We have written about the quality of medical care in the U.S. on previous occasions, but as it turns out, this is one subject, which deserves constant updates.
Both our sitting president, as well as the current Republican presidential candidate have repeatedly referred to our health care system as “the finest in the world”. It is not out of the question that the president of the United States does indeed receive good medical care, and the same possibly goes for a powerful member of the U.S. Senate. How about the tens of millions of Americans who do not have any health insurance? I do believe that this issue is quite obvious, sad and shameful and doesn’t really need very much in the way of further discussion. But just imagine a family, with an income of around $20,000 a year – and there are many of those – having to pay the exorbitant fees that the medical industry charges in the U.S.
Today’s beef is about the much more fortunate segment of our population. Those, who make a decent living and who are fortunate to have health insurance, obtained through their employers. On the surface, those people – myself included – can certainly be considered to be quite a bit more fortunate. But wait! An average of 195,000 people in the USA died due to potentially preventable, in-hospital medical errors in each of the years 2000, 2001 and 2002, according to a study of 37 million patient records that was released by HealthGrades, the health care quality company.
That’s a staggering statistic about supposedly “the best health care system in the world”. In addition to the very real possibility of getting killed by carelessness, stupidity and incompetence, Americans have to pay record amounts for often substandard care.
But let’s not get too excited, or scared for that matter by statistics alone. Let me present a very recent – today’s as a matter of fact – example of how the U.S. health care system really works.
My wife has tripped on the concrete steps of a Metro station, located in the richest county in the whole of the United States. She was lucky to a degree because she has not sustained truly serious injuries, but the fact remains that she did bang up, twist and scrape her knees, front of her leg and face and worst of all, has either twisted, broken, or banged up one of her feet, just below her ankle. Why don’t you know whether her foot was twisted, broken, or banged up, you may ask? Don’t you love your wife enough to find out what is actually wrong with her? Actually I do, but isn’t that the job of the medical establishment?
I did take her to the rather large and prosperous urgent medical care clinic, located (you guessed correctly) in the richest county in the entire United States. After an inordinately long wait and a long and tedious process of filling out the required forms (even though she has been there before), I actually went to my car and brought a first aid kit, so I could clean and disinfect the visible, bleeding wounds on her legs – right in the waiting room, under the impassive stare of the staff. The first aid display might have given them a message, as shortly afterwards a nurse invited her inside. Once inside, my wife was given the standard look-over, asked questions, the usual routine. The nurse cleaned the wounds again, applied an antiseptic and a cheap gauze pad – not as good as the one I was going to use and instead of at once applying an ice pack on the visibly swollen foot, she gave her a heat pack. The south Asian physician came in, looked over the injuries and examined the nurse’s work, declaring: “That foot should be x-rayed, but our x-ray technician is late today. It will be at least an hour”. Some time went by and the doc returned, this time suggesting that my wife walk over across the parking lot to the much larger, multi-story diagnostic complex for the x-rays.
My wife hobbled over there. The place also had the Inova Health System logos prominently displayed. The receptionist (a male this time) once again took his sweet time entering the info from my wife’s insurance card into his computer, even asked her for another form of photo identification and made her fill out another form, although, as in the previous establishment, my wife has been to this facility a few years ago. After the requisite paperwork has been taken care of, the receptionist informed us that the radiologist – the person, who was supposed to examine the x-rays and render a diagnosis as far as the injuries – was not in that day. Could we come back tomorrow?
I said quite loudly and clearly: “And President Bush says that we have the finest health care in the world”, bringing up sympathetic smiles from most of the people sitting around the waiting room and an undisguised scowl from the receptionist.
While all this was going on, I was approached in the parking lot by a shortish, youngish guy in a thoroughly pressed pink (!) shirt and told that he worked for the management company, which owned both of the buildings, between which we were shuttling and that I couldn’t park in that parking lot, unless I was a patient…”Don’t give me any more grief, bud” I hissed.
Needless to say, we hobbled back across the parking lot to the first urgent (????) medical care complex. My wife requested an ice pack for her rapidly swelling foot. It was provided, but only after the staff asked her once more whether she was a patient and what was her name. After only about forty minutes, we were informed that the x-ray technician has arrived! Whoopee!!! The x-rays were taken, but we were told that the results would not be available until the next day. Maybe these twits were using the same radiologist, who didn’t show up for work today at the other place? Considering how lucrative this medical and diagnostic business is, do we really have a shortage of radiologists in this country? Is it any wonder why there are so many malpractice suits in the U.S?
Anyway, this is why we do not know whether my wife’s foot was twisted, broken, or banged up. And this in one of the most prosperous, technically advanced towns, located in the richest county in the entire US of A. Wonder how this kind of “health care” compares to some town in Appalachia, or the deep south, or to health care in some third world country? Frankly, I wouldn’t be at all surprised that Bush’s, Giuliani’s, Clinton’s and McCain’s “finest health care in the world” was well below the standards of care available in all, but the very poorest regions of the world. There is probably just one, single category, in which we do lead everybody. And that is the cost. I rest my case.
Follow-up – next day: The foot and the totally undiagnosed big toe of my wife’s other foot continued to swell. We called the Inova Health System urgent (????) medical care clinic again and were told that the x-rays were sent out to a radiologist and might be available after 1pm. Grrrrrr! I am sure that if this happened 100 years ago, the x-ray results would have been available much, much earlier. Anyway, they also said that they would call only if there was a broken bone. Otherwise -no. I actually drove to the clinic after 1pm. The receptionist said that the x-rays would arrive anytime between 1 and 3pm. I asked to be called when they did. We called them again around 3:30pm, a day and a half after the accident and over 28 hours after the x-rays were finally taken. A woman said “oh yes, the foot is broken, you cannot walk on it, have to get crutches. Do you have crutches?”
Needless to say, we never again intend to visit this particular Inova Health Systems facility, except to collect the x-rays, which we have already paid for, before we visit a qualified physician. I just hope they give us the correct ones. I also wonder if suing the heartless, incompetent, arrogant “health care professionals” and their corporation might be a good idea – if only to force then to provide better service in the future…
The third day: After finally finding out that there was a broken bone, we did make an appointment – unfortunately for the third day – with an orthopedic specialist. Although it is patently obvious that this sort of injuries should be treated as soon as possible, thanks to the performance of the “urgent” medical care establishment we were still at square one, getting ready to see the specialist. I drove over to the Inova Health System urgent (????) medical care clinic in order to retrieve the x-rays, so there wouldn’t be any delays later. After a brief scramble through the envelopes, the receptionist told me that the x-ray tech was busy at the moment and that he would need to make copies of them first. “These are my x-rays, not yours, I paid for them, please give them to me,” I said. “No, we cannot, sir, the law requires us to keep the originals,” said a staff member. “So you actually do abide by the law,” I observed. Good to hear that. I’m sure that my lawyer and the courts will be very happy to hear that as well. You have provided us with the x-ray results some 30 ours after the x-rays were taken, didn’t even call us on your own, to inform us that there was a broken bone and you are telling me that you are following the dictates of a law? What a joke!”
On the way to the orthopedist we did finally pick up the x-rays and a pair of as it turned out unnecessary crutches. The doc looked at the x-rays, examined the foot AND the ankle and said: “They x-rayed the wrong part. This is an x-ray of your foot, but the damage is in the ankle”.
Another x-ray was taken and within less than 10 minutes two pictures were displayed in the computer in the examining room. This is after all 2008. “A bad sprain,” said the doc “with a crack in one of the ankle bones. I will put you in a boot. Recovery will take at least three weeks”. I guess we were lucky that the ankle, or foot bones were not shattered, requiring reconstructive surgery. At least part of our seriously shaken faith in “the best health care system in the world” was restored to a degree, which doesn’t of course mean that it isn’t in need of a serious overhaul.