- The Washington Times - Saturday, May 14, 2005

This item reportedly turned up on a hospital bill recently: “Mucus Retrieval System, $75.” After some questioning of the accounting office, it was identified as a box of tissues normally used to blow one’s nose.

This should really surprise no one really in view of the number of similar charges the cost accountants justify — not in terms of the worth of a $5 aspirin or a $2 single tongue depressor on any number of other outrageously priced items — but in what they contend is the cost of delivering them, including much of the hospital’s overhead. If this isn’t enough to convince you why the price of American medicine is climbing many times faster than the cost of living, try visiting an emergency room sometime.

That opportunity came the other day with a rather painful and thankfully short-lived kidney-stone attack that produced a chain of events that keeps one mentally anguished and physically occupied for days and a still unknown Medicare bill that ultimately must total thousands of dollars. The CTs and X-rays ordered by the ER turned up several suspicious problems other than the mischievous stone in the right kidney, which thankfully passed, and a similar stone lodged in the other.

These problems went to the primary physician, an internist, who read them and said he didn’t think they were anything. But since the ER physician called attention to them, they had to be dealt with (malpractice and all that, don’t you know).

Three referred doctors and scads of further X-rays and CTs, many of them duplicate, and hours of valuable downtime and sleeplessness confirmed the primary’s diagnosis.

In the meantime, a general soreness in muscles and joints had to be treated and a sudden hand condition resulted in two extraordinarily painful shots to the palm. All this resulted in an assessment that, for me, at least, April was miserable and, for Medicare, an inordinately expensive month.

Throughout the entire ordeal, I could only think of Robert Gheris, my family’s physician for 50 years. He was a one-stop shop for everything from a sore throat to a colon-rectal exam, and was pretty good at it, keeping us all relatively healthy and long-lived at $3 for an office visit and $4 if he came to your home. This is not to denigrate the technological wizardry that allows the examination of every nook and cranny of one’s insides or the specialists who rely on them. It is just a nod to the doctors who could peer into the blood vessels of the eyes and discern all kinds of things going on in your system.

At any rate, let’s get back to the most pressing problem facing the nation. With all deference to George W. Bush, it ain’t Social Security. It is health care — specifically Medicare, which is growing so fast it already is in a crisis mode, unlike the 2042 dire-straits date predicted for Social Security.

In fact, without some common-sense reforms, in a couple of decades the nation will spend more on Medicare and its sister program, Medicaid for the indigent, and for Social Security than it now spends on everything else, including defense.

Supporting Medicare and Medicaid will cost workers huge increases in payroll taxes.

What can be done to prevent governmental or individual bankruptcy on a gigantic scale? Maybe the first thing is for Congress to pay attention, to give this dilemma the priority it needs. Whatever Congress can do to reduce costs from relieving doctors of huge insurance payments to warding off malpractice suits, to drowning the hospital bean counters, to permitting nurses and physician’s assistants to do many of the less serious medical procedures, it should begin immediately.

I took my emergency-room CT and X-rays showing the second kidney stone to the referred urologist. He ordered his own at a tremendous cost and inconvenience and some pain to me. “You have a stone in your left kidney,” he said. “I don’t think we need do anything about it.”

“Ka-ching.” Medicare.

Dan K. Thomasson is former editor of the Scripps Howard News Service.

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