Radioactive words: cost containment and rationing. The reality however is that we should all be embracing a strong counter force to the expanding menu of health care options and services that the medical industrial complex is trying to sell us.
A lot of what passes for health care in the United States is cosmetic and elective, not to mention unproven and actually guinea pig medicine. As a formerly well-insured American, my life is littered with examples. I will describe just one of each of the above as I am sure each and every well insured individual can, if honest or more importantly well informed and educated, find that they are also the beneficiaries of this largesse.
As a women with two children, I have undergone two births in the US. In both cases I wanted to have as natural a childbirth as possible. Even though a midwife was not covered by my comprehensive health insurance, I chose to pay from my pocket to have one. But even my midwife's standard prenatal care included having numerous ultrasounds, which were fully covered by my insurance.
In the last two years, researching health care, I have found out that in countries such as Canada, only women who have a complication during pregnancy get an ultrasound. The World Health Organization only recommends ultrasound to diagnose problems. Only about fifteen percent of pregnancies are considered problem pregnancies. The reason for this is we do not yet know enough concerning potential negative side effects to the fetus of all this radiation, yet, in this country, if you are insured, you get at least one ultrasound. The average is actually 2.1 ultrasounds per pregnancy. It is considered basic preventive medicine. The body has numerous natural "alerts" designed to let a women know that there may be an impending problem. However in the United States ultrasounds, instead of being used to diagnose problems as originally intended, are now being used to rule out problems. The bottom line financially is that eighty-five percent of ultrasounds in the US are not needed!
Yes, women do need prenatal monitoring. Coincidentally perhaps, I spent a summer in Honduras during my college years doing just that. I worked in a prenatal clinic in a local hospital, helping women undergo their monthly check-up: recording their weight, taking their blood pressure and spending five to ten minutes talking with the doctor. That is all that is really necessary for eighty-five percent of pregnancies. Ultrasounds to find out the sex of the baby are cosmetic medicine, even if they are being paid for by your insurance dollar.
Now for the case for elective medicine. I was born endowed with double-jointed knees. Double-jointed knees are great for gymnastics but not so great for the longevity of knees. Periodically, my knees give out. One Thanksgiving was particularly funny, I went to get a fancy serving plate that I don't use every day and therefore keep up high and jumped down from the counters. My knee didn't hold, I went down, and had to push myself on my stomach to my seated guests at the Thanksgiving table. What a sight, your hostess on the floor! The point of this story is that at the time, my doctor kept asking me if I wanted a knee operation, my insurance would easily cover it. I was aghast, why should I have a knee operation? Yes, periodically, once every two years or so, I collapse if I do something a bit crazy or just because my knee is having a bad day. No, can't take up skiing. However, high -end insurance premiums price the likelihood that I will have knee surgery (and once you start you need them about every ten to fifteen years) into their premiums. I still have not had the surgery, but it is an interesting experience to have a doctor recommend a medical procedure, have it approved by an insurance company, and turn it down.
Finally, my the best story, regarding unproven guinea pig medicine. We now believe that as a function of frequent childhood ear infections, I developed hearing problems. In other words, I was not born deaf or hard of hearing. At the age of seven or so, I had a tonsillectomy and an ear operation, even forty years ago there was waste in the system. The tonsillectomy was not necessary, my doctor just thought that it should be done. Several years later, at around age eleven, my hearing again declined. This time, the treatment prescribed basically involved pushing a long rod with radioactivity up my nasal canal. This was considered state-of-the-art medicine. The treatment was done and my hearing improved so you could say it was successful. The treatment however, was clearly experimental.
I believe I am one of the lucky ones who has not been harmed but I may be proved wrong. I have been the recipient of cosmetic procedures, been strongly urged to undergo elective procedures and withstood the effects of the effects of state-of-the-art unproven procedures.
It is time, however, for patients to know the facts, understand the side effects and additional cost of what is being done to them in the name of medicine. You may disagree with me and find my arguments radioactive, in which case I would say that they are a function of the health care treatments I received as a child.