:: to the teeth ::    thoughts on social justice, medicine, race, hope and beats

"Another world is not only possible, she is on her way.
On a quiet day, I can hear her breathing." :: Arundhati Roy ::

"The most common way people give up their power is by thinking they don't have any." :: Alice Walker ::
Wednesday, November 10, 2004  

Clinic Update and Case Study of Insane Healthcare Costs

last weekend i sweated it out with some construction workers who volunteered their saturday to build a wheelchair ramp. they rocked, quality work. my health justice team had adviocated fiercely for one of the men who has a serious eye problem (cataract and glaucoma) secondary to an injury in his home months prior. he was told by ophtho that he needs a surgery but when he didn't qualify for financial aid and they realized he is undocumented, they completely changed their medical plan and stated that he no longer needed a surgery. it's all doucmented in his chart. we actually got him a second opinion that concured with the need for surgery. we were ultimately unsuccessful and this man, decided not to pursue legal means of obtaining his necessary eye surgery at our public hospital secondary to fear of deportation. he would rather lose sight in one eye than push against a discriminatory system that might try to harm him even more. asi es la vida en un pais que existe por violencia de la inicia.

i gotta also put out a special thanks to the Melendez fmaily for donating all the cement for the project. we've had all kinds of people donating time, materials, supplies, ideas...

a group from the peace and justice center have been tiling the bedroom with beautiful saltillos as we convert that space into a consult room. a physical therapist with seriuos construction skills helped rip out the front door to widen it for wheelchair access. a massage therapist friend raised over $1200 and a bunch of supplies from her clients. all that money is tagged to go towards the purchase of an ultrasound machine.

check out this... an ultrasound exam costs minimum $350. a decent new machine costs $10,000. used refurbished much less. for the cost of 25 exams you can buy yourself a machine at that cost... we're going to get our own machine, hire an expert technician who can work part-time (starting one day per week) and be able to charge $50 with a slide and still mae enough to pay for the service with some lunch money left over.

the pricing system in the US is sick. delusional at best, psychotic and belligerently exaggerated at worst, sending too many families into bankruptcy.

here's a case study to consider:

i got a call from a man, uninsured, at 4pm, with a bad infection in his left arm. we met at my clinic and it was clear immediately that he had a raging lymphangitis from an infected wound on his left thumb. he had smashed his finger four days prior, is a construction worker, and wasn't able to really take care of it. at 4 o'clock in albuquerque, this man, being uninsured, has a few options. that's if he's taken five years to study the system and is aware of all his options. likely all he knows is that he can go to the ER. but for arguments sake, let's say he has studied the system. his cheapest option is to go to a place called Clini-Med. it's a private clinic that charges $52 for the visit. it's run by nurse practitioners and they likely would have sent him to the ER with this infection. within the safety-net system (the federally qualified clinics, also called sliding scale clinics) there are no after-hours available so he could wait another day and try to get in the next day. this would cost him roughly $50 including the medicine (a shot of ceftriaxone). if he was savvy and realized the difference between urgent care and ER, he could go to the private urgent cares in town (lovelace and presbyterian) and get out of there for $150 plus the cost of the medicine. likely he would have gone to UNMH, our states only public hospital. they would have triaged him into the ER for a bill of roughly $400 + the cost of the medicine. probably he would have been treated with followup to the ER the next day for another $400 with a small chance of being admitted overnight or in OBS for another $500. even if our public hospital had sent him to the urgent care that is right next door to the er, guess what it would have reduced the price by... ZERO. our urgent care has the same pricing as the ER. don't ask me why unless you want me to go off for 1/2 hour about the insanity of certain administrators who follow a tortuous legal logic to justify this.

from my perspective, a $25 charge for the visit and the cost of the antibiotic was appropriate. he got a shot of ceftriaxone in the butt by me and returned the next day vastly improved. i gave him one more shot in the butt and then started him on PO meds with full recovery in a few days. his total cost was roughly $45 and the dude is back at work being a productive non-citizen helping us all live better lives thru indentured servitude.


you gotta lova America. it's where it's all happening.


posted by andru | 11/10/2004 11:29:00 PM | |


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