Friday Rant: Over Spending on Health Care – Medical Risk vs. Legal Liability

When I was in primary school, back in the mid Twentieth Century, I recall our school nurse saying "If you're not bleeding or unconscious, it's back to class with you." These were also the days when physicians frequently answered the phone, listened carefully, asked questions and didn't hesitate to prescribe "two aspirins, a good night's sleep and call me in the morning." Those days, along with $5 doctor visits and polio, are long gone. But we can still all save a great deal on medical expenses by trusting our instincts and not dashing off for an office visit whenever something ails us.

The pendulum has swung so far in the opposite direction that we're constantly bombarded with ads that encourage us to ask our physicians -- or more likely physician assistants -- if we should be taking the latest pharma concoction invented to treat ailments that most of us will never have. Equally absurd is how dependent and needy we have become on expert advice rather than respecting our personal cumulative experience and knowledge.

A case in point: My wife tripped and fell yesterday morning on a rock covered by wet leaves during her morning walk. She stoically hobbled home on a twisted ankle that became increasingly painful while also contemplating a visit to the ER. I've had a few dozen similar injuries in my life and said "okay, I'll take you if you want, but the swelling is minimal without discoloration, and you're able to find a comfortable position. Why not take some anti-inflammatory ibuprofen and hold off for a while... not to mention that we just paid off a mid-summer ER visit for over $1K under our deductible health plan." Now granted, I'm cheap, but hopefully not insensitive. I made a nice lunch and dinner, replete with ice packs, and my wife's ankle is much improved 24 hours later.

The saddest aspect of this tale is that there was also a time when one might have received similar advice to mine from their primary care physician over the phone. Our litigious society not only renders such advice impossible today, it necessitates that medical care facilities perform or prescribe every diagnostic procedure available lest they be sued for neglect. Note: My $1K mid-summer ER bill would have been even higher had I not declined x-rays for a finger laceration. They wanted to see if the bone was fractured. Ridiculous.

Ironically, there have been recent news reports of polling studies performed in regions of high home foreclosure rates that indicate those hardest hit by the housing and job market collapse are also increasingly likely to become seriously ill and not seek timely treatment for anxiety induced ailments. But if you're fortunate enough to have medical insurance -- albeit, and likely, with high deductibles -- you can save yourself a great deal of money in the short term by being self-informed of critical symptoms, waiting out the lesser ones and asking every question you can think of when seeking treatment. If more people would follow suit (pun not intended), we might even see insurance premiums stabilize.

- William Busch

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