Tuesday, September 11, 2007

SOHC 13: from the Corner

Personal anecdote time:

Having just undergone prostate surgery and a somewhat-problematic recovery, I’d like to share a couple of personal reflections about the state of health care reform.

First, it is evident to me that the consumer-driven health care movement is starting to take hold. I’ve never been much of health-care consumer myself – the last time I had surgery was nearly 20 years ago, to stitch together my broken arm after a bizarre newspaper-delivery accident – but I was married to a diabetic with numerous medical complications and spent many years in and out of doctor’s offices and hospital rooms. Things have clearly changed. For the first time, I was actually presented up-front with the price of a procedure, and informed of alternative treatments with different prices and prognoses. Also for the first time, I did not have to explain what a health-savings account was to a medical provider. That’s progress.

Second, I was glad that I lived in the United States and not Canada when, having just come home from the hospital, I read a CBC piece about the severe shortage of urologists in the medical paradise to our north. The waiting time for urology patients in some parts of Canada is now almost a year. For those afflicted with prostate cancer or other serious ailments, such a wait isn’t just an imposition – it’s a prescription for severe pain or worse. In my case, I had my choice of skilled surgeons, a choice informed by word-of-mouth and my personal physician’s advice. And the earliest surgery times available were just a few weeks from the decision date.

In addition, I had no doubt that the urologists in my region (Raleigh-Durham, NC) were up on the latest discoveries and surgical techniques, whereas in single-payer countries the resources devoted to innovation and research are woefully inadequate. They can rely on American ingenuity to some extent, but I prefer to tap my expertise at the source.

Now a complaint: there were still way too many paper forms to fill out and redundant medical questions to answer from multiple docs and nurses. To some extent, I am told, there is a value to redundancy. Patients don’t always remember their histories accurately, or even honestly, so multiple prompts can elicit critical information. But still, we remain a long way from capturing and sharing medical information as well as we do other consumer information. No matter which oil-change location I go to, the mechanics can quickly call up the previous-service record for my car. Let's get on with it.

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