A Personal Look at the American Health Care System

By Ronald Glenn
America’s Right

I have been unable to contribute to America’s Right for several months now because I have been in the process of relocating to the American midwest. My wife has wanted to move closer to home for some time, finally got tired of waiting, and arranged for a purchase of a home last month. I, however, am still stuck on the east coast. Why? Because I am too old to live without medical insurance. None of the employers in the midwest I have spoken with are offering medical benefits. It would seem that permanent part-time employment is the choice of the day. This situation has given me lots of reason to think about America’s medical system.

In my usual fashion, I think the best way to discuss my take on the current system is to tell a couple stories.

When I was eight years old in 1963, my father took my two brothers and I to our local doctor because we had all caught the same cold, and were complaining about low-grade fevers and coughing too much. Our doctor had started practicing medicine before the discovery of antibiotics. He was an “old country doctor” in the classic sense. He had delivered us, and intended to take care of us for the rest of our lives. He had a receptionist and nurse, and he ran his own pharmacy out of his office. He made house calls. He was as imperfect a human being as he was good at what he did. He was overweight, loud, and bossy.

But my father, who had a GED because he had never finished high school, trusted him completely — and my father trusted very few men after having served in World War II and the Korean War. What I remember most about this visit was what happened while we were leaving. The doctor walked out into the waiting room with my dad and told him that we would be OK. This thing, he said, was going around the schools.

Finally, my dad asked, “How much do I owe you?”

The doctor shrugged and said, “Give me five dollars apiece.”

My dad gave him three fives and the doctor stuck the money in his pocket. My dad received neither a receipt nor invoice. What is important about this transaction is that it did not involve an intervening third party. (Remember, money had value in 1963. Five dollars meant something.) There was no insurance company, no government medical card. This was a transaction under the same economic rules as an auto repair.

The system however, had a deep rooted flaw that brought it to an end. It gave the doctor too many God-like powers. He could charge whatever he wanted, and there were many who charged different fees to different patients depending on income. He had sole discretion on the type of care the patient received. “Alternative medicine” was considered witchcraft. From a practical point of view, the medical profession was better at diagnosing an illness than it was at curing it. My doctor, at one point, even confessed to my mom that he could tell people what was wrong with them, but all too often it was too late to do anything to help them get better.

Fast-forward to 2007. I had to go to the hospital for five days and lie in a bed in a cardiac department so my heart specialist could figure out what medicine would properly regulate my heartbeat. I was conscious, in no pain, and really bored. I was in a semi-private room, so what went on in the other half of the room was easy for me to see. On the fourth day, a man was brought into the room at three in the morning. I found out he was 84 years old, had several children and many grandchildren. At around two o’clock in the afternoon, a doctor who appeared to be in his mid-thirties spoke to the 84-year-old man, practicing his best bedside manner.

In summary, the doctor told the patient the following: “The dye that was used for your heart test turned off your kidneys. You have no kidney function at all. That’s why they called me. I’m a kidney specialist. You can either go on dialysis or you can go home and die. I would advise trying dialysis for a while and see if your kidneys start to work again. But it is up to you.”

The patient thought for a moment and said: “I miss my dogs. I want to go home.”

The doctor said he understood, and left.

The issues involved here are enormous. Is the man capable of making his own decisions? Who signed the consent form for the heart test? Was the signer made aware the dye could end his kidney function? Think of the money that would have to be spent if the man chose to go on dialysis for the long term.

This is not a question of handing someone fifteen dollars. This is what all the screaming is about in the halls of Congress concerning the pending health care legislation. In order to be treated for an illness in America, the patient requires an intervening third party to negotiate the payments to the hospital. It will either be an insurance company, the government, or a mixture of the two. The case I have described could have easily ended up with bills from anywhere to a hundred thousand to a million dollars before it was over. Heck, all I did was lie in a bed for five days and take some pills and my bill was almost twenty-five thousand dollars. One could say that I went to dinner and had caviar and then had someone else pick up the check. (My medical premium is $5200 per year.) If I am not going to pay for my meal, it makes it harder to complain about the service.

Anyway, The day after the kidney doctor appeared to speak with my older roommate, another doctor showed up at two o’clock in the afternoon. He was elderly, distinguished, and self-confident. (This was a Saturday, so I suspected he was semi-retired and covered weekends.) He told all the man’s relatives to leave the room and proceeded to explain the world as he saw it.

“Listen to me,” he said. “I’ve read your chart. You are no longer going to make your own medical decisions. It is obvious that has to be turned over to someone else. I expect this to be done as soon as possible.”

The patient listened in attentive silence.

Congress is arguing about what interest the state has in this man’s medical care. Who pays for his care? Who decides what happens to him? Who will decide whether he lives or dies? It is fine to say this is up to the family, but they are not paying for it, and a very valid argument can be made that a technical medical decision is outside the realm of the average citizen.

I am not advocating government control, I am explaining why the argument has come about. Unfortunately, the left wants to resolve this issue by instituting the philosophy of “communitarianism.” This is an outlook that attempts to place the interests of the individual against the interests of the community as a whole. Money that is wasted on useless health care would be better spent on education, for example. At some point in time, the life of an individual is deemed secondary to the survival of the group.

The question, of course, is who makes the decision and what is the process that is used in the course of deliberations? The American public is having doubts that Congress is up to the task, particularly since the Democratic Party has such a twisted idea of what constitutes a community. They seem to think the American community also includes anyone who will pose with President Barack Obama in a photo session and promise to be nice to him in the future if he wishes to visit them again. And President Obama, of course, must perform presidential stretching exercises so he can bow in front of world leaders and touch his head to the floor.

Decisions about health care had previously been made on a personal, family level. Like any person over fifty years of age, I have seen too many ways to die that are terrible, causing financial and spiritual suffering to the families involved, diseases ranging from cancer to Parkinson’s to diabetes to Alzheimer’s. But in the modern world there is only so much a family member can do in the face of well-educated, highly paid professionals.

When I was ten years old, I witnessed an aunt die from cancer. She did not have enough money to go to a hospital, so her daughters took turns sitting by her bedside and injecting her with morphine. I do not know of anyone who has done this within the last ten years. A person in a similar situation today would end up in end-of-life hospice care.

What communitarian philosophy ignores is that most people do not weigh the good of the individual against the need of their community. It is weighed against the good of the family. Personally, I would rather die than deprive my son of a college education because I spent all the family resources to live a couple extra months. Balancing the prolongation of life against the needs of a family is much different from worrying about whether there is enough money for Nancy Pelosi to spend on her nonsense.

Yet, this communitarian ideal has a lot appeal to people if the government sells its medical plan as a way to prevent the destruction of an affluent America. The old, you see, are wrecking the chances of a good future for the young. This would not be as hard to sell as one would imagine since America is a society that has far more reverence for youth and vitality than old age and wisdom. President Obama is a sign that when America wants to be revitalized it turns to youthful vigor instead of age and experience. If the Democratic Party creates a generational battle between the young and old, I think there is the very real possibility the old may lose. To quote the tombstone of Brother Theodore, a twentieth century comedian: “As long as there is death, there is hope.”

Alas, there is a legend I heard many years ago about a race of beings that wanted to be able to foretell the future. They made a deal with the gods that they would sacrifice one of their eyes for this power. The gods of the old world are devious, so they agreed to the bargain, except that the only prophetic power they gave this race was the ability to foresee their own deaths. This race of beings roamed the earth in perpetual sorrow.

If the American public makes a bargain with their political gods from the left on health care, it should consider this legend. The gods love tricks. I pray we keep both of our eyes wide open, and fight to create our own futures instead of asking the gods for favors.

—————
Ronald Glenn has worked in real estate and law for more than twenty years. He now works in Philadelphia, and lives outside the city with his wife. Ron has been writing for America’s Right since January 2009.

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Comments

  1. Gail B says:

    Life sucks, and then you die."

    Ronald, that must be terrible, to have your wife leave for the middle west and leave you on the east coast because of your health insurance!

    Thanks for a thoughtful article. And, I'm happy that you were out of the hospital in five days. Be careful, stay healthy, and stick around! AR needs you!

  2. Anonymous says:

    I love your stories, Ron.

    Thank you.

  3. Anonymous says:

    Ronald,

    The Nephrologist (kidney doctor), you overheard is the "exception". I work as a nurse in a 546 bed level II trauma center. Under our current system, the doctors are paid per procedure. That means that when they order a test, they get paid to read it. When another doctor orders a consult, the consulting doctor gets paid. (Even if the consult happens to be a partner in the same group).The young doctor you overheard certainly passed up alot of potenial bilings. It may sound cynical, but I think 75% of the doctors I deal with are more interested in making money than in what is best for the patient.

    I have met many people recently who sound like you. If you have the time, do a google search of what tax rates were when you and your brother were children….. Maybe its time you did some research. While your at did, try doing a search on "transitive" logic.

    Susan, RN

  4. Juan John says:

    Wishing you and yours a very happy and prosperous new year !

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