Anecdotal musings on healthcare and attitudes
Promoted by Brendan
My better half sprained an ankle last week, for the first time ever. I examined it, determined that it appeared to be a routine even if moderately-severe sprain (accepts pressure, can walk, can move toes and flex foot, minor-to-moderate initial pain, normal swelling and bruising), and followed routine procedures (ice, compression, elevation, and rest). When I was younger, I sprained my ankle several times and also helped my mother through a major sprain, so I have had some personal experience with this type of problem. So far, the injury seems to be progressing normally.
The reaction of friends and acquaintances has been interesting. Most were quite shocked that we did not immediately go to the hospital or an orthopedist for examination and x-rays. I explained that we were already following the exact advice a doctor would have given (backed up by online recommendations linked to below) and that we would see a specialist if the sprain did not seem to be healing as it should or if any other problems arose. Yet the majority of people seem to think our approach is odd.
I did some online research just to reassure the spouse that what we were seeing and doing was normal and appropriate, and to re-confirm my knowledge of the appropriate actions to take. The UK Medinfo site (from a nationalized universal healthcare nation) was the most concise and specific, and it matched my own approach: treat it at home unless you have reason to suspect a much more serious injury. It also was very specific as to when an x-ray was required. The WebMD site (our current commercial healthcare system) was less concise and seemed a bit more vague on when to see a doctor.
Now maybe my background is a bit different than most people. Doctor visits were very rare during my childhood and most injuries and ailments were successfully treated at home. I can only remember going to the doctor once before my mid-teens, for a dislocated neck bone which froze my neck (sister threw my sleeping self onto a bed), and once with a different sister who chopped off her toe with an axe. I do recall hallucinating on the divan* through the Hong Kong flu, but only because fever-induced hallucinations are fascinating and memorable things to a seven year old. As an adult I’ve had more experience than I’d like with doctors, but still under the framework that there is a time when you call the doctor and there are times when you don’t.
One “complaint” right now about our healthcare system is over-utilization. According to the experts, we go to the doctor too much and use medication (like antibiotics) unwisely. If (when) we move to a nationalized healthcare system, we may be asked to adopt the UK attitude instead of the US attitude, and to make better decisions about when we should see a doctor. From my experience with this sprain, getting us to that new attitude might be more of an obstacle than we think.
Your thoughts?
(*Divan, in honor of my mother, who brought me through all the normal childhood illnesses just fine. Most of us call them couches or sofas. )
- Purpleface's diary
- Login or register to post comments
Comments :
100% agreement
I also think that it's a huge problem that people use the medical system for every little minor ailment and injury that will take care of itself, clogging up the system for people with more pressing need. I also think that people who take some sort of pain medication for every minor ache are making a mistake... you might need to build up that pain tolerance for serious pain later in life, and you might need that pain medication to have full effect. Same with people who take antibiotics for every minor infection.
I've had at least three sprained ankles with plenty of swelling and purple bruising from the high ankle down to the foot. hHave not gone to the doctor on any of them, have taken the same approach as you guys did. They look ugly, but my opinion is that if there's more than a sprain, it will become apparent soon enough-- and I'm IN MY BODY, and on things like that I don't think any doctor is going to know better what's going on than I do.
I'm 36, and my doctor visits can be counted on one hand...
A few years back, I gradually started losing my hearing rapidly over a period of few weeks-- my eardrums felt like they needed to be popped constantly. Went to doctor, doctor looked in ears for like 2 seconds, pronounced ear infections in both ears, prescribed antibiotics. They worked after a few days. I definitely needed to go to the doctor that time.
When I was in college, one time I passed a ton of blood thru the rectum. Scared me to death. Went to the emergency room, they examined me, they couldn't find the source of the blood. Never really had the problem again.
Then there were two incidents in middle school--
Had a deep cut in my middle finger with a coping saw in shop class. Got a splint and a tetanus shot at a clinic;
Got tripped from behind running on pavement-- cracked my head open with bloody cut and a big knot. went to clinic and got the would cleaned and dressed.
And that's it! I never would go to the hospital for a cold, and have never had any sickness that was for sure the flu.
At my age, it's probably a good idea to start yearly checkups soon. I dunno, I think I'm in very good health, don't expect any bad things to happen within the next few years...
skymutt: wise and powerful... enlightened...
Health Care
I'm always surprised that people still think government run care is a good idea.
Besides my Canadian friends, all of whom have nothing but bad things to say about their system, and the British, who have had problems with theirs, the Federal Government is inefficient. Every programme that you put in the government's domain goes through dozens of hands, all of whom not only get a paycheque but a government pension at the end of their tenure. The government can't balance the budget, spends our tax dollars on pet projects, and yet you want to hand more money over to them? It's unbelievable. When have they ever shown themselves to be good stewards of our money? There's also nothing in the Constitution about the government being responsible for your health. In fact, the language throughout would imply that government moves things out of the way so YOU can lead your life the way you want to. It's equal opportunity, not equal outcome.
The problem is we have been spoiled. There are times that people need a doctor; I've seen posts about problems that have legitimately needed medical attention; I've broken several bones and had a plate put in my leg, so I know it happens. But a huge portion of the people I know go to doctors for hangnails or any sniffle and demand - and get - antibiotics. They do it because they can; my parents had no health insurance and my brother and I went when we were seriously sick, not because we felt 'off' one day.
I can only offer personal anecdotes; I know someone who had surgery recently - elective, to fix an overbite - and received morphine, no problem, as much as she wanted up to their calculated max for her body weight. At the company I used to work for, we had really comprehensive care. We also had a lot of (legal) immigrant workers, many of whom came from countries that lacked as robust a medical system as ours. They would go to the doctor and demand drugs for whatever they thought ailed them and usually got them. I do seriously know someone - a teen - who never really took good care of her feet and every time she got a hangnail she went to the doctor. I am absolutely serious.
On the other end of the spectrum I know someone who broke their elbow and had to keep moving it, or risk not being able to bend it properly ever again. After two weeks, the ortho said no more pain killers, but my friend still had to use the arm and stretch it every day. He said he pretty much maxed out every over the counter drug; he could feel the bone grind and move as he worked his arm. Yikes! But that is definitely the exception.
I think there is a lot of abuse going on. I don't think a lot of people take personal responsibility for their own health. I do admire Purpleface for her conservative 'wait and see' approach.
When my husband and I started our own small consulting business I shopped around for health care and learned a great deal about what was available. I really like the idea of plans that focus on preventative maintenance of health with good coverage (after a deductable) for more catastrophic things, like broken bones. Except for my high blood pressure, we're pretty healthy and fairly young, so we opted for a plan that paid for our yearly exams, that had a deductible (you could pick between $1000, $1500 or $2000, which raised or lowered your premiums), and after that paid high percentages for specialists, hospital, etc. Less serious stuff wasn't covered as thoroughly. For instance, if you used an ambulance but was admitted, almost the whole ambulance cost was covered. If you weren't admitted, the percentage covered was less. The idea was to encourage judicious use of the system.
I think more versatile plans and the ability, as President Bush mentioned, for smaller groups to pool together to get large group rates is the best solution. Supplemental programmes that you can add on to any base coverage you have that focuses on your needs (child care, elderly care, catastrophic, etc), I think is also a good idea.
It's YOUR health, not anyone else's. Everyone should be willing to pay to maintain their own health. It shouldn't be foisted off on anyone else and it shouldn't go through the government's hands. You can deduct the premiums you pay on your taxes, you know.
Right now our healthcare is also taxed by the illegal immigrant population that doesn't pay but still receives attention. It's causing premiums to go up and healthcare facilities to lose money or go bankrupt. Solving that problem would help tremendously.
I think with competition, everyone wins. People shouldn't have to own a business or even have a job to pay for healthcare. If a single mom can afford it, more power. If a parent wants to buy a policy for their kid while they are in college, they should be able to. If someone young working part time wants to pay for catastrophic, that's great. That is the system we should move towards; more choices, not one choice.
And for God's sake, lets reform medical malpractice and insurance company protocols. Multiple bills after various adjustments and deductions certainly make the system more inefficient and costly, as do egregious medical malpractice suits; there's a difference between negligence and circumstances... doctors are not gods. I read recently that a couple is suing a doctor because their child was born with Downs and they think the doctor should have known, or suspected, or been more worried about it and ordered more tests! No wonder the ob-gyn world is shrinking.
OT: The contact us page is broken, BTW.
Welcome to Swords Crossed!
Your Republican brethren could use some support on this site if this site's bipartisan discussion format appeals to you. We seem to have more regular liberal / independent posters than conservative ones.
"Perplexity is the beginning of knowledge" -- Kahlil Gibran
Ditto on the welcome
With respect to the uninsured and illegal immigrants using ER resources -- what do you think of CA's proposed solution
?
Could we tack on elective coverage above a basic minimum, and so provide options and choice?
P.S. Sorry about the contact form, we had to disable it because it was being used by spammers. If you need anything, you can email me (brendanm_98 -at- yahoo.com)
Come, my friends. 'Tis not too late to seek a newer world -- Tennyson
First, welcome to SC!
It's great to have more right-leaning thinkers on here, so we look forward to having you around to beat us up from time to time.
On this specific comment:
Notwithstanding having one of the longest waiting periods for medical care among industrialized nations, Canadians are still kicking our butts in life expectancy and overall health issues. Somehow I'd rather have their complaints, if it comes with the kind of quality of life they have.
I'd agree, but even with a dramatic cut in the cost of healthcare, how do you expect people with no jobs to be able to afford treatments whose costs alone - even given an ideal level of competition - will lie outside their financial abilities?
Saint, n. A dead sinner revised and edited. - Ambrose Bierce
Great observations
I'm very much like you. I sprained my ankle a half-dozen or more times as a child/teenager (I walk like a duck, so it tended to happen a lot in my clumsy adolescence) and never saw a doctor. I've been to the doctor only a few times in my life and two were for excessive bleeding injuries that required stitches and the others were for pink-eye (which was also common in my teens from my contacts). I've only gone to the doctor once for something that I later thought was trivial (excessive rash that turned out to be just very dry skin).
My wife on the other hand grew up in the medical community (her mother is a nurse and my wife also worked at a hospital for a long stretch of time). She now questions a lot of Western medicine, and avoids the doctor for most things (even to the point where we planned two homebirths for our kids with a midwife), but she is a little too willing to take our son to the doctor for every mild reaction/problem he has, whether it is a sniffle or rash.
One of the funnier things I've noticed/thought about lately is the overuse of vets. For example I have a three year-old husky who we just took in to a 'wellness check' (my wife's doing). Three hundred and fifty dollars plus later, we walk out of there with heart worm pills, and that's about it, since my dog is too hyper to sit still to get her heart beat or temperature measured and one of the two shots missed when she got vaccinated for thing I've never heard of. I haven't been in to the doctor (nevertheless a wellness check) in over 8 years!
My dog also cut her lower leg pretty badly on a piece of glass, and (again under my wife's discretion) we took her to the vet, the first recommendation was for us to put her under general anesthetics to 'operate on her leg' for about $850. I asked if any major arteries or veins had been hit, if the dog would have a lasting limp without the surgery , and if the surgery was absolutely necessary all to which the vet ended up saying no to. I asked if a well-applied bandage would take care of the still tricking bleeding and prevent infection to which the vet answered yes. $40 later, we were out of there. Highway robbery.
Thanks for posting this. It is fun to rant.
Two part post. 1) tx 2) attitudes
1) use ice for 20 minutes every hour while injury is acute (sometimes that means for first 2 weeks, in this case, it would be for a few days). Ice reduces swelling but if you leave it on for too long the body adjusts, sends more blood to the cold area and you end up with even more swelling. Elevate affected area slightly. Initially, stay off foot as much as possible. But do try to use gentle range of motion w/o weight initially. As time goes by, use range of motion with resistance.
2) I work in healthcare. I hate going to Dr's. My co-pay is cheap and I still won't go if I don't absolutely have to.
It's funny because
I hate going to the hospital. Unless I'm afraid my life is in danger, it's kicking and screaming to get me to waste so much time in a doctor's office.
I also worked for years in sports medicine, so a lot of the usual injury stuff I handle myself. We've run into some problems with the better half's thumb, because that joint's a little too complicated for me to make an un-expert evaluation, and he doesn't have health care anyway.
Purpleface, I wonder if it's a feedback loop of sorts rather than just an overreliance on healthcare. My generation was not taught much in the way of home remedies, partially because of burgeoning healthcare availability and partially because of growing suspicion about many home remedies (mustard plasters, anyone?) that cast do-it-yourself nursing in a bad light.
Whether that was caused by overreliance by our parents is another question, but the result is certainly that the reliance keeps building as each generation knows less. A lot of what I know either came through training at work or through scouring the internet.
Saint, n. A dead sinner revised and edited. - Ambrose Bierce
On the button
I think you hit it. It's an intentional feedback loop, IMHO, and one we will have to fix if we are ever to get to some effective form of nationalized healthcare. We have to break the TV commercial mindset that only says "ask your doctor."
I'm not surprised that most posters here stay away from doctors -- most healthly young men do. At your ages, injuries are the biggest risk you face, not chronic conditions or the dreaded "let's check your blood so we can give you expensive drugs that require you to visit us every six months to make sure the drugs aren't destroying your liver."
Specter's wife is the other end of the issue: it's really scary to see your child ill and wonder if, by not taking him to the doctor, you are risking something so precious to you. So today's prudent mother goes, because she is trained to do so and sees little risk in it. But as the UK article I linked mentioned, x-rays are not harmless.
Our current medical system freely prescribes everything needed to satisfy the consumer, without regard to whether it is needed to resolve the illness or injury. For example, the latest studies have shown that all the ear infection antibiotics and medicine (tubes, etc) that was prescribed over the last thirty years was entirely pointless and without medical merit. The proper action for a child's ear infection is rest, aspirin or tylenol, and a warm compress. It was mostly this overuse of antibiotics for ear infections that created the superbugs we are now facing.
We know a young family with little real education and three little ones. They'd rush to the emergency room or free clinic with every fever or cough, because they worried that it might be serious. With three kids, they were doing this every month. So I located a copy of the twenty-year-old Family Medical Guide book that I like to use, and gave it to the mother. Now she has something to go by that gives her clear, specific information about what to expect and how to judge whether or not a doctor is needed. She loves it.
My concern is that any move to a more educated and self-reliant citizen will be perceived as rationing healthcare, which is it not, but how do you explain that to a generation of mothers brought up with the idea that they should run to the doctor for everything, or to the older generation that is conditioned to thinking that getting older means taking medication every day?
And don't dis the mustard plaster. The modern equivalent is Ben-Gay (or Tiger Balm, etc) and I'd bet most of us have used that once or twice.
"Perplexity is the beginning of knowledge" -- Kahlil Gibran
I wish I had your universe
#1 I have a metabolic disorder, that also results in hundreds of bone spurs all over the body, growth quits at puberty but the damage is forever, most folk have 2 bones above hands and feet , three sets of mine are fused together.
#2 another effect is fatigue and occasional "sleepy attacks" that are more like being drugged than like actual sleep. There is medicine for this but it is on Govt' watch lists.
#3 I have reached an age when people without medicine drop dead and people with medicine live another 20 years.
I cannot get medical insurance that is real, but when I could the cost was more than all other bills combined, and still the medicine was more than I spend on food, just for the copay.
I fell off a ladder several years ago, landing on my back across the front steps, and as I could not move, was taken to emergency. Xray found no broken bones so they tossed me out, even though I still could not do more than twist in the bed to find a level of pain that did not induce screaming.
There was not enough drugs to stop the pain but they used enough drugs to stop me from resisting and sent me on out the door. I was paying off the bill for that night for years, and every so often the back still attacks.
It has been widely reported, and I easily believe, that patients pay out of pocket as much as ten times what even insurance companies pay, so your complaint about "excessive use" rings rather hollow to my ears.
The Self Made Man is just not admitting where he got all the parts.
Not a pretty picture.
That sounds quite serious.
Did you have insurance when you fell of the ladder?
It is the economy, stupid.
no
The Self Made Man is just not admitting where he got all the parts.
Sounds awful
I would not call your situation a case of "excessive use." Far from it. An ideal healthcare system would treat chronic debilitating conditions such as yours without driving you into the poorhouse. Under our current system, as you can attest, problems such as yours are ignored or mistreated.
I believe that in Texas they cannot legally prosecute claims for unpaid medical bills. They can hound you by phone and by mail, they can ruin your credit, and that specific hospital/doctor can refuse further treatment, but they cannot do much more than that. The homestead laws prevent them from taking your house, your car, and your possessions.
"Perplexity is the beginning of knowledge" -- Kahlil Gibran
I think if you look the GOP fixed that with Bankruptcy "Reform"
Now Corporations can loot things like worker pension funds and skate free as many have done, but even Religious "Charities" that make millions without paying a dime in taxes, can lay claim to your house (often at "fire sale" prices and extra profit) and garnish your wages, and hound you to the grave. And for bills that are many times what they would charge those who could fight.
The Gang Of Pirates have piled on so much that it will take years if ever to fix this, like first restoring Habeas Corpus, and then the Bill of Rights, before getting to such things.
Even before that Bush found a solution while still Governor. If you are severely disabled and needing constant hospitalization, the hospital simply kills you, either by starvation or cutting off oxygen or such. Even if you are awake, aware, have a mind and such, but are merely not able to pay the bill.
Many have died unheralded that way, but one was noticed when they killed him, for lack of funds, even as they spent millions on Terri Schievo, even though he had a functioning aware brain and Schievo did not. For the money they spent on raw partisanship, they could have kept him going for years.
The Self Made Man is just not admitting where he got all the parts.
It's better to have it
and not need it than to need it and not have it.
I remember skiing in Italy with my X's cousins from Germany not so long ago. On his last run on a particularly steep slope one of them had a spectacular fall and as it seemed at the time badly sprained his wrist. He was all upbeat and ready to drive us all back to Berlin after wrapping his hand with a scarf. Sure it hurt, but don't they all? His wife made him visit a local doctor who without even an x-ray wrapped his hand in a stretch bandage with something inside to stiffen the wrist. The doctor wasn't at all crazy about this guy driving a car for next 10 hrs so the wife drove. By the time we got home the broken wrist ballooned twice its original size and pain killers prescribed by the Italian doctor certainly came to the good use. In Berlin he went to the clinic where they performed very complicated surgery pulling bone fragments shattered by the force of the impact and putting the whole wrist back together. Had he decided to tough it out and maybe try home remedies he'd probably never regained full use of his hand. Or maybe he'd faint from pain somewhere on the autobahn and killed us all...
But guess what - the main factor why people don't go to the doctor, even just in case something is wrong - MONEY - wasn't there. They didn't have to stress out about medical bill that would exceed the cost of entire trip for all four of us. He also got 6 weeks of fully paid sick leave.
People can rationalize their support for the current health care "system" in the US and talk about the evils of "socialized medicine" all they want - to me it all sounds like slaves arguing benefits of slavery.
Sic semper tyrannis
Skiing accidents
Skiing is great fun but man is it hard on the body. My final trip, I fell getting off the lift and sprained a knee on the first run. Made it down on my own but only just. Major bummer.
He was probably being macho and downplaying how bad it hurt. But he knew when to go and he got the care he actually needed.
It's all about how effective you are at making the decision of go/don't go. Part of my point was that our current setup encourages an excessive degree of dependence on the for-profit medical system (but yet complains of over-utilization when people do as they have been trained to do: "ask your doctor").
If we move to some form of universal coverage, we will have to decide how much of this dependence we will pay for within the system, or whether we will address it through education and resources outside the system, such as the British document I cited. Unlike the American version, it was concise, easy to understand and follow, and did not encourage us to seek unnecessary treatment.
But given our current set of expectations, any move to avoid unnecessary or marginally-benefical procedures will be perceived negatively and labeled as rationing, which will make converting to a universal system more difficult. Because out of 300 million of us, somebody is bound to make a bad decision and die because of it.
"Perplexity is the beginning of knowledge" -- Kahlil Gibran