Watching the Health Care Summit this morning, I was pleasantly surprised to hear Republican Tom Coburn making constructively critical, cogent points, backed up by facts that appear to actually be facts. So I'd like to briefly offer a few personal anecdotes to back up his complaints as an MD about having to prescribe unnecessary tests and treat children in the ER.
As has been chronicled on my personal blog, my 4-year-old Adriana suffered for a month from constipation in a way that was both very dramatic (unfortunately, that's genetic) and exhausting (that's just plain old unfortunate). Given my recent divorce and the fact that many doctors are simply not taking new patients (how is that possible?), Adriana's pediatrician is still in the town her father lives in. Desperate and hoping someone could help, I decided to take her to the emergency room, where after several hours they prescribed a pedia-enema, that I was to administer by myself at home. That's frustrating and ridiculous on many levels, because first and foremost, when we checked in the nurse at the front desk asked me if I'd tried giving Adriana an enema, I said, "No. Is that what I should do?" The nurse suddenly became very quiet, replying, "Oh. I don't know. I--" and trailed off, moving on to the next question. Clearly that is what I should have done, since that's what the Doctor's Assistant (yes, I only saw an assistant) ultimately suggested, but because medical professionals seem to dispense advice based in a fear of malpractice lawsuits, (my ex) was forced to pay $60 out of pocket on a $400 bill (for a $2 product). I could have Googled parental poopinions for free, which is why so many people spend so much time on WebMD. Do we really want an entire nation of individuals who are convinced thanks to self-diagnosis that they're suffering from Pneumonoultramicroscopicsilicovolcanoconiosis? (A spelling disorder second only to Supercalifragilisticexpialidocious.)
Secondly, administering an enema at home is even harder (and let's be real, grosser) than it sounds. I don't understand how anyone can charge $400 for ADVICE. I'd be willing to be charged $400 if the medical establishment were willing to provide the actual service of treating my daughter's condition. (Trust me, a mother's comfort is of no worth when you're about to get fluid up the butt - at her hand!) Ultimately, Adriana did see her pediatrician, and he prescribed a laxative, albeit a slightly stronger version of what is already available over the counter. And that brings me to Tom Coburn's point about preventative medicine. In the case of common childhood ailments like constipation, preventative medicine is maybe not super-applicable. (Though her father could have done well to feed her something other than stroopwafels and other syrup-and-pancake-based combinations for an entire weekend, even if it was Sinterklaas's Verjaardag.) I'm talking about the kind of preventative medicine implied as necessary to cure acute asthma, the example referenced today by both Coburn and Obama.
My daughter was born in East Harlem, a NYC neighborhood heavily afflicted by asthma. (Thank God, she hasn't shown symptoms.) It is largely thought that the asthma cases in East Harlem are caused by air pollution, which means the "preventative medicine" required to curb that has to do with emissions control, and that is something only Big Government can act on. So maybe if we made our world a little healthier by paying greater attention to the environment, waste within the heath care system wouldn't be as much of an issue.
Finally, I'd like to say that though I gained many things in my divorce, one of the things I lost is health insurance. I still owe $200 to an urgent care and $79 to a hospital from one visit to a doctor regarding a nasty bout with bronchitis/sinusitis last summer. (Preventative medicine there: quit smoking! Do it!) That's $279 out of pocket for one visit. I can only imagine how difficult (and nigh on impossible) it would have been to get quality pre-natal care without insurance. And I would never have been able to undergo that crazy MRI I got back in 2008. So needless to say, I am all for healthcare reform, and disgusted with Republicans like Lamar Alexander who suggest that we should start healthcare reform with "a blank piece of paper." The only blank piece of paper I want to see is that weirdo white sheet they line the weirdo bench/couch you sit on at the doctor's office the next time I can afford to get a regular checkup.