There's always the option of self-diagnosing...

From yesterday's Dilbert (click on the cartoon for an enlarged, easier-to-read view):

more Dilbert cartoons here.

"Medicine is a noble profession. You render it shameful."

...or "the tale of an unlucky appendix, at the hands of the daughters of charity, in the city of angels."

Robert Issai
President and CEO
Daughters of Charity Health System
26000 Altamont Rd.
Los Altos Hills, CA 94022-4317

Dear Mr. Issai:

I recently suffered from appendicitis, and was admitted to the emergency room at Saint Vincent Medical Center in Los Angeles on November 10 of last year. I underwent an appendectomy and was released from the hospital on the morning of November 12. I have no complaints about the quality of my care. My surgeon, Dr. Charles Hunter, was excellent, and with very few exceptions all of my encounters with hospital staff were as pleasant as they could be under the circumstances. But I received a profound and unpleasant shock shortly after returning home. The bill arrive, account number XXXX, if you're curious.

I was charged -- am being charged, I should say, as I have not yet paid -- $15,833 for the care I received during the 40-odd hours I spent at Saint Vincent. I then received additional bills from the surgeon, the anesthesiologist, and the emergency room physician for their respective services. (The latter is asking for more than $800 for the approximately three minutes he spent at my side.) I am a freelance journalist, and I am fortunate enough to have health insurance at the moment. Blue Cross covered $12463 of your bill. But $3370 is still a considerable sum of money, so I telephoned the billing office and asked for an itemized account of the charges.

I hardly know where to begin. Perhaps with the $21 I was charged for each of ten 10 ml saline IV flushes. I do not know the going rate for a 500 ml bottle of saline solution at CVS, but considerably less than $105, I am sure. I was charged $80 for each of three 50 cc doses of .9% sodium chloride, a few spoonfuls of table salt, and $154 for each of twelve one-liter bags of sugar water. For my pajama pants -- of such flimsiness that I would be hard-pressed to find their equivalent at a 99-cent store -- I was charged $35. Given such absurdities, it seems hardly worth mentioning that I was charged $982 for an hour and three quarters spent unconscious on a gurney in the Recovery Room and $1768 for each night of room and board. Rents are high in Los Angeles I know, but that is nothing less than an outrage.

A few weeks later, I was doing a little research to find out where to send a friend who had broken her ankle in New Mexico and needed surgery in Los Angeles. One of your own orthopedic surgeons advised me to use another hospital. "Saint Vincent is notorious for overcharging its patients," he said. This was not news to me. Another example: my friend was charged $1.05 for a 2 ml dosage of fentanyl at the ER in Albuquerque. At Saint Vincent I was charged $71 for a 250 mcg injection of the same. Assuming a standard 50 mcg/ml concentration, you overcharged me by a factor of approximately 28. I can only congratulate you for your chutzpah.

Mr. Issei, if you were in any other line of work, no one would hesitate to call you a thief. I understand the complexities of our healthcare system better than most do, but this is inexcusable, and all the more so in an institution that masks itself with the gospel of charity. Medicine is a noble profession. You render it shameful. I am sure you have better insurance than I do. I wish you good health, and poor sleep.

Yours sincerely,

Ben Ehrenreich

Source: "Medical Larceny" by Barbara Ehrenreich, in the Huffington Post

Mr. Ehrenreich is author Barbara Ehrenreich's son. She says this about the issue:

The odd thing is that many politicians and pundits believe that the only way to control health costs is to get consumers to limit their consumption of health care - as if an appendectomy, for example, was a kind of self-indulgence. In my son's case, we have someone who is vividly aware of his health care costs, if only because he bears so much of them. His letter is not only an individual complaint but an act of good citizenship. We all need to be prepared to blow the whistle on medical larceny.

There are some interesting comments and perspectives written by readers of the post, at the link above. Imagine what kind of discourse and building and action could grow from folks around the country sharing these stories? What's your story?

(cross-posted at Los Anjalis)

-anjali

An unfinished poem... I don't know if I will ever finish it, so here it is. Not sure if it works or flows.

Sri

On AIDS in Tanzania

Something as simple as a pill in the palm of her hand

This Tanzanian woman

Sings as she breast feeds

They say it was the rain

But it was always my tears and sweat

Which brought up the maize

They said the railroads

Will bring a new day

But it was always diamonds going

with the sunset

The other way

----------------

And now she dies and is dying

-------------------

Something as simple as a pill in the palm of her hand

This Tanzanian woman

Brilliant orange head wrap

Red African mud between her toes

Any pill

Anything close to healing

She does not hold in the palm of her hand.

-----------------------

her left breast sags in

the sun.

ribs exposed

continuum with the spine of her too large wooden chair

she resembles the chair

both of them frail

twigs

ready to snap

-------------------------

a pill

something as simple as a pill in the palm of her hand

her hands scathed

rough as maize husk

she dies and is dying

her 5 month old

baby boy born at dawn

suckles at her dry left breast

he suckles ashes from her left breast

--------------------------------------------

something as simple as a pill in the palm of her hand

Who owns this pill?

What plant or human genome extract gave birth to it?

Who cut the compound, packaged

into compact cure?

In which boardroom, what lawyers patented it?

Blue suits and leather suitcases

tucking death into the space between fine print

---------

Who keeps the cash?

Which markets rose while she fell?

Which corporate graph will track her demise?

Who will clench their fists one over the other as she opens her hand?

--------------------------

This Tanzanian woman

Her baby boy born at dawn

Who will began to ask for a moratorium on their death penalty?

Something as simple

as a pill in the palm of her hand

--------------------------

Who will join this standing up?

A reach to claim the pill

demand the pill

And place it in her hand

Something as simple

And good

As healing

A pill in the palm of her hand

Sri

2/9/07