But We’ve Got Our Health (Craig Douglass On Consumers)

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Socialist! That’s usually what folks who support some kind of comprehensive national health insurance program are called. In the extreme, some versions of national health insurance are compulsory. Ah, “socialized medicine”: An effective tag helping solidify and promote opposition to such plans.

We won’t debate all that here. (The modern debate has been going on since the Truman administration when “Give ’Em Hell, Harry” supported in 1945 a single, universal, comprehensive health insurance plan that included all classes of society, not just the working class and poor, as FDR’s did. And in that era of the growing Cold War and Communists lurking under every bed, the plan went nowhere. Socialized medicine, indeed.)

My current personal insurance plan — private insurance as primary, with Medicare as secondary — has been quite handy lately, and appreciated, as knee-replacement surgery was performed on my left knee the last week in September. The surgery, of course, was covered, as is a specific protocol and period of time for physical therapy and rehabilitation. (The right knee was replaced in May 2007, so I knew what to expect. If the right knee had to be again replaced or, in the medical vernacular, “revised,” would that have been a pre-existing condition? Not sure. Hope not.)

As many know, the pre-op regimen can be extensive. It includes purchasing several pieces of medical equipment to aid in the prevention of possible post-op problems. But where surgery is concerned, some preventive measures before and after surgery are not covered by insurance. Curious.

Prior to knee-replacement surgery, it is recommended, and just makes good common sense, that “pre-hab” exercises or some sort of physical therapy (PT) regimen be prescribed. Pre-op PT makes rehabilitation of the joint, muscles and connective ligaments and tendons more effective, less painful, take fewer weeks to accomplish and generally aids in longer term successful outcomes. However, PT before surgery with professional guidance as a preventive-medicine strategy is not covered by insurance.

Less painful would mean fewer pain medications, which insurance covers. Physical therapy after surgery is covered, too, and would cost the insurance company less if it took less time to accomplish.

The instructions one receives from the orthopedic surgeons’ and physiatrists’ offices, when followed, are invaluable. One instruction is the purchase of a battery-operated pneumatic compression device. Fancy name. The device straps around each leg and provides, through inflated cuffs, periodic compression. This, along with a simple blood thinner like aspirin, helps prevent deep vein thrombosis. That’s another term for blood clots. Seems pretty important, right? Not covered by insurance. But if the patient were to experience a clotting event, resulting in a number of debilitating illnesses, the ensuing medical treatment would be covered. And it would be expensive.

One more example: We’ve all heard stories of infections after surgery. And physicians and the hospitals in which they work take care to prevent infections such as staph. They’re very focused on this risk. Part of the pre-op instructions tells us, “You can make a big difference in your own health” by reducing the risk of infections. To do so, the patient is encouraged to purchase Hibiclens liquid soap at the local pharmacy. The use of the special soap as a body wash, particularly on the surgical area, which should be applied at least three showers prior to surgery, will help “keep you safe.”

Now, if an infection were to occur, well, I’m not a doctor, so let’s just say that if an infection were to occur, it would be bad; it could be serious. And whatever treatment were used to rid the body of the infection would be covered by insurance. But the preventive measure, the Hibiclens soap, is not. You get the point.

Now that I’m a few weeks out from surgery, with the prior help of several months of leg-strengthening exercises, infection-fighting soap, an excellent surgeon, attentive hospital professionals, compression cuffs and PT that is moving right along, I’m a happy boy! Of course, I haven’t received any bills yet, so that may change. But we’ve got our health. And that’s priceless.