Cost and Medical Care

Last month we performed a minor surgical procedure on a young lady. To save the patient money, she was admitted on the morning of surgery, kept overnight, and discharged the next day within twenty-four hours of admission. The charge for the surgical procedure was $35.00. The hospital bill, which included the very minimal services required of laboratory, anesthesia, operating room, and recovery room, was $95.00. The patient was quite correct later when, relating her medical experience at the bridge table, she said: "I went to the doctor who said I needed this little operation done, and it cost me $130.00."

Thirty or forty years ago, and even today in areas where the general practitioner-surgeon holds sway, this procedure could have been done in any office or office-clinic for a total charge to the patient of $25.00. In this particular instance, however, the patient had been referred to Columbus by just such a general practitioner from a small nearby community to have the procedure done here, where specialized knowledge was available and facilities were better.

Whereas the medical profession (in layman language, "the doctors") has borne the load of criticism about charges, the responsibility for the high cost of modern medical care lies fundamentally with the general public and the complex pressures of the society we have created.

The public reads about, and wants, the best of medical care, seeks the latest drugs, demands the newest and finest equipment, and insists on maximum precautions and minimum risks. This insistent "only the best for me and spare no expense" attitude on the part of a spoiled populace overlies a sophisticated and cynical public awareness of recourse to lawsuit and malpractice charges if things do not turn out well.

The hospitals and hospital administrators are caught in the bind of the eight-hour, three-shift day and increased pay scales for nurses, technicians, aides, clerks, cooks, maintenance personnel and ordinary untrained labor. Also, on implied threat of lawsuits because this or that is not available, they must provide costly departments of specialized care, such as the recovery rooms and intensive care units, along with every new, expensive and fashionable piece of mechanical and electronic equipment as it is developed. The doctors, also aware of the growing malpractice dangers, have become cautious, and are less and less inclined to do ordinary minor procedures in offices or dispensaries where maximum facilities are not available. As a result, the costs of medical care skyrocket.

There is no relief in sight, and there is, and will be, no solution to the predicament except in the event of some generalized catastrophe or collapse of the present socio-economic system. The liberal-socialist dream of free government medicine for all provides no answer, in the grubby, affected terminology of the liberals, it will only "escalate" the difficulties by adding bungling bureaucracy and inefficiency to the problem, and further increase the cost of medical care. Someone will still have to pay for it, and someone, as always, will be the tax-burdened public.

Things are tough all over.

(c) The Bulletin of the Muscogee County (Georgia) Medical Society, "The Doctor's Lounge", Apr 1964, Vol. XI No.4, p.12

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