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A Hand in the Health Debate

by: Eugene Robinson  |  The Washington Post

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(Photo: InjuryBoard.com)

    The last thing the surgeon said to me before they rolled me into the operating room was, "You know, if you and Obama had your way with health care, it wouldn't be me doing this operation. It would just be some guy."

    I tried to tell him - somewhat disingenuously, and through a haze of painkillers and anxiety - that I had an open mind on the issue.

    All is well. The surgery was on my left hand, and when I woke up in the recovery room it was still attached to my left arm, with all five fingers. More than a week later, it only hurts when I type.

    My up-close-and-personal investigation of the American health-care system is something I can joke about now, since the ending is a happy one and the tale has such an air of "Seinfeld" about it. When people ask about my bandaged hand and hear the story, they often advise me to make up something more heroic, or at least mΓ‘s macho. The most common suggestion: "Just say you were in a bar fight."

    On Sunday, Feb. 22, I was in my kitchen making a salad. I was scooping the pulp out of an avocado and must not have been paying attention to the task, because I poked myself with the fork I was using - two tiny puncture wounds on my palm, right at the base of my ring finger. The wound yielded only a couple of drops of blood. No harm, no foul; I washed my hand off, slapped on a Band-Aid and went about my business.

    Five days later, I noticed that my hand was a little sore. The following day, a Saturday, my finger was so swollen that I had to take off my wedding ring for the first time in many years. By Sunday morning, my finger hurt like the dickens, and I doubt I'd have been able to get the ring over the swollen knuckle. Monday morning, much worse - obviously, a pretty bad infection. I called my doctor and he prescribed an antibiotic.

    By Wednesday, I was at the doctor's office for an injection of a more powerful antibiotic and a new prescription. By that evening, I was at Georgetown University Hospital with a bloated, misshapen claw where my hand should have been and an IV pumping industrial-strength antibiotics and painkillers into my bloodstream. They kept me in the hospital until Sunday, and the care was so excellent that I didn't mind the doctors' jokes about "killer guacamole."

    None of the truly awful things that could have happened actually came to pass. It turned out not to be one of those dangerous new drug-resistant staph infections but rather a garden-variety strain of streptococcus bacteria that doctors know how to kill. It was caught in time, just before the odds of emerging with all my extremities intact would have begun to turn against me. The wisecracking surgeon who operated on me specializes in hand and elbow surgery; I'm grateful that he was doing the slicing and not "some guy" who might not have been as adept or experienced at working around all the nerves and blood vessels that fingers need to function.

    Did the experience change my thinking about the health-care debate? Probably.

    My misadventure wasn't relevant to one of the central questions, which is whether the most expensive high-tech tests and procedures will somehow have to be rationed if health-care costs are to be brought down. The most exotic test that was done on my hand was an X-ray. The antibiotics I was given are widely used.

    What is relevant is that I have good insurance, which I obtain through my employer, and haven't paid a dime out of pocket for my treatment. If I were among the 46 million Americans who are uninsured, I'd be looking at a huge hospital bill. No one should face financial ruin because of a mishap with a fork and an avocado. The way we ration health care now - according to the individual's ability to pay - is immoral, and if higher taxes are needed to ensure that no one has to choose between health and bankruptcy, I'll pay. That was my position all along, but now it's personal.

    What's changed is that I also feel more strongly about the ability to make my own choices. I decided where I would be treated and, ultimately, what would or wouldn't be done. I'm willing to pay for that, too.

  

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Comments

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I have all those choices

I have all those choices with my Medicare plan. Surely the surgeon knows that!

So do I. But somehow the

So do I. But somehow the propagandists abound, especially those on FOX TV. The misinformation is horrendous, and one must correct people all the time.

I must ask, why were you

I must ask, why were you using a fork when you should have been using a spoon for that task? But, I'm very glad to hear that you're well and your treatment was timely.

I do not understand why

I do not understand why Robinson thinks he will not have a choice in the line of treatment under universal medical care. Surgeons are taught to discuss the procedure and the alternatives before the patient signs the operative permit. In my surgical training in a VA hospital we were reminded again and again that there was no shame in punting to a better, more qualified surgeon. This injury sounds like a tendon sheath infection needing urgent drainage to preserve the tendon and I assure you that if I was presented with one, I would refer it to a hand surgeon if one were available. Otherwise, I would review the procedure carefully, explain my inexperience to the patient, and his choice would be immediate relief with a slightly higher risk or postpone relief and probable have further damage as he traveled to a surgical center where a hand surgeon was available. I was an intern when Blue Cross, Blue Shield came in and some of us thought insurance would be an answer. However, after practicing in the Army, on the mission field, in hospital , in group practice on equal and then incentive pay, and final 8 years as an industrial surgeon, I am convinced that too many people fall between the cracks, good preventive care is not promoted, and too much money, possibly a third is siphoned off by insurance based medical care.

Truth be told it was Nancy

Truth be told it was Nancy Reagan`s well meaning but misguided DEA assault on physicians when Congress told her produce results on the drug war or there will be no further funding in the budget and that is when doctors segmented into "specialty" fields after the DEA Goon squad threatened their practice and future livelihoods for writing legitimate prescriptions which happened to be on their watch lists, some physicians outright quit the medical field altogether and those that remained quickly adapted to the same "G" word(greed)behind our current global catastrophe` and it ain`t gonna change until you start cracking heads together and stop kid gloving these louts!

I'd like to ask Obama and

I'd like to ask Obama and all other elected politicians three questions: What reason, other than political payoff and propaganda, exists for denying universal, single payer health care in any plan you propose? Why, other than political payback, are insurance companies included in medical plans? They have no medical function, disqualify the high risk users, and incur huge costs which must be paid by the government or the patients. Why, other than political payback, is competitive bidding for drugs prevented in the senior drug plan?

It's a lie to say you won't

It's a lie to say you won't have a choice of docs under Obama's plan. Medicare is single payer and choice of physician is completely allowed. But the main reason for not going to a single payer plan immediately is not just payback to the insurance companies. Can you imagine what would happen to the unemployment rates if all the insurance companies starting dumping employees on the breadlines? That's the main reason for an incremental approach. Also we should be moving toward making health care services a non-profit enterprise. Cover costs, yes, but making profits on people's lives is immoral.

"Why, other than political

"Why, other than political payback, are insurance companies included in medical plans? They have no medical function, disqualify the high risk users, and incur huge costs which must be paid by the government or the patients. Why, other than political payback, is competitive bidding for drugs prevented in the senior drug plan?" Remember, these conditions on medical care are the result of GOP control and actions -not Obama's. Dems in Congress fought bitterly against lack of competitive bidding in the drug plan - it was a GOP giveaway to the drug companies. The trouble with Republicans is that they believe in socialism for the rich and capitalism for the poor!

In the health care systems

In the health care systems in Europe you have a choice in your surgeon. You can also switch from one hospital to another, if you so desire, before your operation. You do have a choice. Secondly, the surgeons in Europe, in my 25 years of experience in Europe, are certainly equal to or in some cases even better than US care. Again, I speak from experience, a full knee replacement in Europe and other operations versus my experience as an investigator for a medical board in the USA. Add to this, no insurance fees and high costs and equal medical care for all.

The AMA helps to keep

The AMA helps to keep foreign doctors from coming here and competing, Pharma keeps the market closed to real cost, private health insurance must show a profit to investors, and malpractice insurance for doctors is egregiously high. These are all excellent arguments in favor of universal health care. As for Medicare being "in trouble," all of it's financial problems could be solved merely by lifting the FICA cap and making collections universal. This could be the first step towards providing complete medical care for every American.

Have you been able to ask

Have you been able to ask the surgeon WHY he thinks that way?

A year ago I was in London

A year ago I was in London visiting my daughter who was under treatment for a non-serious but hard to diagnose and treat eye condition. She has seen numerous optometrists, opthalmatists, specialists of all sorts and had test after test and many changes of glasses prescribed and medication given. Her total out of pocket cost? $120 because she was upset and wanted to jump the queque and see a particular specialist. The only way to get care like that in the US is to be a congressperson or a millionaire.