Money and Medicine, revisited

Yesterday, PBS premiered a show called “Money and Medicine,” wherein two hospitals were studied (Ronald Reagan UCLA Medical Center in Los Angeles and Intermountain Medical Center in Salt Lake City) and compared according to their health spending and health outcomes. The film was not incriminating or condescending to either hospital; rather, these examples were used to drive home the point that spending more money on healthcare and spending more time in a hospital will not necessarily give you better health outcomes. Simple, direct, and effective treatments are the better options, where available.

Much of the hourlong presentation was dedicated to emphasizing that a lot of unnecessary treatment is given. There are oftentimes financial advantages for doctors to prescribe more treatments: in any case, the commonality of defensive medicine contributes to the amount of unnecessary procedures, but, in addition to that, doctors often get paid based on the number of procedures they perform. I took note of the following quote from the film: “There’s a disconnect between what we can do and what we can do that helps.” As mentioned in this documentary, America is in the mindset where we feel that we ALWAYS CAN GET MORE HEALTHCARE and that MORE HEALTHCARE IS ALWAYS BETTER. This may not be true in all cases. We do need to be rational in what type of healthcare we receive.

Now, I just said the word ‘rational’, not ‘rationing’. The film also mentioned that there’s a common myth that we have to ration in order to reduce. This is not true. We have to redesign the system; we don’t have to ration. And, as stated by a woman in the film, “It’s not rationing to get rid of something that’s bad for you.”

So, I’ve said plenty about our reasoning in healthcare. But how do we do any of this?

In my opinion, the first step is to find a doctor that you trust. If you’re a university student like me or are in some other circumstance where your location is not constant, this may prove difficult for a while; for those of you who are settled in one location, however, this is an important step. Find a doctor that you can trust, and get to know him/her. Your doctor will likely be your main source of advice and information regarding your medical treatments. If you don’t trust your doctor, you will probably have a very difficult time making tough decisions when they come up.

From there, you can begin to build your foundation of what you’d like to do regarding your health in a variety of circumstances. The adage “When the time for decision arrives, the time for preparation is past” seems to be especially true in the healthcare world. Especially if you are put into a circumstance where someone else has to make decisions on your behalf, it is important for you to have already decided what type of care you would like to receive and to what extent you want to receive it.

In the film, an example was given of a man whose mother was in the hospital for more than 10 months on life support. She was unable to communicate. This man said that his mother would have wanted every effort to be made in order to preserve her life. In the end, the man felt that the decision had been made for him to take his mother off life support and thereby end her life; in his opinion, it was “euthanasia.” It can be difficult to have empathy for the people who are facing this dilemma. However, as one who has had a relative in a similar situation, I can understand the gravity of a decision like that. It is extremely difficult to make a decision to end someone’s life, and when it’s someone you love and you don’t know exactly what they would have wanted, it only increases the difficulty. When we sort out the details of what we would want in an incapacitated situation, we are making things easier for ourselves and for those close to us.

What I took away from this film was mainly that we should be aware and educated about the treatments we agree to receive, and we should be prepared for a vast array of situations so that when those come about, our wishes will be known and that process won’t be any more difficult than it already has to be.