The most recent New York Review of Books includes a long, interesting reveiw/article on US health care. I've yet to finish reading it, but the central argument is that oversupply of services is a major contributor to our spiraling, out of control costs. Doctors have many incentives to order tests and procedures. Financial compensation and fear of liability are major factors in this dynamic. I had my own experience with the system just last week when, quite unexpectedly, I suffered a major reactivation of a long dormant companion: ulcerative colitis. Very mild symptoms, which had been lingering for a few weeks, and which in the past have disappeared on their own, typically in a matter of a few days, suddenly worsened dramatically and I ended up in the E.R., overcome by pain and dehydration. I'm a lucky beneficiary of modern medicine: a simple I.V. feed, spiced with some good narcotic, had me somewhat hydrated and almost pain free in fairly short order. Appropriately, the first call I got that morning, lying in triage, was from my doctor's office, to remind me that I had an 8:30 am appointment. I explained that I was tied to an I.V. at the hospital just up the street and wouldn't be able to make it. Not a problem: Dr. So and So is at the hospital making his rounds and he'll stop by to check on you. But the E.R. doctor got to me first and he ordered a CAT scan. When I got back from that my doctor found me and we were going over my situation. I asked him about the CAT scan, and he confirmed my doubts when he admitted he wouldn't have ordered it since what we really needed done was a colonoscopy, which was performed a short time later at the doctor's office. Waste? Who knows? I can't blame the E.R. doctor, but maybe if someone had told him my doctor was in the hospital they could have consulted briefly. But the hospital has it's routnes. I'm sure this happens everyday all over the country: hey, we've got this really expensive machine, so keep it in use, keep that billing office busy! (At least my doctor got me discharged and could perform this second procedure at significantly less cost than the hospital.) I'm getting great care and I'm extremely grateful: I kind of tail spun into very poor condition and, thankfully, got the help I needed very fast and with fantastic results: those evil pharmaceutical giants do have some good products! But how expensive is too expensive? How are we going to pay for it?
I question myself about posting comments related to private aspects of my life, but in this case I decided to go ahead. It's interesting to see the health care in action, and I'm fascinated by the speedy coming and going of symptoms and pain management. And the same old thing: someday in the future when I'm wondering when it was I had that really bad week I can look it up and I'll find it here.