The Cheapest Healthcare Money Can Buy

Vision simulation of a patient with glaucoma

Why do we buy the things we do?  Sometimes we make purchases quite rationally, being careful to weigh benefits against costs.  Other times we buy impulsively.  In any case, we generally like to think that that we have gotten our money’s worth, regardless of the price.

The same thinking should apply to our health care.  But the days when Americans simply purchased – or refrained from purchasing – their own health care ended well before most of us were born.    We  have all grown up in a system so distorted by government, and other third parties, that the norm is anything but a simple, voluntary purchase.  If we do get value for our money we feel grateful to have survived.  Frequently, we feel resentful of poor, but expensive, treatment.
Once a third party enters any transaction, the complexity of the deal rises and the likelihood of being satisfied with the result is more difficult to achieve.  After all, if I want to buy a new car, but need to borrow money to pay for it, the lender has a say in just what car I can buy.  He may decide that I can’t afford the car I really want, and I either have to compromise my desires or just continue to drive my jalopy.
The same thing happens in the delivery of medical care, but our health is put at risk instead of just our ego.  By nature, third parties want to keep their costs down to the bare minimum.  As long as we have little or no say, expect the cheapest solution that the real decision-maker can get away with.


David E. Woodward, Sr., 87,  had been seeing eye doctors at the Veteran’s Administration Palo Alto Health Care System for years.  In 2004,  he was diagnosed as a glaucoma suspect, but over the next four and a half years he had no treatment for glaucoma and he went legally blind.  Then, much to his chagrin, he received a letter, along with 380 others, in 2009 informing him “that some of the vision loss … may have been preventable had you received a different course of therapy.”
You see, optometrists were treating the glaucoma suspects at this Veteran’s Administration center.  Optometrists have not gone to medical school and have much less training than ophthalmologists.
Optometrists charge commensurately lower fees and often restrict themselves to prescribing spectacles.  I have no problem with optometrists or with anyone who wants to be treated by one. However, I suspect the VA was trying to cut corners rather than hire ophthalmologists to see patients like him.  In the end, Mr. Woodward didn’t want to spend the next couple of years in court, so he settled his case this week for $250,000.

Article first published as The Cheapest Healthcare Money Can Buy on Technorati.

Glenn L. Goodhart, M.D., J.D.

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One Response to The Cheapest Healthcare Money Can Buy

  1. Couldnt be written any better. Reading this post reminds me of my old room mate! He always kept talking about this. I will forward this article to him. Pretty sure he will have a good read. Thanks for sharing!

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