Healthy Journalism

Monday, January 19, 2009

Waste on Wheels

You probably wouldn’t purchase tires or textbooks without comparing prices, figuring out how to spend as little as possible for what you need. You’re motivated to shop around because you know you have only so much to spend, despite those seductive credit cards, and that paying too much for tires could mean missing out on Spring break – or even cutting back on groceries.

When it comes to health care, however, “There is no major constituency for controlling spending. Because most patients don’t pay their medical bill directly, they have little interest in using less care or shopping for lower-priced services. Providers (doctors, hospitals, drug companies, equipment manufacturers) have no interest in limiting care. What others call “health costs” are their incomes – wages, salaries, profits.” That’s how economics columnist Robert J. Samuelson summed it up in a January 19 article in Newsweek.

This wasn’t news to me. I’d written much the same thing in dozens of articles over the years, but I read his words while brooding about a recent experience.

It was early December, and Achilles’ tendon surgery had left me unable to put any weight on my right foot for six weeks. That’s a near-eternity for a hyperactive person like me. After the frustrations of dealing with crutches, a folding metal walker and a wheelchair, I was delighted to discover a scooter-like device called a knee walker: it’s fast, nimble and inspires envy in small children. Plus I was able to rent it from a local medical supply company for $30 each week.

A good friend with a knee-level amputation was intrigued, so I found the identical scooter on Amazon and sent him the link. A new one could be had for $460, and on other sites I found used scooters for less.

When I wheeled into the surgeon’s office to have the staples removed, he thought the scooter was cool and wrote a prescription for its rental. “Maybe your insurance will cover it,” he said.

I phoned the medical supply company to find out, and was astonished to hear that my high-end policy would not pay $30/week to rent the knee-walker – but it would buy me a new one for $720.

“That’s nuts,” I told the lady on the phone, “I could buy the same scooter online for about $250 less.”

“Well,” she said, “if you want to buy it privately, instead of using insurance, we’ll sell it to you for $680.”

Instead, I decided to pay $150 out of pocket to rent the scooter for five weeks. That made more sense than adding another $570 of clinically unnecessary spending to our country’s bloated health care tab – which we would all pay for in the end.

I’m writing this on Inauguration Eve, when there’s a nip of hope in the cold air. Whenever a new president takes office, particularly a Democrat, there’s talk of reforming the system so that all of us, rich and poor, young and old, are ensured preventive services and medical treatments to help us live as long and as well as we can.

Maybe this time we’ll remake the system in ways that matter. In the meantime, we have choices. And it’s possible to just say “no” when we’re offered tests, treatments, or gadgets that we don’t really need.

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