The idea for this post began as I basked in the glow that Rush Limbaugh, after missing the first two days of his show (leaving us to listen to the intelligent but boring-as-shit Mark Steyn), returned to do his first show. Naturally, the beginning topic of discussion was his emergency room visit to the hospital [full transcript]. Unfortunately, while it was a great story, I lacked answers. So, to clarify what might have actually led to the chest pain, I consulted the nurse.
Unfortunately, since I don't have a conservative nurse that I know of to look at it and speculate, I ended up on the other end of the political spectrum. So here's Satyavati's post detailing the problems with the story of Rush's treatment (and professing her everlasting love with every inch of Rush's greatness). For those of you who will whine and refuse to click the link, I'll give you the summation:
So my conclusion is that it's inconclusive. I don't know what, if any, intervention was given for the two-day gap between evaluation and procedure. I don't know how someone can walk out of a procedure and onto a golf course. I'm just seeing a mix of things I know are true and things that appear to be highly irregular. It's just what I'm seeing. There's problems with the story; it's not complete.This was the sense that I got that forced me to seek out professional assessment of the story. It continues me along the lines of asking questions, specifically concerning the fact he is (as far as we know) a recovering addict. And it serves as a disclaimer for citing Rush as the source of the rest of the post.
The relevant part of the story (to this post) is twofold. First, there was the level of treatment that Rush received from the onset of the chest pain. And second, the issue of payment.
Health Care Ain't Broke
Rush has stated in the past, and specifically on Wednesday that, "There's nothing wrong with the American health care system." Well, yes and no. We'll deal with the 'no' part first.
With the obvious exceptions, most nurses and many doctors don't see their work as just a job, or even just a career, but as a calling. They got into their profession to help people. Combine that with the technology that has flourished in a free society, where innovation pays, and we have an excellent system for administering care.
In the Limbaugh case, hotel security helped him until the EMTs got there. They stabilized and transported him to the hospital, where doctors ran their tests. This is what would happen to anyone on the receiving end of emergency service.
The simple fact is, that when our doctors and nurses set out to fix problems and heal people, they generally do a damned good job. And it's when the only people making decisions are the doctors (or nurse practitioners) and patients, the system works best.
It's like tech support (something I know a little about), except with lives. If I can fix it, I'll do my damnedest. If not, I do my best to get them the help they need. So it is with the medical community. At least until we come to....
Paying for Health Care is a Clusterfuck
Rush trumpeted what happened when he paid cash for his stay instead of having to go through an insurance path of some kind. And according to him, he got a discount for paying cash, rather than forcing the hospital to have to submit paperwork to an insurance company, then have it denied, then resubmit with some more documentation, then wait for a couple more months before a check for half the asked amount shows up, then they have to submit something else to get more cash, and so on and so forth (yes that was a runon sentence, but that's the point). And while it wouldn't be practical for most of us (I don't have a documented figure, but it was about $12k) or possible for some of us, the key to fixing health insurance and the price disaster is found in this example.
Because it's something I've been saying for a while now. The biggest problem with access to health care is the price of health care (because the doctors are there) and the biggest cause of the overpricing of health care is that we don't pay for health care ourselves.
There are a few things that counter this trend. The concept of a nurse-in-a-box: a basic health clinic set up in a chain pharmacy or a Wal-Mart that does some basic medical checkups and such, referring anything serious to an actual doctor (because not everybody needs to see a doctor). Web sites that allow you to shop around for procedures or services (still hazy but growing). And more knowledge in general thanks to sites like WebMD (although most of the answers seem to be "go see a doctor"). And the concept of actually getting market forces back into the offering of health care (because health care is mostly an oligopoly).
But most of the things being thrown up (as vomit is) to "solve" the health care "crisis" are simply continuing the trend toward taking what should be simple and personal and direct and making it into a ghastly beastly all-encompassing irrational rationed hell care system.
It began simply enough. We began on the road to the Imperial federal government being the controller and gateway for medical care for all of America with the establishment of Medicare (with the noble "goal" of taking care of our elderly) and Medicaid (doing the poor the same way). (disclaimer: I am currently in the Medicaid system, mainly because I have my children to worry about.) Meanwhile, in the private market, it became part of the compensation package from employers. It seemed sensible at the time: Paying a small amount now as part of your pay to cover expenses down the road. However, when we don't feel the pinch at the time we use something, it's easier to spend it (also how we get into trouble with credit cards, by the way). In addition, large insurance companies, who enticed individual doctors to sign on with them, had more power to bargain for better prices, then be able to control the prices. In the end, both private insurance (continually subjected to more mandates to cover an increasing list of shit (some good, some stupid)) and the government-run monstrosities found that with more people using more services, costs had to be controlled further. To compensate, the prices began going up. Fast. Furthermore, as the states laid more mandates as to what coverage had to be, they also limited what companies were able to even offer insurance, and any semblance of the free market became a joke.
Now, we live in an era where government continues a relentless march to control the purse strings of every individual by demanding either insurance coverage or money. And for those who can afford to go without insurance and pay the penalty, the insurance goes out the door. Add to that the next mandate, covering people who will cost more money than they will pay in, and also mandate that you can't charge for that, and the prices will continue to rise, until no one can reasonably afford it. And as mandates pile on employers to provide or pay, they'll take the less expensive hit and drop coverage. Then there's the taxation of health insurance, especially those policies that are too "extravagant" by government standards (hint, the really rich, like Rush, just pay cash) which means soaking the source of all real tax revenue, the middle class.
In the end, because the system is too controlled, prices spin out of control. This means our Imperial Federal Government gets to ride in to "save" people "and "fix" the mess caused by "private insurers" and the "free market" and the EEEVIL rich, who still have more money than the proletariat.
I've advocated solutions, as have many people. Solutions that don't require the government to mandate what I have to eat to stay healthy, what tests I have to take to keep costs low, what medical care I deserve, or to hold my dick while I piss, because I might turn the stream on them. But in the hellbent rush to "do something" the political class of Washington continues to find their solutions by adding to the pile of laws that caused the problems in the first place. And rather than targeting the actual problems (the 30 million uninsured, for example), it's a mad rush to pile on page after page and bill after bill. And except for devotees to the idea of universal government health (no) care (ask the VA), anyone knows that continuing down the path we've been going since FDR is a continuation of every mistake we've made so far.
In the end, there will be some nice islands in small countries where people like Rush and Obama will go for the best health care in the world.