Monday, September 28, 2020

why that fur coat is not necessary in mexico


Sorting acquisitions is like a treasure hunt.

No. It is a treasure hunt. Even when the acquisitions are not mine.

As you know, my brother and I have have been assisting my mother in transitioning to a retirement apartment. That meant sorting through 92 years of things she had accumulated.

It turns out my name showed up often. Either because the item was mine or I was included in the photograph or document.

I am not a sentimental person, but I am an historian. And I thought you might like to strut down nostalgia promenade with me. We may end up in a cul-de-sac, but it is the journey. Correct?

Let's start with one of my favorites. I have been hospitalized only three times (not counting my birth, which technically was my mother's hospitalization): in 2009 to repair a shattered ankle following an unfortunate landing while ziplining in Mexico; in 2015 for a bout of cellulitis in my left leg in Manzanillo; and the tale I want to share with you today -- the only hospitalization I have had in The States.

Unlike most of my peers, I managed to get to my junior year in high school before I had my tonsils removed. They probably should have come out sooner. I had suffered years of tonsil infections, beaten back each time by a variety of sulfa drugs -- fungus put to good use. When my mother was my seventeen, penicillin had just been put into general use. When my father was seventeen, it was still in its experimental stages.

But one fateful day in the Spring of 1966, my family physician, Dr. Burnham surrendered to the inevitable. My tonsils had to go. And, to do that, into the hospital I went for my only experience of having a part removed from inside my body.

You may well ask yourself why I thought you would be interested in such a pedestrian tale about my adenoids. And you would be right. My interesting find was not the almost-lost memory of my tonsillectomy. It was the bill.

I assume you have already scanned it yourself. But, here is the summary. $58 for two nights in the hospital. $13.10 for drugs. $20 for lab work. $37.50 for miscellaneous. For a total of $128.60. 

And then comes along an interesting figure. Western Teamsters health insurance paid $108.60. The hospital did not handle the extra $20 as a deductible. It was simply written off as a credit.

I am not certain where to start with this bit of history. As far as I know, the procedures used by the hospital were first-rate, or, at least, adequate. And that $128.60 is in 1966 dollars.

But, even extrapolating to 2020 dollars, the total gets pushed up to just over $700. I have not had any reason to price tonsillectomies these days, but I am willing to bet they cost more than $700. Even though I cannot vouch for its accuracy, the median price for a tonsillectomy in Oregon these days appears to be around $7400. Over ten times what the procedure would have cost in 1966 using constant dollars.

And there is the rub. What happened? You can ask any guy at the end of the bar for an opinion, he he will give you the simple answer. Greedy doctors. Greedy Lawyers. Greedy insurance companies. Greedy politicians. Greedy pharma. Or any other cartoon villain that can be plastered on a bit of cardboard.

I suspect, though, the answer is far more complex, and the roots of the answer are the same as why I could work my way through college and come out with no debt while today's university students owe the purchase price of a house in Huron, South Dakota. In education and health, the consumer has been reduced to a bystander and economic cipher. And there are consequences for governmental meddling.

But, I am not really interested in heading off into that bramble patch, and I hope none of you will be tempted to do that, either, in the comments.

I am happy to look at that bill and remember when health care was not only affordable, but easily accessible. Just as it is in Mexico where health insurance is about as necessary as a fur coat -- at least, for me.

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