This piece was posted before. I am recycling it (with light editing) because it’s the most constructive thing I know how to do after the disaster of the so-called health care reform bill passed yesterday. The bill is utterly dishonest; the way it was passed threatens the existence of constitutional government in his country; it’s ruinous.
I know how detestable it is for older men to speak about their health. First, the odds that they are going to come out of all this alive are not good. Second, it’s true that many old geezers replace sexual pleasure with the joys of whining. I am not one of those. I have a legitimate, didactic reason to speak about my health, at least, briefly. It has to do indirectly with the underpinning of the on-going debate on and disgust with health care reform.
About five months ago, I started suffering from carpal tunnel syndrome. In a way, CTS is a happy illness. It’s the illness of writers who actually write. It come from spending too much time intensively using the keyboard. Yet, the pain was intense enough to wake me up at night. The neurologist prescribed Aleve. Then, at my insistence, he described the appropriate surgical intervention. It’s a routine operation; it does not require anesthesia; it works almost all the time. Having little patience, in my mind, I was immediately sold on the procedure.
Then, I started looking at cost. I am on one of the Bush-era, smart versions of Medicare. It’s one of the versions the bill passes by the House on 3/2110 will abolish. It’s designed to give me all that I need but not much more. It’s also intended to give me a little freedom of choice. I knew all this in an abstract way but I had not thought it through because, frankly, who does not have something more exciting to do than reading insurance companies fine print and wooden language? So, I was shocked that my share of the cost for this simple, small operation would come to almost $2,000. I put off the decision because putting of the decision rather than making lemonade, is often the most rational thing you can do when life serves you lemons.
On my next doctor visit, I listened for the first time to the issues of how much Aleve I can afford to take daily and also of how to use the brace, I had purchased distractedly. He said not to wear it only at night, as I had done, but as often as I could, day or night. Fast-forward three months. I still have not had the operation. I take three Aleve a day of the four the doctor allowed. (Because, after all, it’s my liver, not his. Plus, he doesn’t know all the things I did to the self-same liver years ago.) I wear a brace fifteen hours a day on the average. I purchased for $38 the snazzy black variety that makes me look vaguely dangerous instead of the most common flesh-pink old-lady kind. The black looks good against my tanned, muscular, hairy forearm. (If I say so myself.) I think of the brace as the brachial equivalent of a pirate’s eye-patch. The pain has not waken me for weeks. Most of the time, there is barely any pain although a tingle in the fingers remains. What pain there is is on the decline. Right now, I wouldn’t dream of having anyone cut deep into my hand to get to the offending nerve. I saved myself something like $2,000 and the nation several times this amount.
What’s important about this fairly boring story is what it does not say. I have not become a wiser person in the past few months. My propensity to think things through has not improved. My innate rationalism is pretty much where it was last year. I insist: I am not a better person. Instead, the structuring of my particular kind of health insurance gave me a good incentive to do nothing. While I was doing nothing, less obvious solutions than surgery had a chance to show their effectiveness. The problem solved itself to a sufficient extent. Resources were saved. Additional risks to my health were avoided.
Here is a fallacy you have to avoid when reading this story: Yes, in some other case, an operation might have proved necessary, or simply been the better option. But we are not reasoning on averages here. Evey dollar saved is a dollar saved, forever. It’s a dollar that can be spent on something someone really wants. Buying health services should obey the same rules as buying a suit, or a car. Ordinary prudence works well if you have reasons to use it. Most health insurance interposes itself between you and your good judgment, your reasons to use what ordinary prudence you possess. Health insurance makes you stupid and passive. Government health insurance is the worst of all in this respect. It rewards you for not thinking things through. It rewards the worst version of you (and me).