Saturday, September 22, 2007

The High Cost of Health Care

Kiddo, Baby and I are all sick. There's a nasty cold going around, which of course we caught, and we just haven't been getting better. Baby had a Well-Baby checkup this last week, during which the pediatrician discovered an ear infection. I talked to her about my and Kiddo's symptoms, and she very sternly recommended that we both see a doctor. We did: Kiddo has a sinus infection (I fear he inherited his Mom and Nana's sinuses, poor kid), and I have a sinus infection and bronchitis.

We're part of that much-talked-about uninsured demographic. Hubby's new job pays just enough that the kids don't quality for Denali Kid Care any more, and we can't afford even the mediocre insurance offered by Hubby's work ($12,000 a year!). My prescriptions cost over $200 for two weeks of treatment, and we haven't seen the doctors' bills yet.

There's a lot of discussion on why health care is so expensive, and it's usually blamed on insurance providers and drug manufacturers. Here in the Land of the Sue I can kind of understand why physician's malpractice insurance is so high, and I don't pretend to understand the prescription drug trade (my Nasonex prescription was $95!!!). But in the early 90's I worked at our local Operating Room as a database monkey and there was something I saw that I've never seen addressed, and it just appalls me: the sheer amount of waste that happens in the medical industry.

You can probably blame HIV, or rather the whole bloodborne pathogen problem. You see, almost everything used in the medical industry is disposable. Apparently there is such concern about the spread of infection and/or pathogens that almost nothing is reused, no matter how efficient sterilization techniques are. No glass syringes; no washing and reusing sterile field drapes. I'm torn between what may be a medical necessity (theoretically the CDC has a hand in this) and the huge quantity of perfectly good stuff I saw thrown away.

For example: if you have an appendectomy the physician will have provided the facility with a pick sheet of items she prefers for the procedure. Medical supply companies are aware that there's darn near a standard set of items used in such a procedure, so they sell an "Appendectomy Pack" that contains those items, pre-sterilized and ready to go. However, if your physician is extremely efficient (or your case really simple and routine), much of the contents of that pack may be unused.

And they are thrown away, deemed unusable, because they have been opened and are no longer considered sterile. Even if they were opened in a sterile O.R. environment by a nurse who prepared everything according to sterile procedure. They're garbage.

If you get stitches the needles are pre-packaged with a fixed length of thread; surgical staples are a pre-loaded staple gun which is disposed of along with any unused staples; surgical drapes (those blue paper things we all despise when handed one to cover our bare fannies) are garbage even if they sat there and were never unfolded. Not only are the items deemed unusable, but there's a huge amount of packaging involved too.

There is some recycling going on. I know that partially used surgical staplers are often saved for veterinary clinics (apparently our sterilization technology is good enough for animals but not for us); many hospitals save unopened but "not sterile" drapes, needles and other items for donation to third-world countries where relief efforts are happening. Which is all good and fine, waste not want not and charity starts at home, but the patient pays for all that whether it is used or not.

Meanwhile, anything else used during the course of your stay is charged to you too. Hospitals and other medical facilities have high-tech, complex inventory systems to make sure that not a single thing slips through the crack. Those cheap plastic water pitchers? Disposable, and you're charged. The digital oral thermometer? Yep. Your water glass? You betcha. This is why your nurses encourage you to take everything home. If they have to open another pre-packed sterile kit for your procedure you're charged. If they accidentally open the wrong suture? Yep, you're charged. Even the little black cone on the end of the ottoscope (that's the thingie with the light they peer onto your ears and nose with) is disposable.

It angers me, not just because of the cost but it's horribly wasteful. I've never seen this issue addressed, and it should be. Just like turning off lights when not in use adds up, a little efficiency and a re-examination of the use of sterilization could save tons of money.

1 comment:

Anonymous said...

Auntie sez'...
Amen!! Having been throught two major and one minor surguries with amazing insurance (thank you Starbucks), the amount you pay is ridiculous. I had my hand x-rayed at the ER and still paid over $300 AFTER insurance. They say everyone is one major medical disaster from bankruptcy, not hard to believe. Is it. I'll stand on this soap box w/ my sister.

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