For What It's Worth

By Mike Raether

As malodorous as it is, I’m wading into the stinky swamp of the healthcare debate. The experiences of a loved one who’s bogged down in the healthcare quagmire compel me to write.

The nightmare began for my wife Katherine last January with wheezing and shortness of breath. First step on the medical merry-go-round of misery was a chest xray, leading to a CAT scan of her lungs in February. When her lungs proved healthy, Katherine’s primary care provider feared some type heart condition. This lead to an appointment in May with a specialist, a cardiologist. He performed a heart catheterization, suspecting some type of arterial blockage. The good news: the cardiologist found a strong, healthy heart. The bad news: they still didn’t know what was causing Katherine’s breathing problems.

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Finally, although Katherine didn’t manifest the usual symptoms, gastroesophageal reflux disease was suspected. This lead to a “barium swallow” later in May and a breathing test. Now they seemed on the right road. Katherine refluxed all the way to her larynx seven times in five minutes. This suggested severe reflux, and indicated the cause of her breathing problems: gastrointestinal fluids were getting into her lungs. She was drowning in her own stomach acids.

The next round was an appointment with yet another specialist, an endocrinologist. He suggested that surgery was indicated to correct the problem, but he wanted to try and treat her condition with medications first. Various medications and dosages were tried. All the while Katherine continued to suffer horribly. Nothing helped much.

In July Katherine was sent to a third specialist, who performed more tests. In September the fourth specialist was called in, and more tests were executed. So far all the tests confirmed a “classic case of severe reflux” and again suggested that surgery was the answer. But no one wanted to pull the trigger and order the surgery.

Until yesterday. Katherine’s appointment with a fifth specialist lead to the final conclusion that surgery was needed as soon as possible, as her lungs were being destroyed by chronic aspiration of stomach acids. Her lung function was down to 50%. At the moment we’re awaiting notification of the surgery date.

We don’t blame the doctors for this. They were doing their best to be thorough. What we do blame is the practice of defensive medicine. Due to tort litigation and the possibility of being sued for making the wrong diagnosis, doctors are compelled to call for every test available. In some quarters, this is called CYA – or to be more polite, “cover your tracks.”

All of us aware of the mess of the health care system. From upward-spiraling, out-of-control costs to lack of health care for many, the whole thing is about as messy as a one-year-old with his first birthday cake. Few of us would deny that something needs to be done. But what and how are the big questions.

I won’t pretend to have all the answers. But I do know that, at the moment, our legislators seem compelled to “do something.” They’re in a rush to get something on the books before the end of the year. Their motives are varied, ranging from selfishness driven by a personal agenda to a sincere desire to help. But as the old saying goes, “haste makes waste”…or worse.

This is no time to rush in. One-sixth of our economy is at stake here. In the interests of everyone, I say we take the time to get it right. Perhaps the first step is to put a cap on tort litigation to contain the wildfire of lawsuits. This will reduce healthcare costs. Perhaps the second step is to stimulate competition between insurance companies by allowing people to shop for insurance across state lines. This was suggested by President Obama’s healthcare speech to congress on September 10. Perhaps the third step is to find incentives to induce prospective medical personnel into the field. Right now there doesn’t seem to be enough doctors to go around, at least in Montana – earlier this year I had to wait five months to see a specialist about a condition I have.

In the interim, perhaps we could design some kind of voucher system for those without health insurance so they could obtain basic healthcare – while we take the time to sort this thing out.

My last thought is this, and nothing new here: write/call/email your legislators and ask them to slow this train down, before there’s a healthcare train wreck of unrecoverable proportions. Take a few minutes right now to Google “find your legislators” plus your state, and let your thoughts be heard.