2/3 easily.


GLENN: Okay. Now so you know, America, I'm just talking -- this is just one man's opinion. He's just a doctor here in New York.


DR. MUNEY: Yes.


GLENN: But he got sick of it and he decided that he was going to charge all of his patients $79. You weren't going to take any more healthcare, you weren't going to do -- no insurance. Just $79 every month and you can go see him -- you can go -- your patients can come see you as many times in that month as they needed.


DR. MUNEY: That's true. They can come, for $79 there's unlimited preventive checkups and includes the bloodwork, sonogram, x-ray, whatever they need at that time.


GLENN: And if somebody gets sick and they need to see you five times in a month, they only would have paid you $79 and there was no, there was no office pay or anything like that. It was just $79 and you can come as many times as you want.


DR. MUNEY: Yes, that's true. As long as they are coming for preventive checkups, yes.


GLENN: What does that mean?


DR. MUNEY: Well, my original idea was to charge $79 flat rate every month for unlimited visits but unfortunately the state stepped in saying that if I do this, I'm doing insurance business.


GLENN: Okay.


DR. MUNEY: So they --


GLENN: Wait, wait, wait, wait, wait, wait. But what I want to go to originally is you said anything for $79 a month, they could see you for anything. That was your original idea?


DR. MUNEY: That was my original idea.


GLENN: Then the state came in and said, "No, that makes you an insurance company and so you can't do that."


DR. MUNEY: That's true.


GLENN: And then the state sent you a letter saying that you couldn't do that.


DR. MUNEY: Yes.


GLENN: And then you came on my program.


DR. MUNEY: Yes.


GLENN: And then they said, "Okay, you can do that; however, you can't charge the $79, it can only be for preventative medicine."


DR. MUNEY: Yes.


GLENN: A checkup, which kind of defeats the purpose. And then you also have to charge them, what is it, $33?


DR. MUNEY: Yes, $33 for sick visit only. If they come in for sick visits, I must charge them $33 because, to cover my overhead costs. That's the law.


DR. MUNEY: Why -- yeah, I know. It's convenient, isn't it?


DR. MUNEY: Yes.


GLENN: How does that help people getting healthcare, who don't have healthcare, how is that helping to have $79 for preventative and if you get sick, you can also pay $33 when the doctor himself says "I don't need to charge the $33"?


DR. MUNEY: That's true.


GLENN: How is that helping?


DR. MUNEY: I mean, it really makes it more difficult for us to charge $33 because then it will increase or administrative costs as well. But I think $79 will cover my costs. That's what I believe, and I wanted to do this but unfortunately in order for me to salvage the program, I still believe it's a good deal, no question about it in my mind. But I had to agree to some kind of compromise.


GLENN: Okay. Have you asked them if, that let's say you go to a restaurant and it's all you can eat for $9.99 if that $9.99 is an insurance program? Have you asked them if that $9.99 for an all you can eat, if you also wanted dessert if they would have to charge an extra $33 for dessert if that would be fair? Have you asked them how do they explain gym membership?


DR. MUNEY: Lawyers, retainers fees, it works on the same principle.


GLENN: What is their response to that?


DR. MUNEY: Well, I haven't -- I never talked face to face with them. We've been only communicating through letters, and my lawyer has contacted them several times and so this is a compromise we chose. I'm hoping that hopefully some legislator will sponsor a bill to change the law and take the primary care out of the insurance business.


GLENN: You know, Texas, South Carolina.


DR. MUNEY: Washington. Washington, the primary care is not under insurance law. They can do it and they are doing it.


GLENN: And is it working out fine for them?


DR. MUNEY: Yes, exactly. I communicated with a couple of doctors from Washington State.


GLENN: Be careful when they get all this stimulus money. I wonder what kind of strings are attached in that. Dr. Muney, I appreciate you very much, sir.


DR. MUNEY: All right. Bye-bye.


GLENN: This is why -- just don't believe them when they say, oh, we're just trying to help out. No, they're not. No, they're not. They're looking for their own power. That's all they're looking for. When they say that they're against giving bonuses to the AIG executives, ask them, do they have a contract? Yes. Is it valid? Yes. In your bailout did you not say that all contracts signed before this date are valid and must be withheld -- must be upheld? Yes. Did you guys in congress write that law? Yes. So it's a valid contract? Yes. You said that if it was signed before a certain date that it was valid? Yes. It would be honored? Yes. You don't believe we can break the union contracts, right? Of course not, no. But this contract with AIG that makes you popular to fight, you can break that one? Yes. So that's like we enforce the law sometimes on the border and sometimes we don't. That means that sometimes this drug law we need to go ahead and enforce but sometimes we don't. That means that sometimes you'll pay a tax penalty if you don't pay your taxes and sometimes you'll be made secretary of the treasury? Yes. Okay, I just want to make sure I understand the rules, which basically means there are no rules... unless you're important or powerful, which is weird because I think that's the way communist Russia used to work. But call me crazy.