So I made it all the way to age 62 without having to spend a night in a hospital. (Unless you count the day I was born.)
But a week ago last Tuesday, I staggered into an emergency room and said, “I’m having some pretty bad chest pains.” (They let me save the paperwork for later.)
As I told the folks there, I had a clean nuclear stress test about five years ago. (That’s where they put something radioactive in your blood, take a picture of your heart, have you walk on a treadmill for a while and, if you don’t turn into Spider-Man, take another picture.)
And there is little history of heart problems in my family. (We generally die of other things.)
The first round of blood tests, a chest X-ray, even a CT scan, also pointed to something other than a heart attack. But they could see that the pain beneath my sternum had been turned up to 11, so something was wrong.
Soon they started using a word I had never heard before. Pericarditis.
Your heart sits in a membrane called a pericardium. So does mine. What made mine special, though, is that it had become seriously inflamed. Probably because of some otherwise unremarkable viral infection, though there are other things that can bring it on. Including a heart attack.
And it is also possible that, even when the heart wasn’t the problem to begin with, an inflamed pericardium squishing your ticker and interfering with your breathing can lead to some serious stuff.
So, as we Monty Python aficionados all know, it was time to bring in The Machine That Goes Ping. And The Most Expensive Machine in the Hospital.
And no questions from me or anyone in my family. No comparison shopping. No kicking the tires or Google searches or Facebook recommendations or ratings from Consumer Reports.
I am not telling you which hospital this was, though I thought the care I got was top-rate. But, in case I get something wrong in describing what happened, I’d rather not expose the facility to any unfounded ridicule.
One clue. It is the closest hospital to my house. When you think you might be dying, you don’t stop to wonder if the other hospital will provide better care, charge less money, have better food or more TV channels. You just get there.
The doctors in charge said I needed a CT scan, an echocardiogram, a nuclear stress test, an EKG, two chest X-rays, lots of my blood in test tubes and a constant flow of telemetry from my arm, chest and fingers. So that’s what we did.
Some might call that defensive medicine, the practice of over-testing a patient just because the hospital or the doctors fear that if they overlook one tiny little thing they will get sued. Maybe. Or maybe the reason they would get sued is because they did overlook one tiny little thing and I died.
Test on, McDuff.
The only consumer-oriented thought in my head was, “Is this hospital a member of my health insurance plan?” Which, I happened to know, it was.
I don’t even want to think about what might have been running through my mind if I didn’t have health insurance.
Now the insurance provider and the health care provider can fight over how much money the former should provide the latter, and I will wait to see what my share is and probably get chest pains again.
When I am more myself, I might contest one or another line item on the bill. But, unless I see a charge for a service the hospital just didn’t provide, I do not consider myself qualified to second-guess the health care professionals who were on the case and following what were, I trust, well-established best practices.
Given the utter foolishness expressed by members of Congress and of various state legislatures when discussing everything from climate change to ectopic pregnancies, I would far rather these decisions be made by doctors than by politicians. Not that I’d be opposed to some bureaucrats, who hold M.D. degrees, overseeing a quality and efficiency process.
And, as Rep. Ben McAdams tells the story about what Salt Lake County did when he was mayor, there are some ways patients can affect both costs and outcomes in ways that are not just around the margins. Like when we all should have asked if we really needed those expensive and addictive opioids or whether some cheap and non-murderous ibuprofen wouldn’t have worked just as well.
Overall, though, this closes the deal for me. Health care is not a commodity that even relatively well-read people can intelligently shop for. Price signals and other free-market stuff just do not work. You can’t choose and, boy howdy, you can’t walk away.
Medicare for All, I’m all yours.
George Pyle, editorial page editor of The Salt Lake Tribune, worked for billionaire investor Warren Buffett for four years, never met him, but remembers his advice, “If you don’t know jewelry, know your jeweler.”