They Will Still Be Going To the Emergency Room

Emergency-RoomOur favorite young waitress was bringing us more sweet tea.  As she approached, my wife noticed a little “limp” and asked her about it.

“I got a rash on my leg yesterday and it’s worse today,” she said.  “It bothers me when it rubs on my pants.”

Assuming our customary Mom and Pop roles, we chatted about what the cause of the rash might be, considering possible medical solutions.  The young lady’s next line was a stunner.

“I guess I will go to the emergency room after my shift,” she said.

We gasped simultaneously – “the EMERGENCY ROOM?!  Why would you go there?”

Her response: “Well, I don’t have insurance so whenever I need medical care I just go to the emergency room.  They don’t make me pay the bill right away.”

My wife and I exchanged baffled looks and started asking questions.  We wondered how, on a server’s wage, she could afford to make payments on what must be an outrageously expensive emergency room visit.  Maybe she doesn’t pay at all.

“Why don’t you go to an ‘urgent care’ clinic?” we asked.   “There’s one across the street and it probably charges one-tenth of what the emergency room will charge you.”  She gave us a curious look.

We also suggested she could stop in at one of the many nearby drug stores who offer affordable minor-medical care and even free advice from the pharmacist.  She didn’t know there was such a thing.

Then we pointed out that our county provides a list of free and low-cost medical clinics.  But it occurred to me that it would probably cost her a day of work to even get in the door of a government clinic.

The young lady seemed grateful for the Mom and Pop advice, and hopefully she will seek out one of the alternatives we proposed.

Our short conversation with a hard-working young waitress reminds me how badly screwed up so many things are these days: the ridiculous cost of medical care, the failures of our education system, inadequate parenting, bumbling government, our crazy tax system, the challenges of employment, and more.  How does a young woman get to the age of 25 without knowing how to get appropriate minor medical care?  Where were her parents?  Her teachers?  Will she still be a low-wage worker ten years from now, or will she have moved up and out?  Why is even minor medical care so expensive it is out of reach for many workers?  Should restaurant owners pay higher wages or benefits?  Would that squash one of the few remaining industries (and employers) left in our teetering economy?

Our waitress will get a W2 from her employer at the end of the year and will probably take it to H&R Block because, like most Americans, she is afraid and ill-equipped to tackle even the simplest short-form tax return on her own.  And her tax preparer will tell her that because of the new Affordable Care Act she will have to pay a fine next year if she does not obtain a health insurance policy on her own.  I doubt she has ever heard of the ACA — it isn’t listed on I-Tunes.  She doesn’t really know what health insurance is, how it works, or how to get it.  If she did learn and understand the ACA requirements, would she choose to pay the fine or to buy the insurance?  Or would she just continue to use the emergency room?

Lost in the discussion of the ObamaCare mess is the fact that hospitals are still required to provide medical care to anyone who comes in the door, regardless of ability to pay.  And a large percentage of the people within our borders have no more knowledge or sophistication than to go, when sick, to the building where the sick people are.  The ACA personal “mandate” is a joke.

If there is one good thing about the ObamaCare fiasco, it might be that Americans will finally stop and think about the economics of health care in our country.  We only got to this point of helplessness and chaos because for generations we have been dependent on employers and/or the government for our health care.  The concept of shared risk for shared cost – insurance, by definition – is still very valid.  Sadly, that can only work in a prosperous free market economy, which may now be little more than a distant memory in the age of big government.   Every time a government bureaucracy replaces a segment of the free market, disaster results.  A train wreck, even.

The bad thing about the Affordable Health Care Act is that it makes health care more Un-Affordable.  It is clearly about control, politics, and big government, not cost.

The failure of our elected leaders to deal with the festering health-care issue a long time ago led us to the calamity we face now.   They, and we, had better get serious, because, contrary to the campaign speeches, we know there is no such thing as a free lunch.

Oh, speaking of lunch, the gyros were great.

Tom Balek – Rockin’ On the Right Side

Rockin' On the Right Side

All over the country, I’ve seen it the same
Nobody’s winnin’ at this kind of game
We gotta do better, it’s time to begin
You know all the answers must come from within

Free Ride – Edgar Winter Group

Dental Work: $8k in US, $500 in Jordan

On a visit to North Carolina last week, I took my wife’s car to our favorite local shop for some work.  It is owned and operated by two brothers from Amman, Jordan.  They emigrated to the US in the turbulent 1980s when the Jordanian government confiscated their successful business under martial law.  At the shop I always enjoy animated conversation with the brothers about families, world politics, current events, and automotive stuff.

While Jordan is still not exactly paradise, life there has improved dramatically in recent years under King Abdullah.  But that’s not the subject of my post this morning.

I asked Sam, the older brother, why he was out of the country the last time I had visited his shop – did he have a medical problem?  No, he said, he just needed some dental work.  That piqued my curiosity.

Sam said he went to two local dentists, and each one quoted him about $8000 for the job.  They prescribed somewhat different procedures, including removing some teeth that were actually healthy.  Uncomfortable with their approaches, and the cost, Sam had the x-rays sent to his family’s dentist in Jordan for a “third” opinion.  “They’re crazy,” was the opinion of the Jordanian dentist.

So Sam flew to Jordan (the trip cost $1500) and had four crowns, two fillings, two root canals, and deep cleaning done there.  For $500.  And they left his good teeth alone.  When he returned, he had the work checked out by one of his local dentists.  “Nice job,” the dentist reported.  Sam had saved six grand.

This points out what is wrong with our American medical system – fee for service.  The more services that are provided, the more money the doctor makes.  And since most of us don’t pay for medical procedures out of our pockets, we don’t check – or care – how much our medical care costs. The other side of the dilemma – cost shifting.  Doctors provide free or under-compensated services via government programs or charity, financed by overcharging those who do pay.

Is ObamaCare the answer?  Oh, hell no!  Government takeover of the medical industry will result in gross inefficiency, incompetence, and rationing – the normal standard of performance for any government work.

But those who say our current health care system is the best in the world are naive.  Our nation has the wealth to do some things medically that other nations can’t.  But the cost is out of control and the quality is not what it should be.

Our next president will have to address the health care issue – it can’t be kicked down the road any longer, or soon many of us will be “medical tourists”.

Tom Balek – Rockin’ On the Right Side

Here’s an alternate health care plan:
(bet you haven’t heard this one in a while!)

Put the lime in the coconut,
And call me in the morning!

Coconut Song – Harry Nilsson