Thursday, December 10, 2009

Another Health Care Post Or We're Not There Yet

Three and half years ago, my wife was diagnosed with two herniated discs. She was in graduate school with crappy insurance. She got an MRI, the diagnosis of two herniated discs, and the doctors told her that her best option was epidural shots. The idea being that she should avoid surgery and only have surgery as a last option. She had two or three shots over about a twelve month period. They worked for a while. She finally payed off these doctors last month.

Then she transferred, the pain came back, she got a new MRI, and her new doctors didn't think that the shots would help anymore. They sent her to a surgeon. The surgeon told her that given her situation, surgery was not an option. He sent her to a pain management specialist. The pain management specialist treated her with a short-lived chiropractic and physical therapy experiment, prescriptions, a procedure, and more (non-narcotic) prescriptions. He did exactly what he was supposed to do; he managed her pain. She (no, we) still owe these doctors and hospitals a substantial amount of money. They will not be paid in full for at least a year.

Then she got a job and moved. She got another MRI. The new pain management doctor would not treat her, saying that her two herniated discs were beyond pain management. He said that the pain management procedure was useless and unnecessary. She was sent to another surgeon. He said that she should have had surgery years ago. The surgery-hospital experience wasn't great. The nurses couldn't get on the same page to help her recover and be home in a day, but she did well and was home after two days. Right now, she is at a two-month post-surgery appointment and doing better than before the diagnosis. She has much better insurance now, so we will be able to pay most of these doctors and hospitals off in the next month or two.

My wife says that she has lived in pain for three and half years, because she had horrible insurance and self-interested doctors. I think it has more to do with the inexact science of medicine and doctors who do not know and refuse to admit that they don't know.

Today will be the first time she has seen the surgeon in person since she had the surgery. When I met the surgeon, I didn't think he wanted to deal with patients, but I thought he was focused, a quality I appreciate in surgeons. She has been his office for over an hour now. This lack of service isn't something I appreciate.

The whole experience pulls me in different directions. In a way, I think there were a number inefficiencies, the multiple MRIs, the lack of post-op care, the redundancy of visits, the lack of discussion on different options, and the general bureaucracy of insurance and hospitals. But I can't really imagine a better way. I think that a good public insurance program would have worked a similar way and have back-loaded our out-of-pocket expenses. (Our taxable income should be increasing in the next few years.) A bad program would have meant that she wouldn't have had the surgery yet, be addicted to narcotic painkillers, and it would have back-loaded our out-of-pocket expenses.
I guess the point here is that eventually you have to decide what you believe in, what you are willing to fight for, what you want out of the world where you breathe, eat and sleep. I believe in individual freedom. And if "they" cross that line, I am willing to fight for it. But I don't think we're there yet.

We're getting closer, but we're not there yet.

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