My kids call it my 11th toe. I have what’s called a “tag” between my big and middle toes on my left foot. It’s about the size of a raisin. The doctor calls it "nothing to worry about." But it bugs me when I walk barefoot, and over the years it has grown. It's kinda' gross.
So I asked my physician to remove it, and he said that a dermatologist should take a look. She recommended a podiatrist. And I made a third appointment to see one.
------
I own a small business. We buy heath insurance. It’s our largest expense except payroll; more than we pay in rent, taxes, phones, internet, and office supplies, combined, and it gets more expensive each year. To hold costs down, we’ve raised deductibles and increased co-pays. So over the years, as our insurance premiums have climbed, the direct cost of health care to the family has also risen. I can estimate that combined annual health care costs during the last 11 years that I have owned the business have risen about 35% a year, and 600% compounded since we bought our first policy. We are a company of young, healthy people who exercise, eat well, don't smoke and we're not making babies. Our only defense has been to bounce back and forth between the two firms approved to sell insurance in the state. It hasn't worked.
------
While I waited in the lobby, a man limped in helped by a cane. He was disheveled and overweight, well worn shoes unlaced. He seemed to be favoring the insides of his feet, and I assumed that his arches were collapsing. The clerk asked him for a picture ID and an insurance card. A few minutes later, she said, “Sir, I’m sorry but this isn’t your insurance card.”
He tried a well-rehearsed lie, “Oh no, they must’ve given me the wrong card back. I was just at the clinic down the street, and the lady switched them. But it’s the same insurance. I can show you a letter....” Nope. He gathered his cane and the phony card and limped out of the office, looking hopeless.
------
“Mr Hayes?”, called the assistant, and the fleecing began. A nurse gathered the particulars of my visit and took my blood pressure and temperature. A bit later, the doctor came in, glanced at my toe, and said: “It’s benign. Nothing. We could do this in minutes, but I prefer to work at the surgical center. My assistant will explain what you can expect.”
She had five two-sided sheets of instructions to go over: “We’ll see you on a Friday at the surgical center. Our scheduler will call you with options. At least a week before, your primary physician will have to do a complete physical so that the anesthesiologist knows what to expect as they administer your medicines. The morning of, you'll need to shower with an antibacterial soap. We can help you with a prescription. For the surgery, you will be sedated, so you’ll need to have someone pick you up. For at least 3 days you’ll be wearing a special surgical boot that we will provide, because you won’t be able to fit the bandage in your regular shoe. And, although we know that these things are benign, we’ll be sending it to the lab for testing. We'll get back to you with the results.”
I began to connect the dots: 8 to 15 thousand dollars for a harmless raisin-sized soft fleshy mass, followed by big pressure to increase our insurance rates and our out-of-pocket-costs, affecting our ability to hire new employees or to offer competitively priced products and services to our customers. And the guy with the collapsing arches can't get care.
So I’ve told the podiatrist to pound sand starting with this message. If he calls, I'll use harsher language. And I’ve sent this message to my regular physician, my insurance company, the Governor, my senators and I’m sharing it with you.
Why do we need health care reform? Not all, but some doctors see unlimited opportunity to add and charge for ridiculous procedures. Like stealing from a baby. Not all, but many procedures are done to offset very small risks, but nobody is willing to size the procedure to the risk -- not the patient, the doctor, the clinic, the regulators or the insurance companies. Not all, but some insurance companies have no incentive or mechanism to control costs. Not all, but many of the uninsured have to steal to be treated. Almost all policymakers are either spineless or on the dole. Not all, but some employers won’t make it through this recession due to the waste created by a massive poorly regulated oligopoly that we call health care in the United States. And almost all people like me with insurance don’t say stand up and say no. Enough is enough.
I’ve got a tag between my toes. If there’s a doctor out there willing to hold his nose, pour on some alcohol and clip it off, I’ll pay cash. And it you're in Milwaukee and need a Podiatrist, email me and I'll tell you which one to avoid.
--------
Posts
