Thursday, January 23, 2014

Thumbody's lying...The high cost of care and the power of nope...

re: why medical care costs so much and how saying "nope" can help

by Tammy de Leeuw
Head Nope Dealer

Politics aside , Obamacare's biggest Achilles' heel, in my opinion, is its' failure to answer the very real question: "Why the heck does medical care cost so much in the United States?"

Recently, I discovered perhaps a few small reasons why medical treatment in the USA can cost more than the entire GDP of some countries. (hint: it isn't because our technology is sooooooooooo superior)

In a rush to get my kid off to school, I nearly cut my thumb off on a can lid and wound up in the hospital emergency room with a towel wrapped around my hand.

I couldn't even remember the last time I was at a hospital other than to visit friends, so the process for getting treated was a bit mystifying to me.

First, I waited two hours to get called in.  Then, I went to triage, had my blood pressure and weight checked.

A doctor looked at my thumb for about 30 seconds as I explained to him exactly how I had managed to cut it.

"Yep, you really cut it deeply." he advised me. (gee-what gave it away?  The blood-soaked towel?  The red spots on my shirt?)  

I am sure this lengthy exam set the insurance provider back at least $500.

After the doctor's "examination," I was sent out to the waiting room once more, with no explanation.

About an hour later, a white-coated woman came up and told me to follow her.  I had no clue what this next phase of treatment entailed and was more than a little baffled when we entered a room labeled "X-Ray."

"What are we doing here?, " I asked.  

"The doctor ordered an X-ray," intoned the tech, not looking up from her clipboard.

"What? Why?  I told him I cut my thumb on a can of ravioli.  What in the heck would an x-ray show you about a that kind of laceration?"

The tech looked at me as if I had just questioned the law of gravity or something.  "Well, the DOCTOR ordered it," she said gravely, as if my very life depended on blind acceptance of this statement.

I closed my eyes briefly and drew upon the power of NOPE as I told her, nicely but firmly that I did not want the x-ray and I didn't want the insurance provider billed for it either.

You could have heard a dust mite passing gas.

It must have been the first "nope" this tech had heard, because she scurried out of the room to inform the person in charge the patient wasn't down with being unnecessarily exposed to deadly radiation.

She returned, led me quietly out of the room and back into the waiting area, where I entered my fourth hour of waiting with my towel wrapped thumb held above my head.

After 4.25 hours total wait, I finally got to see a nurse, who rolled up a table with a needle on it.

"What's that?" I asked.

"Your tetanus shot," she said cheerfully rubbing a prep pad across my arm.

"Uh... I don't want one of those, " I responded. 

A shocked look similar to that of the tech crossed the nurse's face.  

"B-but.  You said it's been more than ten years since your last tetanus shot.  You need this.  It's part of standard protocol," explained the nurse, a nervous tremor in her voice.

"No thanks," I said.  "Do you know how many people got tetanus in the entire United States last year, I asked.

"No, no I don't but..."

"Fewer than 100.  Out of 300 plus million people.  More people choked to death while eating Taco Bell than got tetanus," I replied. ( I seriously didn't know if that was true, but I wanted to make a point.)

"Also, are you aware what's in that shot?  They still use mercury in the adult version and there is "bovine extract."  What the heck is cow extract?  And you want to put this into my body... for no good reason?"

The nurse was flustered and ran to get the PA, who seemed a little suspicious of me.  For a moment, it looked as if they were going to refuse to stitch me up.  So, I added , "Besides, I have really, really awful allergic reactions," I said.   This wasn't true exactly but after nearly 5 hours in a smelly, noisy hospital, I just wanted out.

"Oh, why didn't you say so?" said the PA.  She entered "allergic to tetanus shot" into the computer and proceeded to stitch me up without further comment.

All of this made me wonder how many times a day this same scenario plays out all across the United States. 

What if EVERY visit to the ER comes with at least one unnecessary procedure that costs an extra $500?     What if hospitals are secretly padding their bills to make up for budget shortfalls?  Or they are getting "incentives" from drug companies to push their vaccines and medicines?   What if they do it only because patients are too conditioned to trust the doctor and never ask questions?

In a way, we are all responsible for the high cost of medicine in America.  Until we start questioning treatment courses, the safety and necessity of drug protocols; until we start saying "Nope," to CYA procedures and bill padding, costs will remain high.

Be a better informed patient and flex your NOPE muscle.  Doctors aren't gods and they make mistakes.  It's up to you to control your own healthcare and to not believe everything you are told.

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