I\u2019ve got to introduce you to this pen of mine, just a run-of-the-mill pen, but oh the story it has to tell. Understanding the power of my pen is a useful lesson in health care, and by the end of this two-part piece what you learn might make you healthier. No kidding.<\/p>\n\n\n\n
But first, let\u2019s make you a little sick.<\/p>\n\n\n\n
You\u2019ve encountered the usual info about our US health care system. Most expensive in the world? Yes indeedy, we spend about 16% of our Gross National Product (GNP) every year on health care. Serious money, totaling in the vicinity of $2.24 trillion dollars ($2,240,000,000,000). You can do this math yourself: Our annual GNP is $14 trillion, ironically now the same as our national debt, and 16% of $14 trillion is $2.24 trillion. (My pocket calculator is audibly panting, challenged by zeroes.)<\/p>\n\n\n\n
Now the fun part. Divide this $2.24 trillion by the current US population of 300,000,000 (three hundred million) and you\u2019ll discover we\u2019re spending roughly $7,500 per year on health care for every person living here, or roughly $144 a week. What? What? We\u2019re spending $144 a week on you and yet you have no health insurance? You say all you\u2019ve got when a health crisis looms is some outdated aspirin in your medicine chest? Is something wrong here?<\/p>\n\n\n\n
For all this money–and no chump change this $2.24 trillion we\u2019re spending annually\u2014we rank 37th<\/sup> worldwide<\/strong><\/em> in terms of the overall health and well-being of our citizenry. Neck and neck with Slovenia.<\/p>\n\n\n\n Okay, so that\u2019s what we spend: $2.24 trillion every year. But wait! Who\u2019s in charge of spending? I am<\/span>\u2014me and my magic pen. Me and my 900,000 physician buddies around the country (along with their own magic pens), a number kept pretty constant by the AMA to keep doctors steadily employed. In fact, once you\u2019ve got your medical license, it\u2019s really a challenge to be unemployed. Somebody will always hire you.<\/p>\n\n\n\n Because somebody wants access to your magic pen.<\/p>\n\n\n\n And that\u2019s because virtually every penny of that $2.24 trillion dollar health-care budget will be apportioned, \u201csigned off on,\u201d by some physician, somewhere. Your office visit is X dollars. Then add every prescription, every lab test and x-ray, every admission to every hospital, nursing home and hospice center, every referral to every specialist (whether to another MD or a physical\/occupational\/speech therapist), every visiting nurse, and every piece of medical equipment, whether for personal use (like a wheelchair or a new hip) or hospital use (new EKG machine, new MRI, updating an operating suite). Every last one of these line items must be OKd by a signature ending with the letters \u201cMD.\u201d The dollars are tacked on to X very quickly.<\/p>\n\n\n\n Now, go back to that $2.24 trillion spent per year and divide that number by the 900,000 physicians who do the apportioning. You\u2019ll find that each and every physician approves approximately $2,500,000 worth of health-care \u201cstuff\u201d every year. Then, allowing 40 years as an average for a doctor\u2019s professional life (assuming ages 27 to 67), take that $2.5 million and multiply it times 40 years and you\u2019ll see how one doctor\u2019s magic pen will, over a lifetime, generate in excess of $100 million worth of health-care expenses.<\/p>\n\n\n\n Stand in silent awe of my one hundred million dollar plastic pen. <\/strong><\/p>\n\n\n\n With numbers like these, money loses its meaning, like Germany in the 1920s, when you bought an orange with a wheelbarrow full of worthless Deutschmarks. Except our US cash isn\u2019t worthless\u2014it\u2019s just sort of, let\u2019s say, unequally distributed. Some people have great health insurance, and our health care system vacuums it up like a spilled box of kitty litter. Other people rely on their expired aspirin and pray they stay healthy.<\/p>\n\n\n\n And with that much cash to divvy up, suddenly everyone wants a piece of the action. You need access to the $2.24 trillion to cover the glistening marble acreage of Northwestern Memorial Hospital, the 1950s horror flick-colored amoeba (aka, Rush University Medical Center) glaring down the Eisenhower Expressway, and the crystalline Blue Cross tower vertiginously soaring over Millennium Park.<\/p>\n\n\n\n Access to all this money<\/em> has created tens of thousands of businesses vying for their share. Billboards urge you to have your baby here<\/em>, your heart transplant there<\/em>. Physician ads claim \u201cSee me! Me! I\u2019m the best!\u201d \u201cInsurance accepted\u201d really means \u201cI want my share of that $2.24 trillion.\u201d Your TV is clotted with hundreds of drug ads: \u201cSwallow me! Me! Live longer! Feel better!\u201d (30 pills $400, insurance accepted).<\/p>\n\n\n\n Every health care company, from Mayo Clinic on one end to the poor slob with his \u201cTired of your C-PAP?\u201d ads on the other, wants me to click my magic pen and jimmy open the money valve so a chunk of my allotted one hundred million smackers gushes in their direction.<\/p>\n\n\n\n Gives you a headache, doesn\u2019t it? Too bad your aspirin is outdated.<\/p>\n\n\n\n Now even the most idealistic among us have to admit a system like this is crazy. Bonkers. And you wonder if you, one innocent person with your elderly bottle of aspirin, can avoid getting sucked into this mess. You can. People do. I meet them every day, but we\u2019ll talk about that next week.<\/p>\n\n\n\n Hint: For those about to pro-and-con me on a single-payer health care system, that\u2019s not the answer.<\/p>\n\n\n\n Be well,<\/p>\n\n\n\n David Edelberg, MD <\/em><\/p>\n","protected":false},"excerpt":{"rendered":" I\u2019ve got to introduce you to this pen of mine, just a run-of-the-mill pen, but oh the story it has to tell. Understanding the power of my pen is a useful lesson in health care, and by the end of this two-part piece what you learn might make you healthier. No kidding.<\/p>\n But first, let\u2019s make you a little sick.<\/p>\n","protected":false},"author":2087,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2,67,203,3,51],"tags":[1265,1070],"class_list":["post-4030","post","type-post","status-publish","format-standard","hentry","category-blog","category-h","category-health-insurance-issues","category-knowledge-base","category-m","tag-health-care-dollars","tag-health-care-reform"],"yoast_head":"\r\n
To be honest, when I completed these calculations, I wasn\u2019t the least bit surprised that my pen was a conduit for $2.5 million a year. Lab tests, x rays, referrals, and emergency room visits day in and day out add up very quickly. An ER admission racks up thousands in a few hours. One hospitalization–let\u2019s say four days in a hospital for elective back surgery–could easily hit you with a bill for around $100,000. Suddenly, $2.5 million sounds like peanuts.<\/p>\n\n\n\n