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, etc.)…some people just have enlarged bones around the brain…you 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 sadubato@aol.com.

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