“Your lab results came back,” the doctor said, grimly. “Your cholesterol has risen to unhealthy levels. If you do not get it under control immediately the next few years might be your last.”
“Certainly, there’s some medicine I could take to help me?” I asked, starting to cry.
“There’s a small pill on the market that reduces cholesterol to normal levels in a matter of hours, with no side effects,” he replied. “But your insurance won’t cover it. Fortunately, you can be completely cured with moderate diet and exercise!” He looked at me for a few minutes in respectful silence. And then he helped me call a funeral director.
This was the sad scene at my physical last week, minus a few artistic liberties in my retelling. The doctor didn’t say those exact words (actual words: “WOW, those are the BIGGEST hemorrhoids I’ve ever seen!”). And I didn’t cry…or even have a physical. But this exact scene nevertheless plays out every day, in every doctor’s office in America. Our aging and ailing population faces life-changing health problems, and is given nothing but a death sentence: “the best treatment is diet and exercise.”
This isn’t for a lack of trying, at least on the part of the patriots behind the pharmaceutical industry. They have pills for nearly everything. I could buy a pill to make me the greatest comedy writer in the universe. But it costs $10/month, making it impractical for this industry. And that’s the problem. Our medical system, thanks to its eagerness to play God, has miracle cures for any ailment, but often no way to make those miracles affordable to the people who need them.
We crave someone to blame for this medical malpractice. And so different parts of our society, depending on their prior biases and background, will blame different parts of the medical industry for why everything is so cost prohibitive.
Me? I blame doctors. Whenever something goes wrong with my body, say the flu, I will call up my provider’s office and ask for an appointment. They, sensing the urgency of my condition, will be sure to schedule me for an expedited visit, usually within the Presidential term limit.
That is, if they let me visit at all. They may insist on the dreaded Telehealth visit. This offers medical care in the convenience of your bedroom by only sacrificing the medical care part. You’ll tell them, in the grainy knock-off Facetime picture, that your throat is sore. They’ll sit in silence for about 15 minutes while your audio buffers, and then tell you to call again in two weeks if it doesn’t go away, since obviously they can’t actually examine your sore throat when they can’t even be sure the single pixel on their screen has a throat.
But let’s say you get the privilege of driving to the actual office. You should plan on sitting there for at least as long as it took them to schedule your appointment. And then, when they finally see you, the doctor may only touch you for 0.045 nanoseconds before giving the same advice as the Telehealth nurse: come back in two weeks. But let’s say you insist that you’ve already been in the waiting room for several months, and you have an ax protruding from your jugular vein, and you really need a solution now. Their new, inevitable advice: diet and exercise.
After all that time and effort, you get sent home expected to fix the problem yourself. I go to the doctor to be healed, preferably in the form of an easy and mildly addictive pill. I don’t call my plumber with a leaking pipe for him to come over and tell me, “You need to fix that pipe. A new pipe should do the trick,” and leave. I call him to fix the pipe. But the doctor makes me do the work. And then charges me $300. At that point, I could have just bought the pill on the black market and felt better already.
Of course, some people think this is too harsh on healthcare workers. They think these issues are really the fault of the insurance companies. Of my $300 doctor’s bill, approximately $299 of those dollars are from the hundreds of staffers and hours the doctor needs to employ to deal with my insurance company. And while my magic pill would normally cost just those $299, the bloated web of insurance contracts means I can only get it for about $299,000, plus tax.
According to such people this is caused by massive structures of corporate expansion. These multibillion-dollar insurance companies create a complex network of backroom negotiations, arcane requirements for coverage, and exorbitant layers of staff, forms, and waiting periods that inflate the time, cost, and complexity of getting real healthcare. This isn’t necessarily malicious. Many of these companies are very old and very, unbelievably large. And as corporations age and start gaining size, certain areas become overly bloated if not properly regulated. It happens to every corporation eventually, if it lives long enough. The only particular problem with insurance companies is that they deal in healthcare.
So, this theory looks at the giant insurers as the real problem. It’s not so much that doctors are overindulging on their costs; it’s that the insurers are swollen to an unhealthy degree.
There are many other theories, all of them stupid. I’ve even heard some really special citizens blame “Big Farm,” apparently unaware that agriculture is a totally separate thing to our nation’s health. But I have to admit the folks who blame insurance make some good points, especially during open enrollment. I still mostly blame doctors. But when I look at my paycheck deductions, rising deductible, and (God forbid) my carrier’s customer service chat, I acknowledge—certainly, a large part of the high costs of healthcare is massive, bulging corporate bloat. That is, unless it’s more doctors expanding their pants pockets. Or “Big Farming” or whatever (not likely). Fortunately, there’s a safe and low-cost treatment for any case: diet and exercise. I’d start calling the corporate-funeral director now.
