Healthcare's Crushing Costs

DizzyLizzyNurse · Jul 11, 2012

OMG what that man went through is one of my worst nightmares.

Fiona59 · Jul 11, 2012

My province has spent more than a million dollars on a couple of patienst I remember. Both returned from out of country surgeries that they felt they couldn't wait for. The province is covering the cost of complications that arose from the surgeries.

One patient was even turned down for the surgery for exactly what they are being treated for now. They are still receiving care and physio. One will require medical intervention for the rest of their life.

Total cost? Who knows.

DoGoodThenGo · Jul 12, 2012

we all know that health care is expensive, especially in the last six months of a person's life. here's an eye-opening article!

http://online.wsj.com/article/sb10001424052702304441404577483050976766184.html?keywords=janet+adamy#articletabs%3darticle

iirc in some eu countries such as germany one healthcare worker (usually a physican) is top dog on the team and runs a patient's care. he or she makes major choices and decisions regarding care but also carries ultimate responsibility. seems that was sorely lacking in this case.

the poor man in the op link had care that was all over the place and the healthcare team was all over the place in the messages it was giving the family.

one physican starts to speak with the family about the grim prognosis and the possiblity of "letting him go", only it seems to back down when the father says something about "i guess t his is all about the money". the two lead doctors aren't in agreement as to if the patient will ever get well, and naturally the family heard what it wanted to from the one that predicted a better outcome. one physican goes as far to say a special effort must be made because the patient received a second heart transplant.

meanwhile the nursing staff is in "moral distress" because the patient is obviously in deep pain during routine care. otho the family feels the patient is being "doped up" because he's so out of it physical theraphy is not possible.

more and more proceedures are done to his patient to treat this or that new aliment, infection, condition until in the end god and or nature did what they probably had been planning all along for this poor man; his demise.

am not trying to sound cruel or harsh but nature and life sometimes are and we must accept that. just as it's sad when a beautiful newborn deer is gobbled up by a lion it's just nature's or god's way sometimes and we must bear it as best we can.

ever since modern antibiotics came upon the medical scene there has been push to "beat" any aliment or disease via technology or advances in care. true quite often it succeeds, but also we are prolonging the inevitable.

as pointed out in the article linked from the op, the united states spends vast sums on healthcare for the elderly, more than any other nation and more that it seems on infant and early child care, yet often has limited to nil effect. patients may live a few months mor or a few years more but the question that must and should be asked is what is/will be their quality of life. healthcare in this country it seems is all about doing something to patients regardless of actual benefit.

anotherone, BSN, RN · Jul 12, 2012

Maybe in a few years it will be pretty much all self pay or charity cases as it is in other places. Who knows. Very interesting and relevent article.

Ruby Vee, BSN · Jul 12, 2012

i waded through 19 pages of comments on the wsj website, and found some that made me cringe and others that seemed to be spot on. it seems that scott crawford's parents were unwilling to let scott go, even in the face of overwhelming odds against his recovery. (not survival, which is one thing, but recovery, which is another.) but they weren't paying for his care, nor were they expecting to get the hospital bills if or when he proved unable to pay them. they were clearly expecting that someone else pick up the whole tab. several writers suggested that if they were given a million dollars at the start and given the option of spending it all on scott's care or the option of calling a halt somewhere along the way and keeping whatever was left of that million dollars, they may have made different choices. as long as we're spending someone else's money, it's easy to choose to go for broke with the esoteric treatments, even if there's little chance of recovery. but if somehow we had money on the table, different choices might be made. they may have chosen to let scott go earlier on with the prospect of taking home some money for his son's education.

i don't know the crawfords and i don't know what they would have chosen. what i do know is that health care costs are unreal. the $30 copay every time i see a physician or have a procedure is a very real part of my budget planning, especially now without a paycheck coming in. the $10 or $20 copay for drugs does make a difference, and i find myself asking my doctors to write a prescription in a certain way to minimize my co-pays. but the bigger things -- the two mris, ct scan, 30 mammograms and surgery i've had in the past few months are unreal. i cannot even comprehend the cost. i don't even see the bills until the insurance company has weighed in. i think it's probably very easy to become complacent about the cost of healthcare under those conditions. in choosing my treatment options, survival rates were my guiding star, not costs. i had a small tumor and caught it early. i have a good prognosis. and scott started out with a good prognosis.

had i read this article before i started down the cancer pathway, i would have had a very different take on it. probably.

i've never intended to let cancer beat me; i'm going to survive. but i've had some very detailed conversations with my husband about when to say when. ultimately, i'm going to have to trust him to call the right shots. i know i don't want to have to live through what mr. crawford's family put him through.

anotherone, BSN, RN · Jul 12, 2012

I couldn't read all the comments through the political rants and nonsence from those whose only experience is through General Hospital or at Seattle Grace . It is not a popular view in our culture that healthcare is /should be/could be/ a business. It is only a business for customer service. It is taboo to refer to it as a business in the FOR profit, PAY for it sence, unless it is a cosmetic elective procedure. Maybe things will change. Values, beliefs, cultural practices do change in different societies either by necessity or otherwise.

classicdame, MSN, EdD · Jul 12, 2012

as a parent the money would not be an issue to me. How much is your child's life worth? I would not care if someone else had to pay if it kept my child alive. However, as a nurse, I know that not everyone can be "saved". Leaving money out of the equation, it is still a hard decision.

OCNRN63, RN · Jul 12, 2012

this article makes me very glad that i have a detailed advance directive and medical poa in place. my parents know what i want. i even carry a copy of my advance directive in a ziplock bag in my purse, just in case something unforeseen would happen to me. i also have cancer. it's in remission right now, but if it comes back, i don't want to go back on chemo if it will mean even more debility than i already have.

i think patients and family mistake the word "treatable" for "cure." you can treat someone right into the grave.

Ruby Vee, BSN · Jul 12, 2012

this article makes me very glad that i have a detailed advance directive and medical poa in place. my parents know what i want. i even carry a copy of my advance directive in a ziplock bag in my purse, just in case something unforeseen would happen to me. i also have cancer. it's in remission right now, but if it comes back, i don't want to go back on chemo if it will mean even more debility than i already have.

i think patients and family mistake the word "treatable" for "cure." you can treat someone right into the grave.

and survival is not recovery. good for you with the advance directive and medical poa!

anotherone, BSN, RN · Jul 12, 2012

as a parent the money would not be an issue to me. How much is your child's life worth? I would not care if someone else had to pay if it kept my child alive. However, as a nurse, I know that not everyone can be "saved". Leaving money out of the equation, it is still a hard decision.

So who pays for it when the resource well dries up? It dosen't factor in for most of us because that is our culture and there are resources in this country for those who are not mega wealthy. I think almost everyone wouldn't care as long as there is someone to pay for it. What if we become a country of pay out of pocket or private insurance only? There are places in the world where that is the case. the rich get to try and purchase what they want, the poor don't. some times there are charity hospitals other times it is like other situations : can't afford it than too bad. I think these will become more common situations in years soon to come.

Esme12, ASN, BSN, RN · Jul 12, 2012

but who decides that one is not worthy. why is dick chaney's healthcare not mentioned? i wonder what all the interventional cardiology, his heart-mate, and subsequent transplant cost to the public who pays his insurance coverage for the rest of his life. what makes that any different?

as some (like me) face the treatment options for auto-immune disorders of ivig (a single ivig infusion costs about $3000 for a child and 10,000-20,000 for an adult) and/or stem cell transplant along with all the other meds to control their immune systems from attacking the body that will cost thousands and thousands of dollars, who decides that they aren't deserving? even if it is not a cure....why can't they have their quality of life improved. auto-immune disorders strike the "young" and many have young children. they are thrown out of their jobs. they are un-insurable. they too want to live. they too want to be made, if not well, better than they are now.

i under stand that there is a limit and the end is inevitable and i too, have had specific conversations about limits.....but give me a chance. i hear people talk about medicare and ssdi like it's a sin to use the money i've paid into for a lifetime. that those who are on disability are leeches sucking on the life's blood of society. get rid of the abuses......... but there are those of us who depend on it to keep our families off the street. not being able to work, losing the income, medical bills that were unpaid by my husbands insurance, the stock market crash all but took lour life savings. but because i am using the money i have had taken out of my paycheck for 34 years of working my behind off...i get to hear other people debate how i should have my medical care.

i never wanted to be in this position. i never dreamed i would be...before "you" judge others remember that you too may someday find yourself in a place you never expected.

there but for the grace of god......