Thursday, July 16, 2009

Health, Health Management and Health Care

As Congress continues to bloviate (Bilbo's word) about health care for our nation with more concern about satisfying their major campaign contributors than the the citizens that need affordable health care, I thought I'd weigh in with a few thoughts.

Actually this health care rant is inspired by a recent family health care issue. A little over a week ago, Hannah was bitten by a neighborhood cat. This cat is not a feral cat or stray, it lives at a home in the neighborhood (at least that's what we believe). We were unable to locate the cat or the owners so to be on the safe side, Hannah is receiving the series of rabies vaccination injections.

Here are some observations and lessons learned from this experience:

Christian County has no program for dealing with stray cats--only dogs.
Though dog bites occur more frequently, cats are much more likely to carry rabies.
NOBODY knows who to contact about rabies shots and it turns out that the only place in our area is the hospital emergency room (even though it may not be a medical emergency).
The County Health Departments only give pre-exposure vaccinations, not post-exposure vaccinations.
Your primary care doctor can't (or maybe won't) get the vaccination for injections in his/her office.
Since you have to go to the emergency room (initially) and it is not a medical emergency, you can expect to get triaged to the very end of the line and be there for a very long time to receive an official okey dokey from a doctor that spent years of school and thousands of dollars to tell you something that everybody already knows--"Yep, that's an animal bite. You should probably get a rabies vaccination."

Any semi-sane individual can see several areas to save lots of money in this isolated case. I'm sure that many of the policies are dictated by insurance companies and are more about liability control than about medical care. By the way, the incubation period for rabies in humans is anywhere from two weeks to several months. However, once a person starts to exhibit symptoms, it is too late. Death will generally occur within a couple of weeks and treatment is pretty much pain management. The series of injections are no longer the 10 painful shots in the abdomen and are only six shots that are like any other vaccination. (we are waiting on #3 as I write)

I think that health management may be a way for companies (and the government) to create incentives for people to take better care of themselves and reduce the need for health care--perhaps discounts or lower insurance rates for people that are participating in fitness programs or discount memberships in health clubs or smoking cessation, weight loss programs or other things that improve health and reduce the need for health care.

An over-simplification of the insurance industry is that the people that don't use the health care system (healthy people) pay for the people that do use the health care system. Maybe we should start rewarding good health--and this from a guy that's 50 pounds overweight! By rewarding good health management, companies can expect more productive employees and fewer sick days. Wouldn't it be grand if they could also expect lower insurance costs?

I guess it is time (actually, way past time) for me to do my part. If they would have had a "fat-boy" award at our family reunion, I think that I would have won it with little competition. Since the beginning of July, I have been making some feeble attempts at better eating habits and getting a little bit of exercise. I'm going to have to do more. I really do need to shed 50 pounds. I started the year with the thought that if I could lose just one pound per week I'd drop 50 in the year. Well, with the year half over, I'm pretty much right where I started. No real plan; no real results. It's time to be purposeful.

I'll let you know how that goes.

John <><


fiona said...

I don't know whether to laugh or cry at the whole Rabies Shot debacle!

Mike said...

See if you can lose 100 pounds and I'll buy some weight credits from you.

Bilbo said...

A great post that puts some of the problems with our health care system into a personal perspective. I want to write about health care again, but I have to wait until I calm down more. Hope Hannah is all right.

John said...

More comments on Facebook if anybody is interested.