About a month ago I tangentially mentioned in a post that I had an incident of kidney stones requiring an ER visit. Since then I have been trying to improve my health despite the best efforts of the American Medical Complex to complicate that.
I am no stranger to the formation of kidney stones. This is my fourth bout with them. And yes, I do all I can to prevent them from occurring. I cut down on salt, avoid oxalate foods, and drink lots of water. But my body just loves to remind me that, as the old adage goes, man plans and god says ha!
I belong to Kaiser Permanente, the largest HMO organization in the country. I like the idea of an HMO. I like that it takes a simple concept, people are generally healthy and it’s good to keep them that way, and uses that idea as the basis for it’s coverage. I’ll put it in my own words: Be proactive not reactive.
Unfortunately despite my numerous times being told to (GROSS STUFF ALERT) pee in the same jar for 24 hours then give them a sample and the number of times I’ve gone into the lab for a spot test (I always feel like an Olympic athlete doing that), I still get those pesky conglomerations of calcium stuck in places where the sun don’t shine and cause a kind of pain that only a man would think was like giving birth and which women who have would say “oh please”. That’s when I have to go the extra 20 miles and get to the big hospital where the reactive doctors play.
And that is why I found myself in the emergency room last month. It’s also where one discovers the flip side of the HMO.
Because as good as Kaiser is at trying to keep you healthy they use the opportunity of your being unwell to trot out all the old American Medical Complex tricks to separate you from the money in your wallet. Oh and your sanity as well.
At the emergency room I had a doctor examine me, an X-Ray, a CT Scan, blood and urine workups, and was prescribed a few medications. Total cost with the medications was $275. Now depending on where you live that’s not a bad deal all said and done. I was also told that I would need to see a urologist for a more extensive exam. I fully expected that.
The next day I got a call from the urology department wanting to set up an appointment. I asked if it could be at the more local medical office and got a surprise when I was told the “exam” would be via phone. Well okay, COVID and all, I suppose this could be handled via telemedicine. A few days later I got an email from a urologist, we’ll call him Dr. Stone, who said he didn’t think there was anything to talk about until we waited a couple of weeks, did another CT Scan, and saw if the stones had moved. The ones in my kidney, not his family. That made sense to me so he set up another scan.
Click the button for more fun and adventures
Imagine my surprise when, two weeks later, I went for the second CT scan and was told that the scan all by itself would cost $325. How could that be, I asked the woman at the check in counter, when I had only paid $275 for an entire raft of services that included a CT scan just two weeks before? She shrugged her shoulders and said she just was there to check me in and take my payment.
By the time I got home there was an email waiting for me from the urologist as well as the results of the new scan. Five stones, a couple of them 6mm big same as the first scan had shown and they had had only minimal movement. A ureteroscopy was going to be necessary. That’s where the doctor (GROSS STUFF ALERT) navigates a tiny camera and laser into the kidney via a natural opening known well and good by all men.
I just saw all you guys cross your legs.
To be honest I was kind of expecting this. I had one done a few years ago and while it thankfully is a procedure that requires anesthesia, it’s fairly quick and the recovery is pretty swift. So I agreed to proceed. I figured Dr. Stone would want me to come into the office, but again he said it wasn’t necessary because you know, COVID. The surgery was set for September 7. I was told that because of, you know COVID, I would have to have a COVID test three days prior and then quarantine in my house until the day of the surgery. As would anyone else who lived with me. The wife (Cruella) was none too happy about that.
About a week later, two of the stones passed. That means they came out that natural opening known well and good by all men. The next day two more emerged the same way. With four out and possibly only one of the smallest stones still left I reached out to Dr. Stone to inquire if we really needed to proceed with the ureteroscopy. While happy to hear that four stones had passed he wanted me to have another scan to see if the last one was still there or if it had disintegrated and been, um, washed away.
That email came in at the same time I received one from the billing department of Kaiser. It informed me that the cost of the ureteroscopy would be $4500. The scream I let out upon reading that was greater than any cry of pain I had from the kidney stones. That price was more than double what I had paid the last time even though in the intervening period the price of my monthly premium had increased by nearly $200 a month and we had moved from high priced Silicon Valley to lower cost Sonoma.
But I went back for the third CT Scan, willing to pay another $325 in order to save $4500 and not put myself and my wife through a three day quarantine. The results of the scan showed the fifth Infinity Stone was still there, though it had moved to a position further along the outbound path. Dr. Stone emailed me that because there was still one stone left he wanted to go ahead with the procedure. That’s where I said I needed to think about it.
And here is where the American Medical Complex is at it’s worst. It’s now pretty obvious to me that rather than wait to see if the stones exited in a natural way, the immediate thought was let’s make some money off this. From my first email to Dr. Stone after the stones had passed his replies had become cover your ass messages warning of all the worst possible conclusions not having all the stones removed could engender. I was not a patient to him, how could I be since he’d never actually seen or even spoken to me. Rather I was a gold mine ready to be tapped and he the miner 49er ready to strike it rich.
Kaiser Permanente made a net profit of 2.2 billion dollars in 2020 down from 3.1 billion in 2019 cause you know COVID. Apparently they are attempting to regain the lost profit all in one fell swoop.
This notion that medicine is a for profit industry has been the American way as far back as colonial days. For profit serves the public well when it’s for the purposes of innovation and invention. When it comes though to heath care as a profit center our humanity becomes lost. Patients are people, not profit centers. Americans shouldn’t be going broke because they can’t afford to get sick. Medications that cost a dollar a pill to produce (including all the research and development) shouldn’t be sold to Americans for $25 per pill while Canadians pay $10. Invasive procedures shouldn’t be the first thought but rather the last line of defense. And the notion that a person with one kind of health insurance can pay one price and another a wildly exorbitant different price just because they have another insurance or no insurance at all as was shown recently in a New York Times article has got to end.
You want to call it Medicare For All, you want to call it Socialized Medicine, you want to call it Full Tilt Obamacare, I don’t care, but America can not sustain this insane method of health care. The only thing that gives me any hope is that all those knee jerk conservatives now fighting for breath through their COVID ventilators because you know freedumb man ™ might leave the hospital facing bankruptcy and thus join the rest of the civilized world in a call for change. Eh, who am I kidding.
By the way, if this subject is of interest to you take a listen to a podcast called AN ARM AND A LEG. It’s all about the costs of health care but done in a very entertaining and enlightening fashion.
Who else but the Stones to sing us out