Health Care Waste

There is lots of talk about waste in the health care system and how to fix it, market forces, personal responsibility, etc. etc. but the talk is always at a very high level.  The abstract nature of it and the billions and billions of dollars involved make it hard to get an understanding of what is happening on a day to day, doctor to patient basis.   Let’s try and change that.

 About 10 weeks ago, I felt a little lump in my right breast just below the nipple.  Not a big deal.  No history of breast cancer in my family, no risk factors and I’m a guy so the risk is really minimal.  I knew that I had a checkup in about 6 weeks so I figured I would try and remember to ask my primary care doctor then.

 Six weeks go by, I go to my check up and just as I am getting ready to get dressed I say “Oh yeah, I have this little lump.”  He looks at it and says, “hmmm it could be (some strange word) or (some other stranger word).”  He asks me a few questions and says “lets have a radiologist take a look at it and see if you should have a mammogram or an ultrasound.”  So I make the appointment for a week later.

I go see the radiologist and without even checking me out she immediately starts prepping me for the mammogram (guys, it ain’t fun) and then moves right onto the ultrasound.  After both tests she says that there is nothing conclusive.  She doesn’t think that it is anything bad but she can’t definitively rule anything out.  She will send the results back to my primary care physician.  I wonder how much it cost for this no answer. 

A fews days later my primary care guy calls and says that he wants to refer me to a surgeon.  I ask him if we can’t just watch it and see if it grows or changes.  The answer is the typical medical hedge… we could but if it changes we might not get to it in time, blah, blah, blah.  I am told that the surgeon will look at it and decide if it should be removed.

I make the appointment and as soon as I walk in the room the surgeon says “so what are we removing today?”  I show him the lump and he says that he can’t tell anything without removing it.  10 minutes later a chunk of my chest about the size of 2 peas is removed, he shows it to me and says he will have the test results back in a week.

As I am heading home I am thinking how wasteful this whole thing has been just because I asked a simple question about a small lump.

From a financial standpoint, there was no copay for the checkup because we are trying to encourage those.  There was no copay for the mammogram because we can’t fight a war on women.  There was a $20 copay for the surgery visit because that isn’t sexist.  I am sure this whole thing cost thousands and I paid $20.  If I had to shoulder more of the cost would I have acted differently, yeah absolutely.  I would have taken a much more active role in understanding my treatment, understanding what happens if… like what are the potential outcomes from the mammogram?  What if they find that it is cancerous?  What if the results are inconclusive (they never rule something out)?  If you write out that decision tree, you end up in the same place – take it out.  So why do the mammogram at all?  Yesterday I found that cost the insurance company $444 (actually seemed cheap to me).  That was money that didn’t need to be spent.  There was no value added.  We would have ended up at removal either way.  (If I was paying I am not sure that I would have had it removed, but for $20 what they heck).

Doctors are following protocols because they are practicing defensive medicine and patients aren’t asking the right questions because they don’t have any skin in the game.  In this case it was only $444 (probably more) but you multiply that by thousands and thousands of interactions a day/week/month/year and we are talking real money.  ObamaCare can not solve this, it can only make it worse because the protocols will be even stricter taking common sense out of the process and making outcomes even worse.

What I will have to show for it all is a 1” scare on my chest.  If anyone asks me about it I will tell them it was from a knife fight in my teens.  Tough neighborhood on the Jersey Shore.  Don’t rat me out.  

Just a day in the life in Obama’s America.



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