Back to the Future

April 13, 2010 8:19 a.m.

TPM Reader VL looks at the intriguing possibilities behind Nevada senate candidate Sue Lowden’s suggestion that we use barter as a way to contain ever-rising medical costs …

I found myself intrigued by the suggestion that we should barter (or even bargain) for our health care. My first thought was of my great grandfather, a country doctor in upstate New York in c. 1880. We still have his account books.

The many farmers in the area did, indeed, pay him by barter. Some of the entries make for good reading. Clearly, a few farmers felt a life long obligation, as they are recorded as dropping off two dozen eggs weekly for years in exchange for a difficult birth. Others, not so much: terse commentary alongside some entries indicates that the doctor did not expect to see anything after this one chicken, despite the complexity of the case.

The doctor’s family remembered always being hardup for money, though they never wanted for food. The problem was, the colleges they attended didn’t accept bushels of carrots in payment.

But my second thought was that Sue Lowden has not had any health care other than a checkup recently.

Last week I had a minor but necessary operation (septoplasty and bilateral turbinate reduction) to help me breath better. The operation was done at a local teaching hospital and it was made clear to me that everything would be charged separately; there was a hospital facility charge; a charge for ‘supplies’; a charge for medications; a charge for equipment use. All of these were bundled together fortunately, but the billing agent enumerated them for me. The doctor bills were another story and necessitated separate payment.

In addition, I had two separate nurses, one ananesthesiologist, his resident, an ear, nose and throat doctor, and his resident, totaling six professionals. When I checked into the hospital, I dealt with two separate billing staff and an orderly. I cannot imagine trying to barter with all of them much less bargain their prices down.

The entire operation took about 45 minutes but of course, I took up a bed in the hospital from 7:00 am until about noon. That has to cost something.

I am particularly puzzled as to how one might bargain with an anesthesiologist. Just make it hurt 50% less? Or maybe, only knock me out for the first half of the operation? Use a hammer instead of those costly opiates to put me under?

Really, does this woman have any idea of the complexity of modern health care? I hate to ill wish people, but I do find myself hoping they get really, really ill and find out what it actually costs to get health care in this country.

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