Outsource Your Facelift
Tuesday, July 21st, 2009Pina Coladas Can be Considered Painkillers
It looks like Obamacare is dead. Thank God. In order for the plan to live, lots of Americans would have had to die. So the way I see it, it was aborted to save lives. That’s pro-choice, isn’t it? And if you believe, as I do, that Obama got elected by accepting money from China and Muslim nations, then the pregnancy was also the result of rape.
It’s odd, but I can’t remember anyone suggesting that caregivers just charge the poor and uninsured less. As it stands now, the poor get all the treatment they need, but then they get charged huge bills they can’t or won’t pay, and the rest of us (the ones who take bills seriously) end up subsidizing them. Why not just admit that we overtreat and overcharge people? Let’s give the poor and uninsured good but not excessive treatment, and let’s charge what the treatment is actually worth. Maybe some of them would actually pay, and that would bring prices down for the rest of us. And the poor would be more likely to go to doctors.
Whenever I think about health care prices, I think about my first kidney stone. Like all medical emergencies, it happened on a weekend night, so I had to go to the ER. They gave me a totally unnecessary scan that cost several thousand dollars. They doped me up and kept me on a Gurney all night, and then they sent me home on Saturday morning–still containing a stone–with enough Percocet to get me through one day. Because clearly, I was a drug-seeking patient, and I had magically generated a kidney stone in order to get enough pills to last until Monday.
In the end, they charged me around six grand. That includes a few hundred bucks for my urologist, who actually provided useful treatment.
What did I really need? I’m not a doctor, but I know what doctors have done with millions of other people with tiny kidney stones. They x-rayed their abdomens (or not), gave them painkillers, and waited for them to pee the stones out. You can do this, including drugs and a follow-up x-ray, for maybe six hundred bucks. Apart from the pointless scan, this is the treatment I received.
The second time I got a stone, I called my urologist’s office, and I got his unbelievably nasty receptionist, and I was so offended, I decided not to get treatment. And a couple of days later, I was fine. Total cost: $0.
Now I lay off the calcium antacids, and I go easy on tea. And I definitely don’t take calcium antacids WITH tea. No more stones.
Apologists can say, “You could have had cancer! You could have been on the verge of death! You should thank God you got that scan!” And my response is that you could say the same thing about someone who went in to get a pimple squeezed. You can mistake cancer for a pimple. Or for hemorrhoids, or for any of a huge number of other trivial ailments. The fact is, the odds that I had a serious problem were incredibly low, and if I had turned out to be seriously ill, it would have become obvious with or without a scan.
The purpose of the scan was to make money. And it worked.
Have you ever gotten sick overseas? It’s a very different experience. The care you get is likely to be nearly as good as the care you get here, but it costs much, much less, and it comes with fewer bells and whistles. For example, I knew a kibbutz volunteer whose appendix went crazy while he was visiting Jerusalem. The same day, he went to a charity hospital in the Old City, and they yanked his appendix out, and they sent him back to the kibbutz when he was ready to travel. Didn’t cost him a thing, because the Catholics paid for it. But if he had been charged, it would still have cost much less than American care, because they didn’t generate 3,000 pages of documentation and give him fifty things he didn’t need, and he didn’t get a private room with cable.
I sliced my finger open in the Bahamas. Did a real number on it. There was no doctor on the island, unless you count the vacationing Americans who were lying drunk on their yachts. I went to the local nurse, and she ran a giant needle up through my fingertip and out of the nail, and she tied it up and bandaged it and sent me home. I was fine. In an American ER, they would have given me a bone scan, an EKG, three caviar enemas, and a grief counselor. I didn’t pay her a dime, but even if she had charged, it would have been dirt cheap.
I’ll bet this would have been a $500 injury in the US. If you’ve paid to have a minor cut stitched, leave a comment and tell me what they charged.
The other big excuse is that lawyers force doctors to overtreat. Yes, I’m sure the added profit is no incentive at all. Because nobody ever went into medicine to make money. Everyone knows lawyers screw life up, but they’re not the whole explanation for our medical costs. Doctors proactively look for ways to charge more. My dentist now has a racket where he tries to charge you for an oral cancer exam, and if you don’t buy it, you have to sign a release. That’s so blatant, it’s nearly a scam. And the obvious inference is that if you don’t pay, and he sees a lesion anyway, he’s not going to tell you. I hope that isn’t the case.
I avoid doctors for the same reason I avoid mechanics. You can’t trust them. You go in for a trivial problem, and while you’re there, they look for other things that can make them money. And unless you’re Superman, they can always find something. Actually, that might not be enough to make you safe. “Hmm…I can’t get this needle into your Kryptonian vein. I better give you an expensive yet inconclusive test for scleroderma. And some type of scan, as soon as Steve gets out of the machine. He has a very ominous pimple.”
If I trusted doctors–if I had not been cheated so many times already–I would be more likely to visit them regularly. It’s that simple.
Here’s another idea. Why not fly the poor overseas for treatment? I know it sounds insane, but it isn’t. You can go to Central America, pay a pittance for top-quality surgery, stay in a resort hospital on a beach, pay for your airfare, and still come out way ahead. If you don’t like arepas, you can go to India and have curry. Or Singapore.
Let’s see. Here’s how it would work. Poor person shows up at hospital. They determine he can’t pay. They diagnose him with a condition requiring expensive surgery. They send him to Belize. He recovers and doesn’t pay. The benefit? Now the hospital can cover his small foreign bill out of money received from paying patients, instead of covering his huge American bill. Sounds nutty, I know, but if it saves money, why not?
I wonder if my medical insurance would cover treatment at a ritzy beach hospital. I would greatly prefer it, wouldn’t you? You’d think they would jump at it, if it saved them money. A 2008 Time article says insurance companies are starting to take the bait.
Speaking of great foreign deals, I still have no Chaiwanese milling machine. The rigger I’m working with just emailed, and he said the shipper called yesterday to ask if he could unload the machine from a box trailer. They were looking for a flatbed and couldn’t find one. This means that as of yesterday, the machine was in…CALIFORNIA. This is amazing. I just checked, and it appears that I ordered this thing seven weeks ago. I hadn’t realized so much time had passed. Twice, I’ve been told they shipped it, and twice it has turned out to be untrue.
The seller says he has a different brand of machine he can sell me; he’ll be getting them in a week and a half. I told him to go ahead and make the switch, if the other machine was still sitting 3000 miles away.
I’ve been waiting for lathe videos from Smartflix, and they arrived yesterday. These are from ATI. I highly recommend their stuff. It’s very methodical and thorough. I guess now that I know the milling machine isn’t going to be here in the near future, I should watch the lathe videos and try to get some things done. It’s tempting to stall when you think a new machine will arrive at any minute. A milling machine would make projects much easier, so I find myself wanting to wait until it gets here. I really don’t understand the guys who claim you can do all sorts of great things with just a lathe. It’s not true. You need to be able to make straight cuts, and you can’t do that with a lathe unless you spring for an expensive milling attachment. Here’s what you can do with just a lathe: you can make a machinist’s jack and a head for a hammer. And you can thread things and cut rods in two. That about sums it up. I’m exaggerating because I’m annoyed, but what I say is true in principle.
Let me close with something useful. Heather’s mom (an actual person) just had more surgery. Stents in her urinary tract. Please offer a prayer.
She probably should have gone to Costa Rica.





