Thursday, August 13, 2009

The Medical Appointment That Missed Me

Many of you know that I my health care is provided by the federal government, specifically military medicine. Yesterday, I had a medical appointment that missed me and believe my experience informs the current debate. Allow me to explain. Last month I ripped a calf muscle in my leg. I was concerned that I might have detached the muscle from the tendon, I tried to get an appointment with my primary care facility. No such luck, the first appointment was twelve days out. But primary care was not going to give me an appointment regardless, saying that I had to go to the emergency room. Now I knew I just needed to see the orthopedic doctors in the cast room. I have been to this hospital enough times with injuries to myself or my kids to know the drill. However, it wasn't until 8 hours later that I emerged with crutches, a wrap around my leg and pain killers. So how did my care differ in any significant way from what the indigent have today? I guess my wait was a little shorter and I probably got better drugs.

Actually, this experience was not as egregious as a similar experience two months earlier with a broken bone in my hand. In that case, I knew what was wrong, I needed an X-Ray so that I could get a cast. However, my primary care facility no longer takes X-rays in a cost cutting move. Previously, I would have gotten the X-Rays and received a same or next day referral to orthopedics, and gotten my cast. Total time - 2 hours, and I'm not clogging up the emergency room. Instead I spent six hours at the emergency room, clogging up the system for what was not really an emergency.

Fast forward to yesterday's events. I was given a follow up appointment at physical therapy to get some training in exercises to bring the calf back into shape, at least that's what I assume. To be honest, I think I knew what exercises I should be doing but wanted to be sure. If I was paying an out of pocket co-pay, would I have made the appointment? I am not sure, but it probably would have tilted me from going. I already had some literature, so the physical therapy was more to make sure I was ready and to get a little training. Unfortunately, 45 minutes after the scheduled appointment time and an hour after my arrival, no one had called my name. When I questioned the front desk, they said they would look into it; but I told them not to bother, I had to get back to work. In fairness, they did call me back at work to re-schedule.

In my opinion, if there was some economic incentive on both parties, this likely would not have happened. They had no direct economic incentive to treat me on time, because they didn't lose money when I walked away. I might not have made the appointment in the first place if I had a significant co-pay.

This is the myth of single-payer. Obama's former personal physician, Dr. David Scheiner, was on Larry King spouting off how single payer would be so much more efficient as a health care system and we should just abolish insurance companies. There are many things wrong with our current system, but the lack of economic incentive that accrues to single payer would devastate health care. At least with insurance, somebody has some skin in the game to push for efficiency. I am already seeing the effects of single payer in the relatively well funded military medical system, but it is struggling to contain costs. How much worse would it be for the whole country, which cannot afford the per person expense of military medicine.

P.S. The President has repeatedly lied about his previous support for a single payer system. If Bush had lied this egregiously the MSM would have been killing him nightly.

In case you're wondering, the picture above is of the actual facility where I my appointment was located. Beautiful facility, but as you can see from the picture, the lights were on, but nobody was home.


  1. Thanks Dawg, I think you're missing the bigger picture here. I prefer to think of myself as ahead of the curve, at least with regards to my health.

  2. In regards to the health plan being pushed on us. I can only quote the Joker, "People will die."

  3. Yep, this.

    Or my brother's "sprained" ankle...which he did two more jumps on at the on-site doctor's insistence, that day, even though the civi medic that was with them said "I think that's actually damaged, man."

    Ended up being broken in, I think, four places?

  4. Just messing, brother, you're still my hero.
    (Like I can talk with my new pregnancy!)

    No I didn't miss the big picture, I had to have my nose re-broken in the army because of the time it took to get it set right the first time.

    I'll keep my Kaiser Permanente, thank you please.

  5. Ms. Fier,
    Jumps? Your brother a fellow Paratrooper? OOOOOHRAAAAH! All the way!

  6. Ugly Brother assures us he's "just the radio support" for a SEAL team, which is "no-where near as dangerous."

    So not exactly, but kinda similar-- with more offensive driving classes.