Nanny-State Healthcare: Something To Cry About

MORE THAN ANY ELECTION IN MEMORY, this time around the politicians are trying to impose upon me a relationship I do not want or need. I hear the term "What I'm going to do for you" more and more. But I just want to be left alone.

Remember the "soshes" in high school who ran for student body office? They were budding politicians then, promising the moon and, of course, delivering an empty, dark sky. Nothing has changed. Modern politics -- whether it's on the high school quad or in Washington -- has become someone promising to give me things I do not need and don't want and probably cannot afford. Cradle-to-grave healthcare, for example.

Pols of both stripes often bandy this "fact" around: Over 47 million Americans do not have health insurance! As if no health insurance meant no health care. Yet I am one of those 47 million and I'm just fine with it. The reason? Because health insurance is a scam designed to separate me from my money, and to put my money to work, not on my behalf, but to pay for unnecessary, expensive life-extending procedures, defend doctors and hospitals against frivilous lawsuits, and to pay for the burgeoning healthcare bureaucracy. This may sound troglodytic, but I don't want to live forever. I may not even want to live to be a hundred, as statistics routinely say I will. I live what most would call a risk-averse life: I don't smoke, exercise regularly, watch my weight, and drive the speed limit. The unpredictable and incurable Lou Gehrig's Disease (ALS) killed my father, and the expensive and painful procedures he went through (including chemotherapy) merely extended a steadily-deteriorating life another eighteen months. And after all was said and done, he still died. It's been eighteen years now; frankly, what does it matter if it were nineteen and one half? He'd still be gone almost two decades.

So I have the minimum health insurance I can responsibly have. It covers only catastrophic illness, like cancer. For everything else, I'm footing the bill. I consider this a benefit, because I take care of myself and avoid risky behavior (I am one of the few boomers who did not bungee jump and now that that trend is over, how was my life impoverished?). I pay as I go. The ER is open to anyone, whether they can pay or not, and I've used it here and there throughout my life. And because I'm the one who pays, I have a financial incentive to stay healthy, so I do.

So, being generally a healthy guy, I've had very few brushes with the health care horror show. But I had one recently, and it was instructive: For a couple of years I've had a condition called a "trigger" finger, where the tendon on my right ring finger occasionally gets momentarily stuck in the pulley under the second knuckle, preventing me from straightening the finger. It can be manually straightened, so it's inconvenient but not life-threatening. More like life-irritating. So I went to a hand specialist who'd sewed me up before (a slip of a utility knife) and he gave me a reasonable bid for his services, if I paid cash. But the hospital surgery center where he worked wanted four times his charges for this simple procedure. "Why?" I asked.

The doctor shrugged. "Liability and staffing issues."

"Staffing issues?" I asked. "Who do we need beyond you, an anesthesiologist, and maybe a nurse to dab the sweat from your forehead?"

He smiled. "Oh, about seven people in all are required."

The lawyer in me sat up straighter. "Required. By law, you mean."

The doctor nodded. "By hospital experience currently being codified into law."

As our conversation continued, I was enlightened about how many people needed to be there when he made a half-inch incision in my palm and perforated the pulley restricting my tendon, just in case I went into cardiac arrest. Then he enlightened me further: "Why don't you shop around?" he said. "I know all the hand specialists in town. I'll give you a few names. Maybe you can find a better price."

"What?" I exclaimed, now sitting fully upright, forgetting my aching finger entirely. "Shop around?"

"Just ask them if they can maybe do it in office -- I'm not allowed to do that here -- and what it will cost. Bargain with them. You know, dicker a little."

I left this good doctor's office, my head spinning. And I did what he advised. I found a doctor who could do the procedure in his office -- using a syringe needle, no less, poking me through the skin and thereby perforating the restricted pulley, allowing the tendon to move freely without getting stuck. No incision, no stitches, no general anesthesia, as my first doctor was required to do.

And here's the kicker: it cost me 1/10th of what it would have cost me at the surgery center at my fave doc's hospital.

And it gets better: After the procedure I sat in the windowless payment office and chatted with the accountant. "If you pay today," she said, "we'll cut the price another twenty-five percent."

I immediately dug out my checkbook, my bandaged finger already feeling better.

Now, what will we get if the politicians, in a transparent attempt not only to curry our favor and votes, but to keep us infants on the government teat, mandate comprehensive health insurance be purchased for all Americans, including me? We'll get procedures that will require me to take the day off work, sign a stack of release forms, undergo general anesthesia, and have to return a week later to remove the stitches. And you, dear reader, will help pay for my little surgery, which won't be done for cash anymore. It will enter the insurance labyrinth, occupy a dozen or more people at least a half-day, and end up costing over $4000.

In short, when politicians treat us like babies, we get procedures we don't need, at costs we cannot afford.

Oh, and did I mention? When the accountant discovered I was a contractor, she asked me if I could come by her house and bid a job for her. Later that week, I went by and got the job, which put many times the amount the procedure cost in my pocket.

So my trigger finger turned out to be a money-maker. I owe no thanks to government or the medical establishment, but effusive gratitude to two great doctors who, despite straight-jacketing laws and procedures, still managed to give me appropriate and inexpensive health care. Just like in the old days, when your mom took you down to the doctor's office for your strep throat and he met you at the door, gently treated you, and gave you a sucker on your way out.

Now, if the nanny trend continues, you'll sit in a waiting room all morning, be treated indifferently by file clerks, see the doctor for two minutes, get a ridiculously-priced medication, and have to schlep to the drug store for your pills, where they will not be allowed to tell you about the generic drug costing half the amount of the name brand advertised all day on TV.

And guess what? You're the sucker.