thoughts at day three

We’ve had such a great time reading all the comments that have come through—many from family and friends, but an astonishing number from people we’ve never met. Thank you so much! Even though we’ve been confined more or less in this hospital room, we feel like Valor already has an amazing number of friends.

Occasionally, however, we receive comments from strangers which are less nice than others. Here is one that came in late last night on the thoughts at thirty-five post:

“So government, taxpayer-funded insurance was ok for your family when you needed it for James, but now that you guys don’t need it anymore it’s ‘too costly’ to offer that same care to everyone.

[expletive] typical.”

Yeah, not making this up, unfortunately.

Just to clarify, I believe health care needs reform. I don’t think I know anyone who believes otherwise. From my vantage point, health insurance needs to be divorced from employment, because the connection creates a catch-22 when employees lose their insurance when their healthcare needs result in them losing their job. It also creates an unfair situation for small businesses (including where I work) which cannot negotiate reasonable terms for small group policies. On the flip-side, without group policies, many individuals cannot pass the underwriting hurdle and wind up uninsurable. In summary, I see reducing or eliminating the number of uninsured is a big part of health care reform, along with reining in skyrocketing costs and preserving—if not increasing—the actual quality of care our country enjoys.

Believe me, if I knew all the answers, I’d write about it a lot more.

The House of Gjertsen does not tolerate vulgarity, which is the main reason I didn’t approve the comment. However, I see where the author is coming from, and I’m sensitive to that tension. In a way, it’s right at the heart of what makes health reform so difficult to implement. We want people to use common sense and make good lifestyle choices, as if they were paying for their consequences, but share risk in such a way that avoids the impossible financial burden that advanced care can create. As the commenter correctly observes, there are programs that the state uses to assist parents of medically fragile children, many of them need-based, but all of them publicly-funded. That does seem like the only socially-appropriate solution, and I hope that I, nor any other critic of ObamaCare, have implied that we should do away with such programs. But can we—or should we—apply the same paradigm of fully-subsidized government health care to the relatively healthy majority of the population?

I do know, as a student of economics, that if there is no intersection between the patient and the customer, there are insufficient controls on cost, and the customer almost always makes wasteful choices. In the context of unprecedented levels of federal debt, I don’t see it as economically sustainable that the government be the only “customer” concerning the health of 300 million Americans.

Anyway, here are a couple of anecdotes which I thought sort of magically tied together my earlier post about healthcare with what’s actually happened to us at the hospital.

Anecdote #1:

A half hour before I read that comment, my foot got caught under the rolling leg of a table in our hospital room, and I fell over, hitting the railing of the Murphy bed, my camera, and some other furniture as I fell. (Valor was safe in his bassinet on the other side of the room.) While I bruised various parts of my body in the fall, the most significant was my left foot, which was sprained near some of my toes.

Not a great thing to do, apparently, in a hospital for women & children. After telling the nursing station what happened and asking for a bag of ice, I was informed by two nurses with utmost sincerity that the hospital protocol was to be for me to go to the ORMC emergency room a few blocks away.

Really.

I was relieved when I finally got the ice and understood that their counsel, though serious, was not something they could make me do. I know a thing or two about foot sprains: ice, compression, elevation, possibly tape. And I know that going to wait in an emergency room at midnight instead of going to bed isn’t going to treat me any differently (I’ve been to an ER several years back after a soccer injury left me with a badly sprained ankle), but that it will, with my high-deductible insurance plan, probably cost $2000 out of pocket to have a doctor tell me to use ice, compression, elevation, and possibly tape. The benefit of being the patient and the consumer meant that common sense was brought to bear on the situation. The choice the hospital staff wanted me to make was clear, as was the fact that their policy was constructed with litigation in mind. I wonder if the government were paying all the bills whether I would have gone to the ER (and would I have had a choice? And would I still be there waiting to get service?) Isn’t tort reform an indispensable element of health care reform?

Anecdote #2:

Valor had a tough day yesterday, and did a lot more screaming. Some of it was probably related to his circumcision, and some of it probably related to having gas he couldn’t get out. But around 1:30 am, as I lay on the Murphy bed with ice on my foot, and Abby tried unsuccessfully to get Valor to sleep, we decided for the second night in a row that letting Valor go spend a few hours in the nursery with the professionals (and some people “his own age”) was a better option than trying to be heroes.

We slept pretty well.

Around 4:30, our nurse came in our room and explained to us that he had had a couple episodes of “dusky” color and that he had been put on monitors which meant he wasn’t going to come back in our room until the hospital pediatrician would see him in a couple hours.

When we did hear from the pediatrician, he was concerned because of our family history and wanted to continue to observe Valor today and possibly tonight if necessary. I was somewhat concerned that because of James, they would be more apt to slip into the mentality of over-testing, but after a really good consultation with the pediatrician, he seemed to have a very reasonable balance of caution and common sense. He was hopeful it was no more than an anomaly, and that if not, it wouldn’t require extraordinary measures to diagnose or treat. We thought it was an excellent example of a physician who was authentically putting the patient’s health in the right perspective, and not letting fear of liability drive him to over-test or over-prescribe.

I’ll leave it to the reader to figure out how these things factor into the ways health care needs fixing. Everyone is entitled to their opinion, and I believe as a country we’re having the right debate over how to improve a system that provides a higher level of care at a lower cost for more people. Our elected leaders would do better if they spent more time listening to their constituents (as opposed to steamrollering their own agenda), and the rest of us would do better to keep our rhetoric constructive. If you want to argue with me, I guarantee you that if you keep it expletive free and respectful, I’m happy to return the favor. That’s how we roll in the House of Gjertsen.

If the thoughts don’t make any sense, I’m a little sleep-deprived.

So, the bottom line as far as our hospital stay is it’s likely we’ll leave later today, but we’re still waiting for an obstetrician to sign off on releasing Abby. So far, Valor is doing great. And both Abby and I can still walk, though we’re not as ambulatory as we will eventually be. Thanks for being patient with the long post, even though I suspect a great many of you just scrolled down to get to: