I talk about my illness here because I think I'm a really good example of how even the most knowledgeable patients can be jerked around by the system. I know the gastroenterologist in New York has lost her mind. I know she definitely didn't need to repeat all the blood work and stool cultures that were just done on June 5. I didn't need a flexible sigmoidoscopy for $800 -- I've never had disease in the procto-sigmoid region. Why didn't I argue with her? Why did I let her waste my (and my insurance company's, to the extent they decide to cover any of it) money?
I was wrong, and it won't happen again. I am a smart patient. Yes, I feel desperate for some relief. I am going to the bathroom too often and I am in too much pain. My fatigue level is over the moon. So yes, I felt desperate, willing to let her do anything she wanted to do if it would make me feel better. Except I'm also smart enough to know that all that messing around will not make me feel better at all. If anything, now I'm just depressed and angry on top of feeling sick.
We don't fire our doctors often enough -- perhaps no more often than they "fire" us. But as I said yesterday, unless it turns out that this doctor is the sole genius who saw something on the CT scan that nobody else saw -- highly unlikely -- she's going to get fired, and I am going to find someone who recognizes my symptoms for what they are and actually treats them.
But even more -- way bigger than my individual circumstances -- is the fact that we are wasting money on health care. Two sets of labs in under 2 weeks is a complete waste. An $800 sigmoidoscopy is a waste. Spending over $2500 in one visit at least, by the time all the labs are paid for, is obscene. How can we have health care reform as long as we operate this way? We can't.
Health care reform is stalled because health care costs too much. The pharmaceutical companies made a concession over the week-end for those on Medicare Part D, but my friend Karen, whose 25% of her multiple sclerosis medicine costs about $600 per month, meaning she's going without medication even though she's on Medicare Part D -- what about her?
Health care reform is going to take reform on everyone's part. We patients will give something up -- what else is new? But everyone else, including doctors, are going to have to give something up, as well. No more business as usual. No more duplicating labs. No more unnecessary tests. No more should the best doctors be permitted to simply opt out of all insurance, including Medicare, so they can keep practicing as if cost is not a factor.
If we need to curb costs so that everyone can have health care, then we need to control both the consumer side of the equation and the provider side of the equation. I'm convinced that consumers don't ask for more than they need, but I take responsibility for allowing my doctor to abuse my pocketbook and my insurance company's, too. But my doctor has to take responsibility, as well. It made really good sense to do stool cultures with my symptoms. But it made no sense to do them twice.
I wish so much more than I can say that I did not have to interact with the health care system, cost so much money, and require so much care. I also wish my doctors would think before writing orders -- especially the fancy New York doctors who take no insurance no matter what. Controlling the consumer side of the equation is only part of the answer. Jennifer