Breakfast was oatmeal with lots of apple slices from the Beacon.
Barbara and I were listening to National Public Radio when Steve Inskeep interviewed David Goldhill, the author of a forthcoming Atlantic article, “How American Health Care Killed my Father.” Goldhill, a media executive, believes that a consumer-driven health care system would produce better results at lower costs.
Goldhill’s key evidence is his father’s death at the hands of a negligent hospital. The story is that the hospital admitted the senior Goldhill -- who was suffering from pneumonia, and who subsequently died from sepsis contracted there -- then billed Medicare in excess of 600 thousand dollars. The telling detail of the story is Goldhill’s stopping a routine, billable blood test in the final hours of the deathwatch. Goldhill contends that things would have been different had the hospital been obliged to present the bill to his newly widowed mother, instead of to a federal bureaucracy. Goldhill's father died because he was not the hospital’s customer.
In one of those coincidences that make me believe in synchronicity -- or a liberal conspiracy involving Public Radio producers -- a local story followed soon after, in which a practitioner of consumer-driven health care was accused of fraud, if not negligence. The Minnesota Attorney General is suing Express Health chiropractic clinic over its practice of obtaining high-interest credit cards for patients, sometimes without the patients’ knowledge, and pre-billing the patients for procedures. Chiropractors do Workman’s Comp and liability business, but their customers and patients are usually one and the same.
On another commercial-medical front, insurers are historically skittish about covering psychological health. I can’t help wondering how many billable hours psychologists and psychiatrists have spent barking up the wrong theory on the patient’s very own dime.
There’s no denying the truth of Goldhill’s story or its implications, but iatragenic death is the exception, and we consult physicians because we want to be whole and comfortable, and we want to delay death. We are often neither informed nor rational about those things, and I like the idea of a third party keeping everybody honest and up-to-date.
I believe in commerce, but luck, too. In a world in which resources and griefs are unevenly distributed, and in which wealthy people organize to protect and increase their wealth, devil take the hindmost, I’ll go for the public option.