Smoking Crack & Coat Hangers

I can no longer keep quiet about the whole “nationalize our healthcare” movement. I’m not sure what is worse, people who know absolutely squat about healthcare are making huge changes to it; or the fact that most of those people who are making the changes are lawyers.

Here’s the reality. One of the reasons healthcare costs are so high is because no one holds the patients accountable for their own healthcare. Physicians are forced to practice defensive medicine because society has gotten out of control with lawsuits. Medicine is not an exact science, and doctors are not super-human: they are human.

Consider this scenario: A 17 year-old male walks into the ER complaining of chest pain. He appears healthy and has no health problems. He fails to tell the doctor that he has been hitting up the crack pipe and snorting massive lines of cocaine for the past 5 hours. The patient tells him that the chest pain came on suddenly, he has shortness of breath, and he has some tingling in his arms and hands. The patient appears anxious, but otherwise his assessment is negative. The patient does tell the doctor that he has been stressed out lately, but still fails to mention his crack use. The patient’s vital signs are stable, besides some mild tachycardia (fast heart rate), and a mildly elevated blood pressure. There is no family history of cardiac problems, and the patient has no medical problems. He does not take any medications. The physician asks the patient if he has done any illicit drugs and the patient tells him “no”. Based on this interaction, the physician concludes that the patient is likely having a panic attack, and is having some anxiety. He does order an ECG just to rule out anything acute, but does not order a full cardiac work-up which includes labs, x-rays, etc. Before the ECG gets done, the patient suddenly codes (heart stops, stops breathing), and the patient can not be resuscitated.

So, who is at fault? Well, in this case the physician, the hospital, and the nurses involved in the case get slapped with a lovely lawsuit. They called it medical negligence. Say what??? Hmmm, it’s funny that no one questioned why the patient lied to the doctor and failed to tell him about his drug use. This little piece of information would have drastically changed the course of treatment. Sadly, these types of scenarios are what has forced many doctors to practice medicine as if each and every patient is going to sue them. They feel that they have to order tests that they probably don’t need to order. They feel if they don’t run them and something happens, they will get sued. This non-essential testing is a minute cause that driven up healthcare costs.
Then, you have the insurance companies who attempt to dictate to the physicians how they practice medicine. If a physician orders a test that is non-essential, but he orders it anyway, he runs the risk that the insurance company won’t pay because it wasn’t “medically necessary”. They are damned if they do, and damned if they don’t.

Second. It TOTALLY PISSES ME OFF when people receive government assistance and they abuse it. Johnny Doe receives Medicaid (state government funded healthcare) benefits. He has been told he has high blood pressure. He gets a prescription for high blood pressure pills. He doesn’t get them filled because he says he doesn’t have any money. FYI: MOST people who receive Medicaid benefits do not pay any more than $5 for any medication, while those of us who pay for private insurance can pay co-pays up to $75. Anyway, Johnny says he doesn’t have any money, but he just got a new I-Phone, and smokes a carton of cigarettes per week. Johnny’s kidneys eventually fail because of his un-controlled high blood pressure that he refused to take responsibility for. Now, Johnny is on hemo-dialysis 3 times a week for the rest of his life! So, instead of paying $5/month to fill his prescription, he now costs Thousands per week (at the tax payers expense) to take care of.

Third. (I swear this is not about me, but it did happen) Jane is pregnant. She is about 1 week away from her due date. Jane just can’t take it anymore. She and her mother come up with a plan to use a wire coat hanger to break her bag of water in order to induce labor. Jane is not successful. I think we can all agree she is not the sharpest tool in the shed. Wow! Now Jane has raging infection, and her unborn child is at risk for complications. Hmmmm. Now instead of having a normal delivery, she has complications that triple the cost of the care she will require.

Let’s nationalize healthcare and make people even less responsible than they already are! It’s not rocket science, it’s medicine. It’s not exact, there are advances, and there are set-backs. There are break-throughs and there are break-downs. There is not an easy solution to the problem, but nationalizing the system is not the answer. If people took a common sense approach to their own healthcare, perhaps this would help. If people made an informed decision to purchase their blood pressure medication, instead of crack, then we wouldn’t have such an issue.

Mr. President Obama: Quit chastising the physicians for how they practice medicine, and please don’t threaten them. Perhaps you should tell Johnny to say “no” to crack and “yes” to Norvasc! Tell Jane coat hangers are used for hanging coats, and should not be used as a tool to induce labor. Finally, tell that dead young man that smoked crack and snorted coke for 5 hrs that he is dead because of mistakes that he made, not mistakes that the healthcare team made. Say no to Crack!