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Harvard-educated David Goldhill is the president of GSN, the Game Show Network on American television. He is also, it turns out, an expert on American healthcare and health insurance policy, becoming a vocal critic of the system after his then-83 year-old father died of sepsis after entering a highly regarded, "well run" New York hospital for treatment of pneumonia.
When the senior Goldhill went to the hospital for treatment of pneumonia, he had been able to walk in the door. In less than 36 hours, however, David Goldhill's father had developed sepsis, an intractable and largely untreatable bacterial infection that slowly kills its victims from the inside out. Over the next five weeks, Goldhill, the son, sat with Goldhill, the father, and watched enormously expensive American medicine unable to save a life that was lost because someone during the first day of treatment failed to wash his or her hand or observe basic sterilization procedures.
I know a little about watching your dad die of sepsis. In my own father's case, it was not a failing of sanitary procedure that he came down with the disease. My own father, whose name was Raymond Rister, had been given a medication he did not need that had two side effects. One was shutting down his ability to urinate, and the other was aggravating dementia. My father had to be fitted with a catheter so he could pee, and he couldn't remember why it was there so he kept pulling it out. My dad lived a little more than four weeks after his doctors pronounced him "not worth" saving.
David Goldhill's response to iatrogenic medicine has been to campaign for healthcare reform that really makes sense. But to do that, Goldhill argues, we need to start by dispelling ideas that don't make any sense. With thanks to Mr. Goldhill, I'll restate 10 strange facts about healthcare that run counter to ordinary perceptions.
1. Healthcare is measured in terms of cost rather than in terms of price.
There's no doubt that healthcare costs have our attention, especially when we hear about procedures that cost $10,000 at one hospital and $100,000 at another. It's a crazy system that allows variation of 1000%, and more, in the costs of well-established care. But during most years, most of us won't have any procedures at all. So what really makes an economic difference when we aren't in the hospital, when we don't have to get any of those outrageously expensive hospital services?
It's the price of healthcare, of course, the price we pay, if we have health insurance, that creeps up each and every years. The Health Care Cost Institute tells us that not only did American health care cost $18,000 per family of four in 2011, it cost $672 more than in 2010. It's the $50 per month per year that gets us, not the $250,000 for a cardiovascular stent we never actually pay.
2. Healthcare isn't necessarily what makes us healthy.
Despite what the naysayers tell us, death rates from heart disease and cancer are actually down, slightly, and or life expectancies are actually up, considerably. But it isn't necessarily healthcare that makes the difference. Fewer people smoke, more people get diagnostic procedures sooner, people don't even give a second thought to buckling up their seat belts (unlike 40 years ago, when protest of seat belt laws was leading the news), and suicide hot lines help prevent the despondent from ending their lives early. Much, Goldhill cites the New England Journal of Medicine's claim of about half, of health progress has relies on changes in lifestyle.
3. Health insurance and healthcare are not the same thing.
You can have health insurance and not get healthcare, and you get healthcare even if you don't have health insurance (although wheelbarrows filled with money would help). Having comprehensive health insurance that covers all kinds of healthcare costs does not necessarily mean you'll get the treatment you need.