Ten Strange Things We All Believe About Healthcare

Harvard-educated David Goldhill is the president of GSN, the Game Show Network on American television. He is also, as it turns out, an expert on the American healthcare system 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 the treatment of his 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 the enormously expensive American medicine that was claimed to be amazing be unable to save a life that was lost because someone during the first day of his father's treatment failed to wash his or her hands or observe basic sterilization procedures before treatment.

I know a little about watching your dad die of sepsis when the hospital is unable to help. In my own father's case, it was not a failing of sanitary procedure in the hospital, but that he came down with the disease. My own father, whose name was Raymond Rister, had been given a medication at the hospital that 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 even 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 the 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. Did you believe any of these strange things?

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 even more at times, in the costs of well-established care. But during most years, most of us won't have to worry about undergoing any procedures at all. So what really makes an economic difference when we aren't even in the hospital, when we don't have to get any of those outrageously expensive hospital services?

It's the price of the healthcare, of course, the price that we have to pay, if we want to have health insurance, that creeps up on all of us each and every year. The Health Care Cost Institute tells us that not only did American health care cost $18,000 per family of four in 2011, but it cost $672 more than in 2010. It's the fact that it costs $50 per month per year that gets us, not the $250,000 for a cardiovascular stent that 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, and considerably. But it isn't necessarily the healthcare system 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 when in a car (unlike 40 years ago, when protests of seat belt laws were all over 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 people's lifestyle over the many years.

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 certainly help a lot). Having comprehensive health insurance that covers all kinds of healthcare costs does not necessarily mean you'll get the treatment you need when you need it.