The Dallas Morning News reports that Texas has no health economist so, my dear neighbors, please allow me to volunteer to so serve. I am only a matter of days beyond a three-day hospital stay, which prompts me to feel that I’m the right case study for the role.
When I phoned my primary care physician to report unwavering acute pain in the left side of my chest that was then three hours old, his assistant took the call and said, “You better head for the emergency room, the hospital will then keep us advised.”
It turned out that four physicians, all different specialists, were drawn into my treatment. As the pain suggested, my heart was the immediate concern. The several expensive procedures they put me through undoubtedly turned into huge reimbursements from Medicare. I’ve yet to be billed for any copayment. I will make sure that I am, the sooner the better, because I am very grateful that I am eligible for Medicare, and have been for 18 years.
Medicare should be the health coverage for all Americans. But there are too many lobbies and inconvenient truths working against it. The biggest is our loose borders, protected by the special interests who demand a steady supply of workers of foreign origin who are incapable of fighting for fair pay or equal rights. It’s the same loose borders that enable our illegal drug traffic, which feeds an epidemic that the health care industry can’t begin to solve.
Yet our doctors and hospitals live by a code that says all comers who ail or hurt will be served, and the tab for those without insurance will be paid by the taxpayers. Ironically, the uninsured patients, if they have jobs at all, aren’t taxed enough to help the system.
But such uncovered costs are hardly the biggest impediment to universal health care, by Medicare or any other national system. The biggest, which is more ironic still, is the health insurance industry, which spares no resources to keep its profits and executive pay unthreatened by the public interest or the greater good.
We all know that American health care is the costliest in the world, in part because it is so loosely and badly managed and overwhelmed with the paper work that helps keep the ambulance-chasing lawyers at bay. Nowhere more obviously than in Medicare, which gets me back to the intense and expensive learning experience of my hospital stay.
The physician that the hospital assigned to manage my case then teamed with three specialists. Together they sanctioned an elaborate nuclear study of my lungs and the procedure in which the cardiologist went through my femoral artery to scan my heart. Later, a cat-scan found the actual problem, which was acute pneumonia in the left lung. That finding then put my immediate care thankfully in the hands of a pulmonologist, whom I will continue to consult as needed on lingering respiratory problems.
These team approaches to care can’t help but add to the costs of Medicare. Seniors who land in hospitals become fruitful prospects for specialists looking to enlarge their client base and keep their private practice and its staff drawing steady incomes. It would defy human nature if the specialists involved with hospitals didn’t check incoming cases to offer consultation from which they might land new clients for their private practice. Medicare will pick up the tab.
Surely the pulmonolgist, and probably the cardiologist who scoped by heart, remain key in my ongoing care, even though my primary care doctor may wish otherwise. Such are the doors that Medicare opens for seniors – cost be damned. Because we find the system so accessible and comforting, we seniors should bend over backwards not to abuse it. As needs arise, I will always start with my primary doctor, whom I’ve found to be very astute.
The cardiologist scheduled me the next week for a visit to his office, to check the healing on my incision. His work had shown that my heart was sound and protected by clear vessels all around. The office follow-up led him to propose the extra precaution of the procedure that scopes the carotid arteries. After his techie had completed this computerized exam, the doctor reported the following. “Frank, the right carotid has some blockage, between 20 and 40 percent. But it becomes serious only at 70 percent. But on your left side, the artery to your brain is perfectly clear.” I said, “Doctor, there’s a simple and obvious explanation. The left artery is clear because all my life I’ve been a staunch Democrat!”
The beauty and sorrow of Medicare are one and the same: it should cover every citizen.
But as things stand, we cannot afford quality, universal health care and a military that is so obscenely bloated that the next dozen major powers don’t together match our costs. We’re addicted to an arms race that never ends. It rewards us with chronic weaknesses and threats that we lack the will to solve, including the ever-growing national debt, the insatiable right-wing appetite for war, a dwindling middle class, and schools so enthralled with the religion of football that they show no hope of meeting global competition in math and science in secondary schools. The emergence of football as our leading medium of entertainment, based on dollars spent, does zero for our competitiveness in global economics. Whatever its pride on teamwork, football cannot turn up a new middle class.
Our rank as the only superpower has heightened our fears, not lessened them. We’ve become the handiest target of every gang of terrorists and fanatics on the planet. And the arms race will never change that. The arms race feeds our fears, even as it feeds on them. It’s that last and grandest dream of our inventors: the perpetual motion machine. Its price is its fuel: national paranoia.
Whether Medicare can compete over time with this machine will say a lot about our future as a democracy, as a free people. If it can’t, then our drift toward oligarchy will continue, and only one outcome will be possible: corporate fascism. In fact, the world is nearly there. It’s taking root no less in Texas, freeing it of any need for a health economist. But I won’t give up.
Frank Mensel – September 2012