Thursday, January 12, 2017

Why Healthcare Got Crazy Expensive - Sleep Studies

People actually go to the hospital to sleep, as the doctor told them they are sleeping wrong....

My neighbors have odd sleep habits.   They are up all night and sleep all day and are unhappy about this.   So they go to the doctor and he says to have a "sleep study" where they go to a hospital and sleep while technicians watch them.

I am not making this shit up.

I mentioned this to another friend, and instead of being alarmed at this idiocy, she chimed in with, "isn't that the greatest thing?  Of course, you never leave those places without them recommending some kind of treatment....."

Yes, some kind of treatment, because they make money finding problems in your life and don't make money saying you are healthy and should stop worrying so much and STOP BEING A FUCKING HYPOCHONDRIAC FOR CHRISSAKES!  YOU ARE THE REASON MY INSURANCE PREMIUMS ARE $1400 MONTH!   Well, you and the drug addicts who are getting prescription opiates.

Not that I feel strongly about any of this, of course.

But wait, it gets worse.   Once they go to the sleepy doctor, he tells them they have "sleep apnea" and need to wear a snorkel to bed.   Some of these look like oxygen masks and they call them CPAP machines, and they even sell a device to clean them because as you can imagine, your breath in a tube gets pretty gross after a while.

This looks like a comfortable and relaxing way to sleep!

All I can say is, this has to be hell on your love life, unless you wife has a Darth Vader sex fantasy.

Between this and the "night guard" scam that many Dentists try to (literally) shove down your throat, it is amazing Americans are not all choking to death on this crap as they sleep.

Here's the deal:   Grandpa didn't have "Sleep Apnea" but just snored badly.  Grandma slept in the other room.   And he lived to be 95 - far longer than you will live (our generation for some reason has a shorter life expectancy, even though our parents generation smoked, inhaled asbestos, and fought in a World War).  Maybe over-medication is killing us off - just a thought.

Are you having trouble getting to sleep?   Let me tell you something an old Navy doctor told me, and it is good advice.   I was having trouble sleeping and even waking up at night sweating, which was concerning.  He looked me over and said, "Let me guess, you tend to eat later in the evening, "European Style" right?

"Uh, yea," I replied.

"And the night you couldn't sleep," he continued, "You had a big meal - steak and potatoes, or pasta with sauce and meatballs?"

"Well, it was sausage, but yea" I admitted.

He explained to me that digesting all that crap, so late at night was like asking my intestines to run a marathon while I slept.   No wonder I had trouble getting to sleep - and waking up in the middle of the night.

We started eating earlier and eating less and funny thing, the sleep problems vanished.   Total cost: $0.

My friends who went to the "sleep clinic" love to eat late and eat large.  When I explained this to them, they told me what do I know?  After all, a doctor told them they needed a Darth Vader mask!

Well, OK, I guess so.   But this strikes me as the sort of silly and ludicrous "medicine" we have today, along with these pharmaceuticals for stupid things like "active bladder" - that are curing problems that either (a) don't exist or (b) are somewhat trivial and we lived with them in the past.

Oh, and like with my night guard that I let a dentist talk me into, my friend's CPAP machine ended up sitting on a shelf after three nights, because no one can sleep with something in their mouth or a mask over their head.

Yes, I still grind my teeth sometimes.   No, they are in no danger of falling out.  They will last me another 30 years which is as long as I plan on needing them. My dentist was prescribing a cure for a problem that didn't exist, and it was a cure that didn't work and wasn't practical.   It did, however, lighten my wallet and fatten his.   This is how modern medicine works.

Not everything that can be cured needs to be cured - or should be.   Life has discomforts and inconveniences.   Leave the doctors and hospitals for the really sick.

And lest you think I am picking on doctors, lawyers and other professionals are no better.  Go to a divorce lawyer and odds are, he isn't going to suggest couples counseling.   Go to a bankruptcy attorney and he isn't going to suggest credit counseling.  Even the guy at the brake shop is going to say you need new brakes, if yours are even looking close to being worn.   It is not that these people are crooked per se, but when you put money on the table, people tend to go for it, even subconsciously.  It is very rare you meet a professional of any kind who turns away business, when they can sell you something.  This is just a fact of life.  Act shocked.

The business of medicine is a business of profit - at least in this country.   As I noted in another posting, I went to an "imaging center" for a colonoscopy.   Was this necessary or not?   It is now being recommended for everyone over 50, every ten years, or even every five, if there is a history of cancer in your family.   And Obamacare helpfully pays for it (as well as your transgender surgery).  The guy running the imaging center has a real racket going, with people on gurneys lined up like Guernsey cows, waiting to be probed.   $1500 to $3000 a pop.  Not bad work, if you don't mind seeing a lot of pink on an endoscope.

One friend tells me the doctor recommended one for his 80 year old grandmother, which is a risky procedure at that age, where tissues can tear easily.   A cancer diagnosis at that age is really irrelevant anyway, as the treatments are often more deadly than the disease.

My parents who lived to a ripe old age, and their parents did as well - and none of them ever had such levels of treatment when they were younger, if at all.  Are we better off than the previous generation?   If so, why did life expectancy drop last year?

Medicine is rapidly becoming one of the largest sectors in our economy.   Every town and city has a large "medical district" with a hospital and treatment centers, ringed with arrays of doctor's and specialist's offices.  Doctors rarely treat patients anymore, but are just an insurance gateway to the specialists. 

Don't get me wrong.  I am happy that a friend of mine lives today because of a bone marrow transplant that a few decades ago was an "experimental treatment".   It cost two million dollars to save her life, but it was worth it.

But other treatments, I think are cures looking for an illness.   Advertising prescription medicines is troubling, as there are people who are susceptible to thinking they have Chronic Farting Disorder (CFD) if you put a two-page spread in Newsweek magazine.   Hell, these are the same people who decide they need a lumbering SUV to drive to work in - alone.  People are highly suggestible.

Granted, health care costs are going to go up over time, just due to inflation.   And new procedures and medical devices are not going to be cheap.   But it seems that the costs are increasing at a rate far beyond inflation and far beyond that attributable to new technology.  And technology - and pharmaceuticals - should become less expensive over time not moreso.

We have become a nation of patients it seems - willing to run off to the doctor for any perceived malady or discomfort.

And maybe, this is partly the problem of making medical care cost-free and consequence-free to the patient.  When there are no or low co-pays, the hypochondriac has no incentive to stay home.

Here on retirement island, most folks are on Medicare.   And if you can make it to age 65 and Medicare, they will rebuild you like the bionic man.   When my Dad hit that age, they did a quadruple bypass - in the process finding a hole in his heart that he had since a kid.   They also replaced the lenses in his eyes to fix a cataract problem.   The net result was he had 20:30 vision for the first time in over a half-century and was in better physical shape than I was at age 40.

But you have to make it to age 65 to get that.   Between now and then it is, "your insurance doesn't cover that, sorry!"   But they can do a sleep study.  Maybe a colonoscopy while you wait.

Most oldsters here on the island also have a bevy of pills they take every day - and will bore you for hours about what pills they take - and offer you some of their "stash" too!   No, seriously, I have been offered things like Percodan and even Viagra ("my husband just died, and this was left over, you want it?").  I am not sure what I would do with expired Viagra - or whether it is even safe.

While some of these "meds" are no doubt a good thing - extending life expectancy and making people more comfortable - I wonder if all of them are equally as necessary.   Some of the symptoms they are supposed to "cure" (restless leg syndrome?  That's a thing?  Drink more water!) seem pretty trivial.

I am not sure what the point of all this is, other that if this trend continues, healthcare will become the single largest industry in the country - and in a way,  it may already be.

According to one site, healthcare accounts for over 17% of the GDP of the USA - rising over 5% in 2015 alone to nearly $10,000 per person.   This may not sound like much, but bear in mind the entire auto industry including dealerships, accounts for only 3-3.5% of GDP historicallyAccording to this site, health care accounts for "only" 8% of GDP, but ties for third place with finance and insurance, behind only real estate and government.  It leads durable manufacturing, wholesale and retail trade, which all tie at only 6% of GDP.  Healthcare trumps all manufacturing in the USA today.

Healthcare is big business.   Someone is clearly making a lot of money at this.

As I noted in an earlier posting on Dentists, as a patient you do have to be careful and look out for your own interests:
"I went through this with one Dentist, who suggested jaw surgery. After explaining all the benefits of this painful, protracted process, she mentioned that it would cost $10,000 or more, but that "my Dental Insurance would cover it". When I explained that I did not have Dental Insurance (and didn't have $10,000 laying around), she said. "Oh, well, then you really don't need the surgery."

Huh? Did I miss something here? The need for surgical procedures is based on your ability to pay? This, in a nutshell, illustrates what is wrong with insurance-based health care. If someone has insurance (or medicare), procedures are recommended that are not recommended for the uninsured or under-insured."

Of course, Doctors operate under a higher standard, and would never recommend unnecessary procedures just to bill some hours or to fill a hospital bed, right?

Right.   Patient, heal thyself.

Now, I am off to bed, sans night guard or CPAP device, for a good night's sleep!

UPDATE:  I revised this posting as the image link to "sleep study" at UCLA died.  While searching for a new image, I was kind of shocked at how many "selfies" people put up of themselves covered with electrodes, ready for a "good night's sleep" - as if they were enjoying this a little too much.   People like to be catered to and special, and how much more special can you be than to have people watch you sleep?

What did we do in the age before "sleep studies" and in the age before insurance paid for this?   How did my ancestors live into their 80's and 90's without sleep studies?   It is an interesting question.  Perhaps we have too much medicine in this country - an industry setting out to find problems that don't exist, because it makes a lot of money for the industry.

I saw the doctor pull out of one of the three "sports injury" clinics in our town (we are quite athletic here in Georgia, although most don't look it).  She was driving a Maserati.   I guess they give those away after your 10,000th Oxycontin prescription.

I don't put a lot of faith in doctors - nurses, maybe, except for the ones who kill their patients on purpose.