Worried about what's happening to medical care? Part one in a series.
I am out in the Chicago suburbs with some of my New Criterion colleagues to talk about our thirtieth anniversary season and the desirability of assuring that the magazine has the wherewithal to make it to 35. (You, too, can help: click here to see how!) Last night, before NRO's Andy McCarthy and I spoke to a terrific group of people that our hosts had invited to learn about Thew New Criterion, I was chatting with a young emergency room doctor about his experiences at the local hospital. His father, also a doctor, prodded him to tell us about a lady that had shown up at the ER about midnight recently demanding a pregnancy test.
Take a moment to ponder that. Why would you 1) go to the ER at any time of day for a pregnancy test? Isn't that why God made Walgreens/Rite Aid/CVS? Isn't that why the land is awash in gynecologists? And 2) why would you go to the ER at midnight to conduct any such routine test?
These are deep waters and I don't pretend to have the answers. But if you want a good example of one thing that is very wrong with the way medical care is delivered in America today, attend to what happened next. My friend the ER doctor digested the woman's request and then pointed out the "ER" stood for "Emergency Room," i.e., it was a hospital facility designed for the treatment of acute medical emergencies, not routine inquiries. He refused to order the test and directed her instead to a local pharmacy which, for an extremely modest consideration, would be pleased to furnish her with a pregnancy test kit.
"Yes, but it's free here," came the reply. The woman had a Medicaid card, you see, so the ER charge would be paid not by her but by, well, by you and me, i.e., the tax-paying chumps of this great republic.
My friend, since he is not insane, told the woman that this was preposterous and pointed out that "Exit" was Latin for "get lost," which he suggested she promptly do.
Well, she toddled away briefly but then came back complaining of stomach pains.
"When did you start having stomach pains," the Doc asked, not unreasonably. "When you told me you wouldn't order the pregnancy test," replied the deadbeat.
Now, I'd wager, just as you would, that those stomach pains were entirely imaginary or, not to put too fine a point on it, that the woman was lying through her teeth, assuming she still had some. But her's the rub. Stomach pains are a possible symptom of an ectopic pregnancy and my friend, though he knew with 99.99999% certainly that the woman was full of merde, was duty bound to perform the following:
1. A pregnancy test.
2. An ultrasound test.
3. Various blood tests.
Cost to you, the taxpayer: About $4000.
Cost to the deadbeat: $0.
But wait: we had a hard time getting this story out of my friend. His father had to keep prodding him for the details. Why? "It happens all the time," he said wearily. "At least once a week someone comes in asking for something like this. Often it's for painkillers or other drugs. They take the train in from Chicago and come to the ER at all hours. They're all on Medicaid so it doesn't cost them a cent."
Want to fix American health care? The first step is to abolish Medicaid and replace it with a more rational system to help the truly needy and exclude the moochers and deadbeats.