Last week in the mailbag I wrote about the absurdity of health care costs. At Outkick we have a ton of readers who are doctors because, in general, doctors tend not to be pussies. They work their asses off and have to put up with asshole patients all day long.
I respect that. It’s why I hope one day one of my kids will be a doctor. (Also so he can get me prescriptions for my syphilis without making me go to the doctor.)
Last night a doctor fired off this epic email that he agreed to let me post in full.
Basically, all of you suck.
And I think you’ll love this.
Angry doctor writes:
As an avid listener (on an ALMOST daily basis), and as someone who has 30 years experience as a physician and 20 years experience as an attorney, and an expert in American health policy, I feel I have to weigh in on your health care comments.
I will start by apologizing for not being able to catch your recent comments on the healthcare system live. I am only able to listen to your show from 5 am to 6 am during my morning commute to the ER where I work, and it’s an hour drive from my house when my shift starts at 6. Usually I will listen to the remainder of that morning’s show on the way home via podcast.
Yes, healthcare “costs too much” in this country. And yes, Americans have bizarre expectations when it comes to healthcare, and who should pay for it, and how much of it should be “consumed,” and how much is “enough.”
But comparing life expectancy and overall healthcare costs vis a vis the U.S. to other countries is completely useless. It is worse than comparing apples to oranges, it is in fact comparing apples to orangutans. Why?
Because Americans LOVE to consume healthcare, its just that we just don’t like to pay for it. I have worked in emergency rooms and hospitals for 30 years, and during that time I have seen a literal explosion in the numbers of people who use the ER for their own private 24/7 walk-in free clinic. I’ll be willing to bet that you and your family have been to an actual ER maybe what, 2-3 times in your whole life? I’m the same, and I’m a lot older than you. (I know about the whole bitten by a German Shepherd incident, BTW, I’ve stitched up folks with much worse)
Well, we have something called Medicaid in this country. It is 100% free for anyone who gets it. They can go to almost any doctor, they pay zero for medicine, zero for copay, zero for premiums, zero for hospital bills. They can and do go to ER anytime their kid has a runny nose. They can and do go for menstrual cramps. They can and do go for a bug bite. They can and do go for a work excuse. All of it paid for by taxpayer dollars. And we just expanded the number of people on it by tens of millions. Now truly indigent people do need assistance with health coverage, and it is noble and appropriate for the government to try and help them, but do we really need for 75 MILLION PEOPLE IN THIS COUNTRY TO HAVE free healthcare, which is paid for by maybe 90 million others? (Assuming there are 215 million tax “returns” but less than half of those people are actually paying tax).
We are also a violent society. In every major (and even smaller) city and town, we have shootings, drive-bys, people stabbing each other, beating each other, and generally being assholes. We have people who get drunk and do stupid stuff and end up in the ER. We have people who are texting and wreck their cars and then end up in the ER. We have dumbasses who haul butt down the highway on their choppers with no helmets and then smash their brains out and expect the helicopter to come fly them to the trauma center. All that stuff costs BIG BIG money. Cuba might be a crappy third world little shithole, but they aren’t having drive bys every night. Sweden doesn’t really have a huge problem with teen pregnancy. Half the people in France are not on the verge of being morbidly obese.
And it’s not just folks with Medicaid, or folks gang-banging away with AK-47’s. It’s folks who have a 3mph fender-bender in the walmart parking lot, who aren’t hurt but need to call their lawyer first and then the ambulance has to bring them, fully packaged on a spine board and c-collar, to the ER, where they discover that 17 people got there before they did in the last 45 minuntes and none of them have a very serious complaint either. It’s also people who, even though their beloved grandma is 97 years old and has terminal cancer, have to call the ambulance so they can go to the ER with lights and siren and then have a $10,000 “Code Blue” which, in all likelihood, will be futile.
Cuba doesn’t have a lot of folks that it’s treating with HIV. Venezuela isn’t spending a lot of money on 1100 gram 24 week gestation meth/crack babies, whose mom is 13 years old. Finland doesn’t have lawyers on TV 24 hrs a day shilling for you to call if you ever took a blood thinner prescribed by your doctor, and it ACTUALLY THINNED your blood so now you want to sue. Japan doesn’t have 26 lawyers for every doctor in the country.
I visited England a few years ago. I went to a small town, about the size of my home town in the U.S. The ER that I visited had NO DOCTOR on call. It was staffed by a nurse. If your kid fell, cut his lip, the NURSE would put a stitch in it, or maybe just a band aid on it, and you would get some advil. Then you would go home and your kid would have a deformed lip for the rest of his life. No problem. It would give the other Brits something to look at besides their bad dentition.
But in the U.S., the same size town now has to have MULTIPLE PHYSICIANS staffing the ER 24/7, usually with the assistance of a score of nurses, and nurse practitioners. They might see 2000 patients IN A MONTH. It is their job to take care of you when you sprain your ankle at a softball game, and make sure that you have designated your pain level (mandated by the federal government) on a scale of 1-10 (surprise! everyone says “ten”), and you can get your $5000 MRI scan done before you leave with your bottle of advil and your ace bandage, and your referral to the sports-medicine orthopedic physician whose billboard is on the highway, oh, and your prescription for 40 OXYCONTIN.
In the U.S., try telling the mom of the kid who fell and cut his lip in two that a nurse will put a band aid on it. How many lawyers do you think would kill themselves trying to get that mom as a client? How many negative “Facebook” comments do you think that would glean? In the U.S., people DEMAND that a plastic surgeon be summoned in the middle of the night and fix their problem ASAP, and if they don’t, then there will be $ millions in lawsuits.
Now I did not say this is necessarily BAD, I just said it is the way that it is. It is all about expectations. You can live a long and generally healthy life, even if you are in Alabama or Cuba or France or Thailand, as long as you:
1) aren’t obese
2) don’t do drugs or smoke or drink to excess
3) don’t go around shooting at people (or have them shooting a you)
4) wear your condoms so you don’t get HIV
5) don’t get pregnant at 14 (and again at 15 and again at 16 and again at 18)
6) don’t text and drive, and wear your seat belt.
7) don’t put your 6 year old on an “ATV” and let him drive your 2 year old around w/out a helmet.
You do not need $ 1 million worth of healthcare for that. Just walk a lot. Stop eating all those macwhoppers. Stop smoking. GET YOUR DAMN VACCINATIONS. It’s amazing what a little preventive medicine can do, and for so little cost. It’s always more expensive to fix the problem than it is to prevent the problem in the first place. But in the U.S. we like to do bilateral knee replacements on people who are 75 and weigh 340lbs, at $65,000 a knee. It makes lots of $ for the hospital, and lots for the orthopedic doctors, but it ain’t free. Someone, SOMEWHERE is paying for it.
Now that all of that is out — Go Preds!”