Reform School

This is a story about my balls. Not the typical story. You can get that from any number of highly satisfied co-eds and Swedish au pairs. This story is how Health Care Reform^TM is like my nut sack: big, hairy, and when you play with it you end up with a mess on your hands.

Now, I'm a man of a certain age, and, in the way of things that come to men of a certain age, I noticed a suspicious bulge in the groinal area. I'm no stranger to a bulge down there, let me tell you, but this was a bulge where it didn't belong. Since my health insurance is good I bundled myself off to that sadist posing as my general practitioner to sort out the problem. In response this highly trained medico told me to unbutton my pants and then produced a rubber glove and an index finger. He subsequently shoved said index finger up my scrotum and told me to bear down as if I was taking a crap. He repeated the routine on the other side and, with a kind of wizardly knowledge, like that of children's literature's favorite pederast Dumbledore, pronounced the diagnosis: double inguinal hernia. Essentially my guts had escaped their home. The doc's recommendation was surgery, laparoscopic, and the sooner the better. Although I wasn't feeling any constant pain and could probably survive several years without the procedure, if things suddenly went south it could be very bad and expensive indeed. So off he goes and a few minutes later in waddled the nurse and lo and behold I had an appointment with a surgeon.

I didn't get to be a top notch exposer of scams in the Intertubes without a healthy dose of skepticism, so I immediately went to the office and shook the Google tree. Interestingly, there were almost zero crackpot alternatives to surgery. Usually Google has no problem serving up all kinds of wackiness when it comes to medical treatment but this time the sources seemed to agree. “Get thee to a knife,” was the order of the day. So what kind of surgeon had I been booked to see? Well, after a few more shakes, it turned out that in the latest attempt to do me bodily harm, my doctor had arranged for me to be operated on by some frat boy just 3 years out of his residency. Since the only difference between a surgeon and a mugger is that the surgeon will stab you and take your money, I decided that maybe I wanted someone with a little more experience controlling his delirium tremens shoving cold stainless in my gut. I chose somebody else in the practice and scheduled another appointment. Once again it was off with the pants, on with the glove and another finger in my junk. At least this time there was a hot physician's assistant trainee with him. “Yep, gotta cut ya!” was the verdict.

[inset pos=right]So 20 large for a condition detected with a couple of fingers jammed amusingly up my package.[/inset]When your mechanic tells you that you need to have work done on your car, or when you decide that maybe your 105 inch LCD T.V. isn't going to care for a steady drip of water from a leaky roof, you try to get an estimate of what the repair will cost. In those cases it's a complete doddle. “How much?” you ask, and bing bang boom, here comes a number. Usually a wildly inaccurate number, but a number nonetheless. Try doing that with surgery. After being put on indefinite hold several times a day, you decide that maybe it'll just be easier to sharpen your Henckel chef's knife and go at it yourself. Nobody, it seems, has an interest in talking about real dollars. Or even imaginary dollars. Keep that in mind because it's a problem we'll talk about later. Also keep in mind that all of this was based on a medical diagnosis arrived at with finger probes: no MRI, no ultrasound, no X-Rays scrambling my boys. Just two different frat guys poking my meat and veg without even buying me dinner and a movie, or paying my usual fee. Definitely not confidence inspiring.

Some of the People

So ultimately I get all the slice and dice done, emerging as a cyborg with some nifty plastic mesh keeping my intestines safely at home. The time has come for the reckoning. Like any good consumer, and skeptic, I ask for detailed bills to make sure I, or rather my insurance company aren't being charged for things not done. For example the surgery was conducted as outpatient, in and out the same day so I'm looking to make sure I'm not being charged for an overnight stay. The detail shows that the whole shebang was a little over 25,000 smackers. Of course that includes the knife and the gas passer who billed separately from the hospital, the hospital itself accounted for $20,000. So 20 large for a procedure to correct a condition detected not with advanced medical scanning devices but with a couple of fingers jammed amusingly up my package. Definitely a WTF kind of moment.

Of course I didn't pay anywhere near 20 large and that's the key to Health Care Reform^TM. Neither did my insurance company, and that's another key to Health Care Reform^TM. The bill was cut automatically in half due to a discount the insurer had negotiated with the hospital. So the question that our elected representatives or so-called journalists can't bring themselves to ask is “how is this possible.” Either there's a huge markup in these services, or the hospital is performing a majority of surgical procedures at a loss and nobody seems to know which. When we talk about containing “the outrageous cost of health care,” we don't even know what we're talking about. You would think somebody in charge, say Congressional Democrats, would want to haul a bunch of folks up to the Hill and slap them under oath to talk about this. Not in any acrimonious sort of way, as fun as that would be, but just as some basic fact finding. The exchange would go kinda like this.¹

Random Senator: Mister hospital administrator, I have two constituents, frat boys touched their junk and diagnosed inguinal hernias. Each charged was charged 20,000. Is that what you charge?

Hospital Administrator: Yes Senator.

Random Other Senator: I understand that this condition is diagnosed solely by frat boys touching junk.

HA: That is correct Senator.

ROS: And how much do these frat boys charge for touching junk?

HA: That's up to the doctor Senator.

ROS: Would they charge more for senators?

HA: Again that's up to the doctor Senator.

ROS: Would you touch my junk?
ROS: What about my dong?

ROS: My wang?

ROS: Please.

RS: That's enough Franken. Back to my constituents.

ROS: (interrupting): And their junk.

RS: Franken, I'm warning you. Now one of them is insured and the other is not. The insured constituent's insurer negotiated a discount of fifty percent. Was that procedure still profitable for the hospital?

ROS: And is there video of their junk on YouTube?

And of course from there, reform, and Al Franken getting his junk touched, would ensue because finally the people responsible for sorting out the cost of medical care would know what the actual cost of medical care is. We can talk about reasonable profits, or no profits. We can talk about costs related to malpractice. We can talk about the cost of diagnostic techniques more advanced than an index finger. Would an ultrasound and its cost have made me more comfortable with the idea of letting some grinning maniac come at me with a knife? Sure, but did I need it? Nope, everything went fine, no bulges, no problems, no need for my doctor to shrug sheepishly at the malpractice hearing and chant the universal medical mantra “Every case is different.”

So, although I'm not prone to giving uncompensated political advice, I'd like to see the President and his revolutionary cabal in Congress call a bunch of folks up and slap 'em under oath. I know it's going to be hard. I know that there are a lot of campaign dollars at stake. I know that it may be embarrassing for the medical establishment and Al Franken. I know that an embarrassed medical establishment can be more fun than a bunch of drunk GI's at Abu Ghraib if they should get their hands on you. If the intention, however, is to change things, and you're serious about it, then grow some stones and get the information you need from the people that have it. You have nothing to lose but your jobs, but if you're successful, at least you'll have your health, and touched junk.³

(1) This exchange is heavily edited. We sat down and wrote out the actual dialog with all the appropriate grandstanding and sound biting, spending months of real time and who knows how many intern-hours,² in the process. Then, because a certain corpulent editor felt that “If people wanted that much bullshit they'd watch CSPAN” we dumped all that work into the Spectra 5000 Political Language Discombulator. The Discombulator is a device that separates out all the political speech and gets down to the nub of a politician's utterings. Amazingly it actually spit something out. We're not sure how Al Franken's name came up because we didn't include any names in the original script, but the Discombulator knows what it's doing.

(2) A third less productive than your regular hours.

(3) If you're interested dear reader you can help. Drag yourself away from World of Warcraft long enough to send me an email expressing your support for Congressional hearings. Include your zip code, and I'll send it along to your elected representative. You can then get back to cyberspace and touching your own junk. You won't even have to leave your mom's basement.