Tuesday, March 23, 2010

The Scariest Thing About American Health Care

Last night I heard a story about a 57-year-old man who was visiting a relative at a local hospital and unfortunately had a heart attack while he was there. It happened around 11:00 PM while he was standing on the sidewalk just outside the door of the emergency room. Of course no one wants to have a heart attack, but if you're going to have one, this is probably one of the better places you could choose.

Or maybe not. When an employee discovered the man passed out in the bushes on her way in to work, she called the emergency room, identified herself, and asked for someone to bring out a wheelchair (she didn't try to move him herself because it's against hospital policy). After the receptionist lazily asked questions for several minutes (from 30 feet away) in order to assure herself that it wasn't a hoax, the employee was finally allowed in. There followed still more questions, an eventual call to the night watchman, and some confused haggling over who should find and haul out the wheelchair. After more than ten minutes, the ER staff at last made their weary way outside to pick up the patient...who was now dead.

Since I only heard this story because I know someone who was there, I have to wonder how often things like this happen. It reminded me of the excellent article "How American Health Care Killed My Father," in which the author, David Goldhill, talks about some of the built-in disincentives to excellence that exist in our health care industry. But as I talked to my friend who saw the whole thing, I also thought about another factor that's much simpler and more disturbing, at least for me. The whole half-assed endeavor was really just another example of the ubiquitous phenomenon that I've called post-modern capitalism--an economy based on goods (or services, in this case) that are designed for appearance rather than function. No doubt the hospital staff went home in the morning with their McGriddles and coffee feeling that they'd done their jobs. A life may not have been saved, but they had in fact staffed a hospital. What more do you want?

For me then, the scariest thing about American health care is that it's run by us Americans--the same people who run the DMV, the cable company, the fast food chain, and every other establishment where the employees treat you like a menace to their God-given sense of entitlement. Despite all the ideological battles over the merits of private vs. public enterprise, this is one thing they will always have in common. Some blame the government for our faults, some blame the capitalists, and some blame a lack of religious faith. I don't know all the answers. Everyone's probably right to some extent. The question is, how do you reform a system in which we all seem trained to think like cattle, going from the milker to the pasture and back again, with no sense of purpose and no concern for anything that may fall in our way?

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