Healthcare Hullabaloo: My Family Doctor

OK, back to problem solving 101:

I am at that awkward age where my wife calls me ‘middle aged’ and my children ask me what it was like to live before electricity. The truth lies somewhere in the middle.

So, lets start by looking at STEP ONE:

For this, I am hopping into Peabody’s ‘Wayback Machine’ (if you know what this is, you are at least as ‘chronologically impaired’ as I am), and I travel back to when I was a boy where I met one of the best Doctors I have ever known – Good ‘Ole Dr. Rusen. When I was sick, Good ‘Ole Dr. Rusen would come by the house in his Grey Ford sedan, examine me, and then give my Mom some sage nursing advice. In bad cases, he would telephone the pharmacy, who would soon deliver some vile elixir in a brown bottle the taste of which was worse then the illness itself. (Yeah, the pharmacy made housecalls too back then). Through Good ‘Ole Dr. Rusen medical expertise, I was usually on my way back to health in a day or two. If my disease was particularly stubborn, he might swab my throat and culture the result (back then, Doctors had microscopes in their offices that they actually used themselves to diagnose patients). And what did Good ‘Ole Dr. Rusen get for his trouble and expert advice? I think it was something like $10 or $15. My parents did not have ‘health insurance’ so they paid out of pocket. Now, they did have ‘hospitalization’ which covered the real big medical expenses, but few people back then had ‘health insurance’, as we know it today. Those who did have insurance still paid out of pocket – it was up to them to fill out the forms and submit them to their carrier for reimbursement.

Funny thing was, back then, nobody complained about ‘the cost of healthcare’. My parents could easily afford the 10 or 15 dollars they laid out when someone got sick because they weren’t spending a couple of hundred dollars (over a thousand in today’s money) for health insurance premiums every month. The Doctor made a real nice living, too. His only overhead was the office in the first floor of his house, a receptionist, and gas for his gray Ford, so he kept proportionally more of the money he was paid. He didn’t need a small army of employees to fill out and collect on insurance claims. Malpractice Premiums? He never heard of them. Even the local pharmacist was happy – he could make a couple of bucks on that elixir that he most likely mixed up himself. (At that time, no marketing genius had yet thought to give elixirs vaguely scientific, yet familiar sounding names and advertise them on television).

Yes, Virginia, things have certainly changed since then. Today, doctor’s are scrambling to keep their income somewhat in line to what they were making ten years ago. Their overhead continues to rise. House calls are as much of an anachronism as blood letting. Patients struggle to pay for their insurance premiums, prescriptions and co-pays. The local pharmacist sold out to a major chain a few years back when he couldn’t cover his overhead anymore. And that magical (but foul tasting) elixir has been made obsolete by the introduction of Sensocorium (which is basically the same drug, modified just enough to patent, mass produced and marketed by Pharmaglomorate Labs). By the eay, Sensocorium sells for $500 a bottle ($150 in Canada). It now tastes vaguely like cherries – science does march forward.

Now, I’m not so naive that I don’t realize that medicine is much better then it was when I was a kid. And that these advances in medicine, pharmaceuticals, and diagnostics don’t cost more money – they do. But the sad fact remains that we spend a heck of a lot more – proportionate to our incomes - for our healthcare then we did just 30 or 40 years ago even when we factor in the added costs of healthcare advances. And in spite of all the noise and fury, our healthcare dollars continue to be sucked into an ever-widening black hole. We better start fixing things – fast—because our entire economy is approaching the event horizon. (Don’t know what an ‘event horizon’ is? Google it and see how clever I am with healthcare and theoretical physics).

Dr. Kildare meets Dr. Kaku