My comments on the health care “system:”

            Not quite two weeks have passed since I had surgery to replace a severely arthritic left knee, a 20-year pain that not everyone can appreciate. It’s the first major surgery I’ve had in 13 years.

A lot of my phone callers have asked me, since I am politically active, to share my opinions on the status of the “health care system”—you know, because the President and Congress are scaring the whole country with their alleged proposals. You know, the 1,000-page bills that nobody reads?

I’m not going to mention any names about my providers, but I have plenty of opinions, too.

First, I have to compliment my surgeon—even though he’s just a high-paid carpenter with a computer. He’s a young guy, maybe 33, red-headed (I call him “Opie,” and I’m not sure he even knows the TV show I’m talking about). Beforehand, I had heard nothing but great things about the successful experiences of his patients. I like him so well, I’m going to have him do the right knee sometime this fall.

The hospital, however, was a big disappointment, at least the first couple of days. In general, it’s clear to me that “Cover Your Ass” is alive and well and living in our health care institutions. The nurses, physical therapists, CNAs, etc. kept me awake at all hours of the day and night doing things I thought didn’t need to be done.

I chose this hospital because I had witnessed extremely kind care for the widow of my high school football coach last April, as she was dying from cancer. My own experience was disappointing.

Why did I need to have blood drawn 3-4 times a day? And why was it necessary to take two vials at 3 a.m. every day? The whole hospital staff appeared to be “over-proceduralized,” and none of them were really listening to me, although their last comments were always something like “call me if I can do anything for you.”

The problem was, nobody was really “listening” to me.

The first night was horrible. The excruciating pain I expected from my left knee was, instead, coming from my right hip. It took Tony, a physical therapist I met the second day, to help me understand the position the surgeon had me in on the operating table.

To make matters worse, I had an inflatable bed that didn’t inflate—and I was expected to sleep on a steel frame rack. It took most of the second day before the staff finally figured out that I needed a new bed. My back and my butt were killing me; the knee felt a little stiff.

The doctors let my blood sugars get out of control, too, which irritates me severely, since I am a diabetic. They wanted me to come to the hospital with my sugar “a little higher than normal” for my surgery. Two hours before surgery, it was 133. The next day, it got to 266 and the third day, 286—just before they brought in another meal with five servings of carbohydrates.

That’s when I demanded to talk to the surgeon. I had heard all of the surgery-causes-stress-which-causes-blood-sugar-to-elevate that I wanted to hear. My surgeon finally agreed to consult with an internist, which was an admission to me that he didn’t know much about diabetes and old people. The last two days I was there, we were able to get back to the low 100s.

As a diabetic, my mind went back to an 18-day hospital stay in 1996 in which my blood sugars ran wild. I came out of that experience with moderate neuropathy in both feet—and shooting insulin for the first time.

The first physical therapists I saw last week rigged up this awkward device on top of a walker “to take advantage of” the strength in my left biceps in my crippled left arm—although I told them the whole while that I didn’t need the damn thing. The thing looked like a Martian signaling station and was no easier to use than the “plain Jane” walker that my mother had 15 years ago (which I had brought to the hospital to use).

The next lady came in to “sell” me on “devices” to help me get up out of the bed. She was a sweet enough person, even attractive, but she wouldn’t take “no” for an answer, even though that’s all she got from me. Finally, I convinced her to let me call her if I needed such devices. I didn’t see or talk to her again.

In short, between the hospital administration and the doctors, the nurses and other staff were kept busy doing things that didn’t appear to matter…except in the all-important category of CYA, or let’s-not-give-anyone-any-reason-to-sue-us. Let’s test, then test again, then test some more.

On top of that, the insurance claim was screwed up regarding the home health care after I came home. “Someone” at the hospital told the insurance company that my home health care provider was “out-of-network”—after telling me before I left the hospital that it was “in” the network.

I also had this non-stretch (seemingly) stocking I had to wear on the leg that wasn’t operated on. Taking this thing on and off was pure torture as the nurse’s knuckles dug into the thin flesh of my lower leg. I don’t believe our government would allow this to be done to the prisoners at Guantonamo Bay.

Besides that were these little air-puff-every-15-seconds booties on both feet. Sleep, nay, rest, was impossible. Both the booties and the iron stocking were supposed to make blood clots in my legs far less likely, even though they were also giving me blood thinners. 

Finally, this nice gentleman from “administration” came by to ask me about the “quality of my experience.” Boy, was he right on time? I plan to mail him a copy of this missive.

Speaking of medications, “something” I’m taking—pain medication, iron, blood thinner or antibiotic—makes me extremely light-headed occasionally, and I have fallen twice in the first 10 days at home. I actually passed out sitting on my new toilet and fell forward onto my new ceramic tile floor, bleeding all over everything from my head and from the incision on my knee.

So much, so far, for the “quality” of my “experience.” Still, my knee is actually doing better than most patients’ experience, if I can avoid banging it again in these stupid falls.

What does this have to do with the debate raging nationally about what Congress ought to do about health care? I hope to recover in spite of my experiences, and I gained perspective on the national debate.

Like most good moderate-to-conservative folks in this country, I don’t want anything to do with any kind of government-run health care system. I just can’t see any way that such a system would work for most Americans, because there is no motive for bureaucrats to achieve efficiency or effectiveness. Medicare and Medicaid are proof enough, if you care to check into it.

However, I do believe changes are coming, and certainly, some changes are needed. I don’t think Mr. Obama and I are thinking about the same changes, though.

One of the main problems is, the person who pays the bill is NOT the same person who received the medical care. In the ‘50s, I accidentally dropped an axe on my big toe, and my dad ran me up to old Doc Leonard’s office. The Doc had no nurse and no receptionist, and he did blood and urine analyses himself. After eight stitches, I remember my dad pulling out a $10 bill to pay him. We need to approach that kind of simplicity again.

First of all, as an insurance agent who offers several health care plans to clients, I believe the focus of the congressional plan that will be successful at year-end will be on reforming the insurance industry first. There is, after all, this idea that insurance companies are getting rich on the misery of everyone’s personal health care crises.

“Pre-existing conditions” need to be covered immediately when someone takes out a new health insurance policy. Rules on portability need to be relaxed, too. Under any plans, patients and doctors need to make all the health care decisions, not the insurance claim departments. A wide range of patient choice should be allowed, too. Uniformity of regulation throughout the industry should keep it competitive.

But I also believe you need to include at least two other “industries” in any “health care reform” effort—sue-happy lawyers and the pharmaceutical industry.

Both lawyers and pharmaceutical companies can still get plenty rich, even if the Congress enacts “tort reform” as well as limits on U.S. pharmaceutical profits. Together, these industries can account for hundreds of billions of dollars in savings each year.

For instance, there is a medication I’ve taken for 10 years at about $8 per dose. Two years ago, I started getting the same exact generic formula for 46 cents a dose from a Canadian pharmacy. The drug is manufactured in India. That’s less than 5% of what I had been paying—out-of-whack by a whole lot.

Regarding the lawyers, just how many John Edwards’s do we really need?

Tort reform will still provide hundreds of thousands of dollars to each patient wronged by a doctor, hospital or other medical staff. In extreme cases, millions may still be appropriate. In a world in which awards are tightly controlled, though, malpractice insurance premiums can be scaled back drastically—saving money at every step along the way.

Without going to a town hall meeting and shouting, my opinion is, control costs by limiting unnecessarily big payouts to insurance companies, lawyers and pharmaceutical companies. Leave choices and decisions to patients and doctors. In the end, I believe cooler heads will prevail in Congress, and the final health care reform package will deal with all of these.