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My 157th doctor visit (or thereabouts) - Arvind Narayanan's journal [entries|archive|friends|userinfo]

My 157th doctor visit (or thereabouts) [Feb. 28th, 2008|05:24 pm]
Arvind Narayanan
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Man, I love this country. I have a numbness in my fingers and they send me to get an MRI scan of my neck to check for cervical spondylitis or some crap like that. Overprotected kids, overreacting adults, a pathologically petrified populace and an economy that's evolved to exploit it all.

The MRI machines apparently cost 2-3 million. I'm sure each visit costs several hundred dollars. I love the attitude they have about it -- as long as you have insurance, who cares how much it costs? Hey, I know, let's make all healthcare "FREE" so that no one will ever have to pay. Or have the slightest incentive to be efficient. Fuckity fuck.

Anyway, it was my first MRI and kinda fun. I figured they were going to shoot some ions into my head and then I'd be done, right? Nope, that's a CT scan. An MRI is a much longer process. You have this machine that makes more noise than a jet and you're inside it. I suspect if your industrial strength earplugs somehow fell off, you're gonna go deaf instantly.

It lasts half an hour or more. I was fine, but someone who's even slightly claustrophobic could have a really hard time of it. It's sad because there's things they could do do make it a lot easier for queasy patients -- like play a reassuring recorded message between individual scans when there's not much noise, at least to tell you how far along the damn process you've gotten. It's not easy to tell time when you can see nothing and your body is almost in a vice.

Did I tell you how in India, when I had diarrhea, I got a consultation, pills, and a shot of antibiotic that cost me a total of Rs. 121? That's three dollars. Yeah, we don't even know what insurance is over there. For the most part. And I didn't have to make a fucking appointment a week in advance. I just walked in, and the whole thing took half an hour.

Anyway, that's my rant for the day. Boy, am I going to be eating my words if it turns out I actually have cervical spondy-whatever!
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[User Picture]From: arvindn
2008-02-29 02:17 am (UTC)
oh, i'm totally aware of that. it's something i think about a lot. but two things:

first, forget medicines. the consultation including the shot cost me only Rs. 50. it isn't even really about the money, it's really the culture of nanny state-ism and mandatory healthcare and horribly inefficient insurance that i have a problem with.

now let's get to the pills. walk into your local drugstore and check the prices on generic, store-brand acetaminophen. it's usually 3/4 of what tylenol costs, even though it's generic and the cost of research doesn't factor into the price. it's mass manufactured, and shouldn't cost more than vitamins. really. the margins on these things are insane. apparently if you go to costco you can in fact get them dirt cheap.

worse, people will buy brand name tylenol even though the generics are *right next to it* in the store and cost less. the notion that pills are expensive is so ingrained in the collective consciousness of the people that there isn't a cluestick good enough to bat it out of them.

finally, i don't like the way the US uses WIPO to muscle india into conforming to it's patent regime, making life hard for cipla and ranbaxy and the like. india really really needs its generics maufacturers right now. the purchasing power parity is so skewed and the potential for saving life and improving health so great that it would be a tragedy if it got any worse than it is.
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From: fixious
2008-02-29 01:21 am (UTC)
It's been my experience that university student health centers don't seem to rush you to get tests and pills for every damned thing. The atmosphere is also a lot more like clinics in India... walk-in consultations, friendly staff, and minimal bureaucracy.
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[User Picture]From: arvindn
2008-02-29 02:22 am (UTC)
well, lucky you. that's not been my experience, not by a long shot. walk-in consultation? i wish! you won't believe what the clerk said -- your appointment is at 10 am, but i'll put down 9:30 to allow you half an hour for paperwork. HALF AN HOUR FOR PAPERWORK. anyway i went in at 9:55 and it was fine.
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From: fixious
2008-02-29 03:00 am (UTC)
Hm, perhaps because you're at a large state univ...
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[User Picture]From: cubby_t_bear
2008-02-29 02:39 am (UTC)
The amusing part of the cost of health care in America that I don't see many people talking about, is the crazy monopoly exercised by the AMA.

Medical schools deliberately admit less than they can take, and extremely rigorous licensure schemes on top of that reduce the supply of medical care providers.

So while it's partially true that in America labor is way more expensive, trained medical labor is *particularly* expensive. Everything besides that, is mostly peanuts.
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