In a recent edition of your web column you said: “The original idea of insurance was based on a cost-effective plan, where you get back essentially what you put in.”
Here’s the American Heritage Dictionary definition of insurance: “The action, process, or means of insuring or the state of being insured usually against loss or damage by a contingent event.”
Protecting oneself against the risk of an adverse event is the “original idea of insurance.” It wasn’t meant to be some sort of account where you get back essentially what you put in.
Instead of coddling the guy who wrote the letter, you should have told him that if you have SARS-like symptoms, don’t wait two weeks to go to the local clinic. Get your mother (or a friend) who lives nearby to drive you to the VA. If he had gone when the symptoms first manifested themselves, he might have had to pay only $88.
I think you have a point. But consider too that we don’t have a system that encourages prevention or early intervention. A patient such as the one who wrote flinches at the anticipated costs and lives in denial until it is almost too late–more evidence that the system needs reform all the way to the roots. And not because these were “SARS-like symptoms” but because when you aren’t feeling well, you should have access to regular, ongoing medical care.
I’m disturbed by a recent new advertising campaign in Columbus that is being conducted by a bariatric surgery corporation. Well-placed Internet and television ads target obese patients for relief through surgery. I once read an article about the dangers of this type of procedure and wonder if you have an opinion on the matter. It disturbs me to see doctors trying to make money by selling a risky surgical procedure that may not be necessary or beneficial. I understand the dangers of obesity, but isn’t this procedure a marginal solution, to be used only in extreme cases? Is this “industry” crossing the line of acceptable medical ethics? Or am I off-base here?
You are not off-base. Aggressive advertising can create need and expand a service beyond its prudent use. For many, fad diets and procedures are driven more by narcissistic needs than common-sense health practices. The procedure has a use for extreme cases, as you say, but for more common, moderate obesity, better nutrition and exercise are first-line treatments. Of course, no one is advertising exercise–except health clubs and gyms–and as far as diet, I suppose the dairy manufacturers could get together with the cholesterol-lowering drug manufacturers and advertise simultaneously. A boon for one would ultimately mean a boon for the other.