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!