Because You Never Asked

HEALTH CARE

(This essay was written in '99)

     If someone were to give me a word association test and the words were "health care", my response would be "the weather".

     The weather?

     Yes, because it's something we always talk about but never do anything about.

     After 54 years of life in this galaxy, I finally had my first serious brush with the omnipotent corporate behemoth of drug companies, insurance companies and medical professionals responsible for keeping us the healthy consumers the global economy demands. I never considered that this possibility would be a pleasant experience, but, much the same as my occasional contacts with modern cinema or daily TV (see essays "The Movies", "Jerry Springer or Pro Wrestling Revisited", and others), I was surprised to find that it would be worse than I had imagined.

     One day --- a day that now seems a lifetime ago --- I was playing tennis at the local public courts. In an attempt to intercept a well-played return, I stepped to my right and felt a slight pop in my right knee. My life has not been the same since that fateful moment. (About the only consolation I can find in all this is that I did put the volley away).

     One year later, when I had finally decided that the peg-legged existence I was living was not adequate, I handed myself over to the corporate behemoth spoken of above. It was my fervent desire to have my torn meniscus cartilage repaired by way of what has now become a fairly routine procedure known as "arthroscopic surgery". I would not be cut open. I would spend no more than seven hours in the hospital.

     There are supposedly 40 million Americans who work and do not have health insurance. There are also many millions more who are referred to as "under insured". One can only guess as to what that means. Having now had some experience with our health "industry", my guess is that such people are only covered for the kind of sickness or injury for which health professionals are not needed.

     My status is not so nebulous; I am uninsured. Being such, before having my operation, I did some research as to approximate cost. Amongst the sources I consulted was a friend I've worked with for many years. He had suffered a ruptured appendix two years before and had to be rushed to the hospital in a life-threatening situation. He was cut open. There must have been blood, guts and gore in abundance. He was stitched up externally and internally like a brand new baseball. He spent 12 days in the hospital with a full bevy of nurses and technicians fawning over him 24 hours a day. He had to be fed, cleaned, and generally kept alive. The day I visited, he had tubes and pipes coming in and out of him from all the cardinal points on the globe. He was a Godforsaken mess.

     Thankfully, he's OK now. He told me he was paying off a bill of about $14,000.

     I suppose it's relevant to mention that between the time of my friend's $14,000, 12 day stay in the ruptured appendix ward, and my seven hour visit to the bad knee emporium, the hospital in my town changed hands. For those of us who are generally healthy and do not work in this industry, the idea of a hospital actually being somebody's business, like a supermarket or restaurant, is a foggy concept that translates imprecisely into the realm of our everyday lives. It's as if somebody told you that the road you ride to work on every day had just been sold to a different road company.

     The hospital business is like a "Stealth" industry operating off the radar screen and out of the average man's consciousness. It's easy to comprehend going to the store and buying a tomato, but going to the hospital and "buying" a cure for illness seems somehow perverse. Perhaps the hospital of the future will have check out lines with cash registers and you will show the cashier a voucher for "chemotherapy", or "ruptured appendix", or "heart bypass", and they will ring it up right there for you. Maybe you'll be able to say, "hey, wait a minute, they're offering a sale on 'heart bypass' at the hospital on the other side of town." Or maybe you'll start to get coupons in the mail, like from Pizza Hut or Dominos, offering 30% off on any "tonsil removal". The marketing possibilities are endless.

     In any event, the hospital changed hands. Given the rhetoric we are constantly being fed by the people responsible for cramming this system of health up our asses, one would assume that the consumer would benefit from this change. Hasn't our country rejected other ways to deliver medical care in order to be improving and doing it better than before?

     Yeah, and Michael Jordan is Swedish.

     When I decided to take the plunge, I paid the orthopedic surgeon $2500 up front, a price I considered reasonable. In my mind, he was the Mark McGwire in this line up and I thought this would be the bulk of the cost. In light of the investigations I had done, and considering what a 12 day stay in the hospital with a ruptured appendix had cost, I figured my seven hour use of the hospital facilities, including the anesthesiologist, a nurse here and there, and whoever it was who wheeled me around, would cost up to, but perhaps less than $2000. About ten days after the operation, an itemized bill I really did not understand, arrived to my house in the amount of $5000. After a few days of dumbfounded stupor, I engaged the financial department of our freshly purchased hospital in a series of heated debates. They listened politely. They promised to check their figures. I returned a few days later. Their answer, though very cordial, could be translated thusly: "screw you buddy, pay up."

     I forked over another $1000 and made arrangements to pay the rest in monthly $50 installments. As I was leaving the financial office, I was politely informed (These people are very polite. If I ever have to be executed, I'd like for them to do it.) that this arrangement was subject to review every six months. For the only time in my life, I wished I had a machine gun in my hands.

     About a week later, at a time when I had made emotional peace with all this and was getting on with my life, another medical bill arrived to my house. I had no idea who this doctor was or what role he had played in what has turned out to be a mediocre reparation of my knee. He wanted $87. I sent him a check. In the ensuing weeks and months it became evident that there was a swirling flock of medical buzzards circling ominously over my financial carcass. Hardly a week goes by where I do not receive another bill from another unknown doctor whose role in all this is totally mysterious to me. These bills always come in very trendy looking envelopes; cream colored pin stripes, grainy paper in pastel colors, clever logos and letterheads. They always come with equally beautiful matching envelopes enclosed. They always have nice windows where the address on the bill will fit just right. They make it very easy for you to fork over your money. These people are very polite.

     At first, all these bills made me very anxious. By now I've crossed that threshold. All I do is throw them in the garbage. I don't even open them. I pay my $50 a month. I feel no guilt.

     In a commercially competitive society such as ours, where happiness seems to be measured by the goods one can purchase, it makes perfect sense for a rich man to have the things money can buy. He doesn't have to live in the South Bronx. If he wants a Lexus with Carnegie Hall sound, he should have it. If his wife wants an Imelda closet full of shoes under a forest of skirts, dresses and matching tops, she should have it. Vacations to exotic places? Yes. Good seats for the World Series at Yankee Stadium? Yes. Shrimp cocktails and a good Chardonnay? Yes.

     But any society with positive pretensions cannot look at one's physical well being as if it were something to be purchased at Bloomingdale's. You must earn your right to a two-week vacation in the French wine country, but all human beings are born with the right to be healed. Not everyone is ambitious. Not everyone is driven to triumph. Not everyone is shrewd and cunning. Not everyone is financially adept or materially driven. We are all not put on this Earth to be E-Trading yuppies with well-planned portfolios. Some of us are "nerds". Some of us are not "players". Some of us are downright losers. But we all have one thing in common:

     Nobody wants to be sick.

     Any society that looks at its healing technology as something to be purchased, like any other commodity on the free market, is beginning to lose its concept of humanity. Any society that cannot grasp the fact that all its inhabitants have a right to this access, at least with some approximate degree of equality, is flirting with the label "uncivilized". Health care, in this modern world of plenty, is not something we should ever sell to each other; it's something we have to put our energies together to provide for one another. If you are barbaric enough to still not grasp this concept, consider this: even the most degenerate bum, living the most fetid life on the homeless streets of the world's only super power, contributes some part of his estate to the public well being. Every time he buys a pack of cigarettes or a six pack of Old Milwaukee, he contributes.

     Alan Keyes, the Don King of American politics, has got his idea of immorality all wrong. The most immoral aspect of our society is not our capacity for erotic behavior; it's our capacity for material greed.

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Email: JerryG@postcman.info