The state of health care …

… in this country is probably just one indicator of a much larger problem, namely that the cost of all kind of services is going up while their value is going down. I suspect that this is a mechanism for self-preservation in late-stage social systems. As the added value diminishes, the system inflates itself in a cancerous manner to create the appearance of value – until a catastrophic failure ends this process.

What happened today? My 2 year old daughter was diagnosed with an ear infection after she had complained about pain in her ear all day. Our pediatrician Dr. Vonnegut was kind enough to call in the prescription to the local pharmacy. When I got there 3 hours later to pick it up, there was nothing on record. Never make a trip like that without taking your cell phone! I did, so I had to return home empty-handed. My wife usually handles situations like this better than me, so I let her make a few phone calls, resulting in Dr. Vonnegut calling the pharmacy again.
So I made another trip to this desperate place. Again, the guy behind the counter did not know what I was talking about, but after 10 minutes of intense conversations with his colleagues he brightly announced that they had located a voice message and that they were about to call the pediatrician back. From that moment on, it only took about 30 minutes to have the prescription for Amoxicillin filled. It took four people about 1 hour of collaboration to make this happen, plus 2 trips to the pharmacy which is about 1 mile from my house.

I was a consumer of the Austrian health care system for 35 years. Back there, a prescription like this takes a single pharmacist about 30 seconds to fill. Since we travel to Austria a lot, and my kids have a tendency to acquire pneumonia, tonsillitis, and other unpleasant conditions while we are there, I have some idea of what health care services cost back home. Because hospitals in the US can’t figure out how to bill my health insurance for emergency room services and their invoices frequently end up in 0ur mail, I have some idea of what health care services cost here. The difference is about 1:10 – one order of magnitude.

Examples:

Off-hours ER visit at St. Anna Children’s hospital in Vienna, diagnosis and prescription	€35
Pediatrician house call, diagnosis and referral for an X-Ray	€30
Chest X-Ray at a radiological center, findings in writing and a letter to the pediatrician	€48

Needless to say that I did not try to get reimbursed from my insurance back in the US, since my co-payment would have been higher than what we actually paid for the service.

I don’t think a hospital around here provides any services that cost less than $200. When a kidney stone tortured me a couple of years ago and I went to Mass General hospital, they performed a CT scan and some lab work and I ended up with a bill for over $3000 in the mail. They must have had a staff of 50 doing paperwork for my case. No wonder this system is falling appart. The sad thing is – it would not take much to fix it. Just a little bit of common sense.