Who's to Blame for Health Care Mess?
Steve Adubato, Ph.D.
When it comes to fixing the health care problem in New Jersey and
the nation, we tend to talk about who is to blame. The HMOs, the
doctors, the lawyers and the hospitals. Clearly, there are many
players who have contributed to the nagging dilemma. We all like
to point the finger and assign blame for the rising health care
costs and the ever increasing number of people with little or no
health insurance-over 1 million in NJ and nearly 40 million nationwide.
Recently, I was preparing for a speech on the health care crisis.
In doing so, I came across some notes for a piece I wrote in June
of 1992 on the same subject. Interestingly, much of that material
is just as relevant nearly a decade later. Consider the sobering
words of former U.S. Surgeon General C. Everett Koop delivered at
the time at Summit High School. Dr. Koop points the finger in the
direction we're not used to seeing.
"Patients are among the most greedy in the whole health care
system. They want everything and they want it with every health
system they encounter
Insurance costs too much because health
care costs too much
We spend billions of dollars on tests patients
don't need or want. More is not better
There is no panacea.
No easy answers-only a series of difficult choices."
As I reviewed Dr. Koop's comments, I have the same mixed feelings
today as I did at that time. I was angry at him for blaming consumers
(that's me) for the health care crisis. Surely, with all the powerful
special interests involved in this issue-regular consumers are minor
players at best. Then, about a week after Dr. Koop's speech, I had
an experience that would radically change my perspective on health
care and helped me better understand Dr. Koop's words.
I was experiencing terrible sinus headaches. The pain was terrible
so I went to the emergency room. The emergency room doctor then
gave me the following diagnosis; "You have an acute sinus infection."
Then he added; "We have another problem. The bone surrounding
you're your pituitary (in the brain) is abnormally enlarged. I'd
like you to get an MRI right away." Then came these "reassuring"
words; "Don't worry, it may not be a brain tumor."
Needless to say, I was stunned. I called my own physician who told
me "You don't have any symptoms (dizziness, partial blindness,
some people just have enlarged bones around the brain
don't need an MRI, especially not right away."
I told my doctor that I had to know right away if I had a brain
tumor, so he makes an emergency appointment for me to get the MRI.
Sure, it cost $1,000 but I'm not paying for it. My insurance covers
it. Luckily, my doctor was right. I didn't have a brain tumor; I
had a sinus infection.
It's funny. As a commentator I can call for cost containment and
criticize the "waste" in our health care system. But as
an individual patient, all of that goes out the window when my health
is on the line. As a matter of fact, this past month when I experienced
severe back pain I got an MRI which showed I had a serious disc
problem. I needed surgery and I got it. I stayed in the hospital
for five days and was given a variety of painkillers, muscle relaxers
and pills to help me sleep. All of it was covered by my insurance.
I never saw a single bill.
Finally, during the past week or so, I had some shoulder and arm
pain so my doctor prescribed two separate MRIs, one for the shoulder
and one for my upper spine. That's three MRIs in five weeks! Bottom
line to all this? Cost containment? Forget it. Waste in the health
care system? You're talking about someone else, not me, right? Were
some of these procedures and prescriptions necessary? Absolutely.
All of them? I'm not so sure. What would you have done if you were
in my position? Am I not typical of the average health care consumer?
Isn't it a fact that most of us have the attitude we do about health
care because we don't think the money is coming out of our pockets?
Somebody else is paying, right? Fact is, it's not that simple. But
nearly a decade later, C. Everett Koop's sobering words seem crystal
clear. There is no free lunch when it comes to health care.
Some people say they want national health care. Sounds great, but
are we really willing to put out the bucks and more taxes to pay
for it? Do we really trust the government to decide which medical
procedures we can and can't get? Or, do we want the health care
we want, when we want it, without paying a penny more? It's easier
to point fingers at other people. The doctors, lawyers, hospitals
and the HMOs. But like I said, there is enough blame to go around
and until we as consumers look at the role we play in this health
care crisis, there is no reason to think things are going to get
better any time soon.
Steve Adubato, Ph.D. is a commentator, lecturer and former state
legislator. Dr. Adubato is also an Emmy Award-winning television
anchor and syndicated columnist.
He can be reached by fax (973) 509-1659 or e-mail him at firstname.lastname@example.org.
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