Dislocations

Whalen, James P

DISLOCATIONS James P. Whalen While swimming with my ten-year-old son two summers ago, I dived into the pool and hurt my right shoulder. After medical evaluation, physical therapy, an injection, an...

...Many senior citizens must choose between buying needed drugs and paying rent...
...It cost the health-care system over $20,000...
...After all, we have a system that is full of dislocations...
...Yet state-of-the-art management of this condition is impossible under most insurance policies, and the best management regimes for depression are therefore available to only those who have considerable financial resources...
...In contrast to the bottomless trough available to me for my shoulder travails, coverage for psychiatric troubles in my policy is limited to thirty days of hospital care and twenty sessions of out-patient therapy per calendar year...
...The only thing that really mattered to me was that I couldn't throw a baseball, and I suppose I could have found a way to manage my baseball team without doing that...
...And my coverage for psychiatric illness is actually better than a lot of policies available...
...Lately, I have noticed a pain in my right hip...
...now I have virtually no limitations...
...Had I had any complications or the need for more work on the shoulder, my medical insurance would have kept pumping in whatever money was necessary to cover expenses...
...There has been no particular injury, but it is getting worse, despite my use of anti-inflammatory agents and cessation of running...
...Before surgery, my shoulder gave me no pain if I avoided certain movements, and my only real limitations were inconveniences...
...It causes uncountable days of lost work and can actually be life-threatening...
...My friend's medical insurance policy was so deficient in benefits, though, that he was trying to find the money to pay bills that would far exceed what his insurance would cover...
...By April, I was pitching batting practice to the Little League team I manage, which was the main goal in my decision to have surgery...
...The whole experience cost me about $2,000 in co-payments and deductibles...
...But my work wasn't compromised: I am a physician (an internist), and I can practice easily with limited shoulder movement...
...I may undergo the cycle of evaluation, physical therapy, fancy X-rays, and surgery again...
...The madness goes on and on, topped off by the fact that Americans pay almost twice as much per capita for health care as citizens of any other country in the world...
...On the one hand, our setup for health care depends on a system of medical insurance that will put infinite resources into what is essentially a physical irritant...
...Before the procedure, I could not lift my arm...
...After medical evaluation, physical therapy, an injection, an MRI, and more physical therapy, I underwent surgery early that November, where a completely torn muscle in my rotator cuff was identified and repaired...
...I just hope I don't get depressed by the whole thing.le thing...
...Forty-five million Americans have high blood pressure, 30 million of whom go undiagnosed or undertreated, resulting in hundreds of thousands of avoidable strokes each year...
...It is amenable to therapy that often includes psychiatric evaluation, counseling, medications, and hospitalization...
...This prompted me to check my medical insurance benefits for psychiatric illness...
...it disrupts the life of the patient and family...
...If I need more than that, I'm on my own...
...On the other hand, my friend's son has a serious disease...
...In relating my experience to a friend while recovering from surgery, I learned that his son had had a serious bout of depression-serious enough to require withdrawal from school and intensive psychotherapy...
...Dressing was somewhat awkward, and I couldn't tune the car radio without using my left arm to lift my right up to the controls...
...Depression is a chronic and remitting condition...
...More than 40 million Americans have no medical coverage at all...
...I don't look forward to this, but at least I know that whatever I need will not pauperize me...
...This odd set of priorities should come as no surprise to seasoned observers of the health-care system...
...Most patients with terminal cancer who have debilitating pain die with that pain...

Vol. 130 • July 2003 • No. 13


 
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