Thoughts On Our Current Health Care System

This post is a little different than my usual DIY ideas. If you subscribe to my newsletter, you’re probably aware that I’ve been dealing with a swallowing/esophagus problem which ended up being diagnosed as Achalasia. I underwent surgery recently and am now looking forward to better days ahead. But prior to developing this problem, I was a healthy person. I had very little contact with the U.S. health care system beyond a few routine checkups and such. But that was about to change.

These last couple of years filled with tests, and doctors, and procedures, and insurance has left me with lots of thoughts rolling around in my head. So I decided to gather some of these thoughts together here. Feel free to leave a comment if you can relate and would like a place to leave your thoughts on this subject too.

1. They Can Do Some Amazing Stuff

Lest you think my sole purpose in sharing here today is to just complain, let me begin by saying that modern medicine can do some amazing things and I am very thankful for how they helped me. It takes a lot of skill to do the type of endoscopic procedure that my surgeon performed (POEM surgery). I feel like he has given me my life back.

2. But You Will Wait For It

So yes, I’m thankful for the surgery I received, but it did not come quickly. I had three separate tests, each of which I had to wait at least 2 months to finally receive. When it was at last decided I was indeed a candidate for surgery, it was scheduled 15 weeks out, almost 4 months! At one point I was referred to a nutritionist to help me in the meantime with some high calorie food ideas. That appointment was also set with a four month wait. How in the heck was that supposed to help me “in the meantime”?

And in that “meantime” I quickly learned that it was up to me to manage my own problem. I had to do my own research, I had to learn on my own if there were trigger foods. At last I found a helpful article saying Achalasia sufferers should avoid “congealing” foods and that made a huge difference for me. But no doctor I saw ever shared info like that with me. That was disappointing, especially in light of the fact that they could not move things along in a timely way.

3. Because Health Care Is So Big

So perhaps the reason we wait so long now is that there are just more sick people than there are doctors to take care of them. Perhaps. But I think another factor certainly coming in to play is that there are so few independent practices now and everyone is working within these giant health care provider systems. Anytime I had to call, I would sit on hold for at least 20 minutes. You can’t just “call your doctor’s office” anymore.

That being said, almost everyone who took care of me was a kind, helpful person. But they’re all working within this quite frustrating and impersonal giant system that seems to only be able to move along very slowly.

And even the buildings are big! Pictured below is the University of Michigan Hospital where I was. The parking ramps were always full and we would go around and around hoping to spot a space. And we needed a map to find our way around the building. When you’re not feeling well, these can be intimidating things and it’s a good thing I had Bob to help me along. It’s becoming ever more necessary for everyone to have a helper or an advocate with them in these giant facilities.

4. And It Wasn’t Slow When I Needed It To Be Slow

Yes, things went slowly with a lot of waiting, except for the one time I needed it slower. My surgery was categorized as Outpatient and I got kicked out the door way too fast. Is that because insurance is running the show? It makes me wonder! Here’s how it went for me coming around after surgery:

Me: I’m still having a lot of pain
Them: OK, here’s some Oxycodone!
Me: But I still feel really nauseous from the anesthesia too (urping noises)
Them: OK, here’s some Zofran and a barf bucket. We’ll have your husband bring the car around!
Me: Urp, barf, ouch, umm OK I guess

And home we went. Now in my husband’s defense, he thought I would do better once we were home in familiar surroundings again and I did have some meds that were supposed to help. Unfortunately I just ended up in the ER again a couple days later, totally dehydrated, too weak to even stand, with my heart flipping around in A-fib. I really feel all that could have been avoided if they had just kept me overnight in the first place.

5. Oh, Those Prices!

And finally, anyone whose health goes downhill and starts needing more appointments and tests, will soon discover how much they will be charged for all of it. Yes, we have insurance but I’m still taken aback by the costs.

The estimate I was given for the POEM surgery is that it will probably be around $50,000. Again, I’m very thankful for my amazing surgeon but should two hours of an expert’s time be billed at the equivalent of an annual salary for most ordinary folks?

And is it any wonder the insurance companies are becoming more controlling? If the money comes out of their pocket, of course they are going to do what they can to control their costs. The problem is, they should not have the final say on what treatments you can or cannot receive. That should be a decision between you and your doctor, and it should be much more affordable for us regular people.

Is This Your Experience Too?

If you’ve read this far, maybe some of these observations are resonating with you too. It seems to be a common experience for those Navigating the American Health Care System. In fact South Park (the rather irreverent animated television show) has recently made this song on this very subject that had me laughing out loud in a few places.

And we go back to the doctor
We go back to the specialist
Who talks to the insurance company
That faxes the medical advisor . . .

And we’re going in one place
And we’re getting out the other place
And we’re back over here now
And I was just over there . . .

In Summary

As much as the above video made me laugh, it makes me sad too. It really shouldn’t be like this.

After my year of navigating the American health care system, I keep summing it up like this: There are still many caring and talented people working in health care who are genuinely hoping to help you, but the systems they work within are big and move very slowly now, are organized into very specific categories so they have to keep referring you on to someone else, and are becoming ever more frustrating for the ordinary person to work with.

My hope is that perhaps we will see a few more doctors go back to private or smaller practices again and that more efforts can be made toward price transparency and accountability.

I continue to be thankful that my POEM surgery for Achalasia has so far been a success for me and I continue to work on getting back to eating a wider variety of foods again, putting the lost weight back on, and having more energy again for something besides just sitting and knitting! Thank you also to all of you readers who have emailed me or commented with your helpful and positive thoughts. It helped me more than you will know and was so very appreciated!