Fields: Wasting Healthcare Dollars In The Name of Miracles; Should We Let ‘Em Die?
BY SAM FIELDS
Guest Columnist
Delilah Nevaeh Valdez is one of those tiny patients that the media loves to dub A Miracle Baby.
Born in San Antonio Texas in September, doctors diagnosed something called Megacyctis Microcolon Intestinal Hypoperistalsis Syndrome.
They gave her one day to live.
Enter Jackson Memorial Hospital.
Delilah was rushed to Miami. She received 14 hours of surgery. It involved 7 transplants covering her entire digestive system.
She spent eight months in Jackson. You read that right. Eight Months…in an era when most patients are being shown the door almost before their wounds heal!
The baby returned home where doctors are optimistic that she may live as much as four or five years.
Allow me to put a slightly different twist on this Miracle Baby.
She is no Miracle Baby. We need to see her as the poster child for everything that is WRONG with American healthcare.
Want to know why?
Healthcare dollars are not unlimited. They all come from the same place — our pockets in the form of taxes or insurance premiums.
Choices need to be made.
Jackson is financially going under. At the same time they are cutting back on the basic services for those who can’t afford it, this egotistical surgical exercise cost way over a $1 million that the hospital system does not have.
For what? So that doctors can practice doing a procedure that is only slightly more useful than perfecting “The Appendix Transplant?
No one is asking the basic question: Is it worth it? Who will go without so that a baby can live a few more years, never reaching adulthood?
Are these high-risk, low-results procedures just too costly for the American health care system?
We have a system that loves to perform the spectacular at the expense of the basic.
And that’s why Delilah Valdez is the poster child for all that is wrong with American healthcare.
May 7th, 2011 at 1:57 pm
Buddy great that you could spell the condition. agreed this is not a miracle Baby but a miracle surgery.
Again we the tax payers have to foot the bill for a non-resident, yes, the question is Texas has many fine medical facilities, why was it hot done there? At least he 8 month re-coup. Assume it was a charity case! Did JMH invoice the STATE of Texas?
This is the same logic that allows non-citizens to fly in, have their childbirth here, not pay , go back, and have the newborn as an american citizen. all on the pocket of the local taxpayers. So we have this GREAT medical facility hre that we pay for and is losing $$$$. Maybe it is tme for Jackson Healthcare to say “NO MAS”
May 7th, 2011 at 2:27 pm
Gutsy post. How is it that Jackson took on the case of someone out of state? Was she privately insured? Did she get the “Prior Authorization” for every nit-picking procedure that everyone else has to get? Has Jackson gotten any reimbursement for taking care of this child?
May 7th, 2011 at 4:35 pm
because we can…should we??? if I were King I would do it for a kid but not a real old guy who took chances with his health
May 7th, 2011 at 4:47 pm
What this post misses is that Jackson is a teaching/research hospital. Even if the surgery is a failure, what did they learn in the area of research? What did they teach to the MDs of tomorrow? Perhaps the techniques used will perfect other transplants? What is that worth to society?
You are a criminal defense attorney… Do you take SPD JAC cases? The reason I ask is that’s gvt money. Have you tried cases where you KNEW the client was guilty? (of course you have) Why did you waste the money on a trial when the client’s guilt was certain? Test Miranda? Challenge Constitution? Expose misconduct? Just collect the fee?
Another analogy would be this. How much does it cost to prosecute a petit theft case? A guy steals $299 worth of stuff. He is apprehended by store security. Police arrive and it takes them 2 hours to process the guy and write the report and transport him to the jail. You have spent $100 on the cop with pay and benefits. another 10 bucks on the car to get him there. Then you have the Jail deputy who spends an hour processing him IN there’s 35 bucks, The nurse who spends 10 minutes with him theres another 10 bucks. The proprty clerk who processes his belongings in, another 10 bucks. Then you have all of the same costs going out (except the nurse) Then you have all of the court costs, Judge, PD, SAO, Clerk, Court Deputy, and the real costs of copies, paper, building, etc.
It probably costs 1000 to prosecute a 300 crime, when the guy did it. Why do we do that? Because our society say that prosecuting a thief is important.
Just like our society dictates we try to save a life when we can.
May 7th, 2011 at 5:28 pm
@Sam Fields,
The reality is Sam, some of us value life over the Almighty dollar.
May 8th, 2011 at 10:24 am
Frog and Augusta
You personify the American system of health care. First come first serve, all you can eat. And if you are at the end of the line you are S.O.L.
You do not want to consider the consequences of your decisions. You just want to assume some phony/baloney moral high ground that refuses to accept that your position means withholding simple and effective healthcare from large numbers of people.
At a $100 a pop that kid’s healthcare $$$ could have meant check ups for 10,000 other kids. Many of them would have been diagnosed with simple correctable disorders that are likely to balloon into tragedies.
Instead people like Augusta, with her self-righteous unctuous Catholic holier than thou bullshit, will condemn those people as JMH reduces services for the needy so that this kid can be the poster child for misusing precious healthcare funds.
May 8th, 2011 at 3:00 pm
If your insurance company decides that your treatment is too expensive and decides it’s more cost effective to let you die, the company is run by greedy money grubbing bastards who should be forced to pay. But if some governmental body makes the same decision, that’s just too bad and it’s in the interest of society.
May 8th, 2011 at 3:25 pm
Sam,
Really… please don’t hold back on throwing those barbs on my account….
May 8th, 2011 at 8:39 pm
‘GET THIS STRAIGHT’…that will ultimately be the question…although insurance companies do suck a lot of money out of the system…
May 9th, 2011 at 12:56 am
Sam you missed the entire point of my post.
My post was about the “other” benefits of the treatment than the survival of the child. This, to me, an admitted layman, seems like cutting edge surgery. I have poorly articulated my point.
With cutting edge technology, failures (even expensive ones) are almost as important as successes. The research and teaching that went on with this case is more valuable than the cost of the surgery we just can’t quantify it.
To me this is like Ellis Rubin’s handling of the Amy Weiss case. He knew she was guilty of what she was charged with. He raised a constitutional issue and won an appeal (post conviction as I recall) and changed BSO’s Miranda Practice.
May 9th, 2011 at 8:00 am
Dear “Let me,â€
Do you not realize that the failure to make a decision is a decision?
Your decision is to let a few have it all while screwing the millions.
I assume you are a Republican.
May 9th, 2011 at 12:20 pm
Failure to make a decision is a decision? Lawyerspeak for questions without an easy or obvious answer. I’m no more Republican than you are. But I don’t endorse death panels as you obviously do. Don’t worry, even your hero Robert Rubin from the Clinton administration advocates letting Grandma die. I’d suggest you and everybody else reading this get the book “Forever War” by Joe Haldeman. In the middle of the book when the character William Mandella returns to Earth, he finds a different society. One that rates health care for people based on their age. Over 60? You’re on your own. Face it. That’s what Sam is really advocating. First – children who can’t possibly survive. Then seniors approaching end of life. Next – cancer or heart patients with only months to live without intervention. That heart transplant costs half a million. it’s cheaper to let nature take its course. Is this the new Democrat ideal for balancing the budget?
May 9th, 2011 at 5:18 pm
Dear So,
We gave that girl over a cool mil. Where do you want it to come from?
Maybe we should have a world of Terri Schaivos bleeding us to death so that you can feel good about yourself.
How about a case my doctor told me about. 92 year old bedridden women with total dementia. Kidneys are failing and the family insists that Medicare put her on dialysis.
Go down to Key Largo and visit the vegetable farm. Nationally, billions be spent on people laying in bed with little or no functioning brain.
Is that what you want for yourself? Emotionally bleed your family while you financially bleed the country.
Because you are a wimp about making tough choices don’t try and claim a higher moral plane.
May 9th, 2011 at 11:44 pm
Ahhh, Sam, Sam, Sam… You’re avoiding the issue by using the extreme cases. Where would you make the cut? Age? 80 with prostate cancer? No surgery? No meds? How about 65 needing a heart transplant? For every one of those extreme cases you pointed out there are probably a thousand of these that would cost half a mil each. How about 40 with advanced lung cancer? Probably 20 thousand of those at a cost of almost 1 mil each. Pull the plug?
No Sam. You’re the wimp by avoiding the real issue. You brought it up. Answer the question.
May 10th, 2011 at 7:57 am
Dear So,
In case you did not know it they already rank potential recipients for transplants.
A single sixty five year old will be jumped over by a otherwise healthy forty year old with kids.
Private insurance companies already refuse certain coverages when it as viewed a unproductive.
You can’t make a bright line solely on age. For example a forty year old who needs a heart transplant but also has pancreatic cancer (98% fatal) should probably not get a transplant.
Half of all healthcare costs come in the last six months of life. Much of it is wasteful. For example Medicare is now considering a prostate cancer treatment that adds three months to life. The cost is $93,000! For twenty grand you could take him to Vegas for a couple of weeks with hookers and Viagra. That sounds a whole lot better.
And a newborn should not get a $mil in surgery when the optimistic outcome is she will live four or five years bloated on anti-rejection meds.
Hey mom and Dad . Make another kid.
So now you tell me what services would you cut to pay for this baby’s megasurgury?
May 10th, 2011 at 1:05 pm
The ranking of transplant recipients is based on two things. Need and viability. That 40 year old with family will not get the heart if deemed he won’t survive the surgery. The 65 year old will if he can. The ranking is not based on cost savings. Insurance companies can and have been sued successfully to reverse such decisions, few as they may be. Try that with a government death panel.
Insurance companies may challenge hundreds of cases while the death panels will have the power to reject millions of cases based on cost savings. You’re correct that half of health care costs come in the last six months of life. But which high dollar cases end in death and which of those live for several years? The last six month routine is simply statistics, not reality in each high dollar case. The million dollar surgery for the baby may have been one case of waste, but maybe not. How much did the doctors learn? What would be the outcome of such surgery in the future?
The lives of the first few heart transplant patients were measured in days. Now it’s years with some living 25 years. Were the first few a waste? The first recipients of artificial hearts lived days or weeks. Now patients are living for two years or more with mechanical hearts. Ventricle assist devices came from the research enabling heart patients to survive long enough to either get a new heart or for their own heart to recover enough to take over the job. Those first few cost more than the half mil in today’s dollars. A waste? I hardly think so. I’d hate to think you were making decisions for those patients and those who followed.
Cancer treatment followed the same learning curve. 40 years ago, cancer was a death sentence. For the most part, it isn’t today. But the experimental treatments back then were hideously expensive. And by the way, cancer is also a disease of age. Do we look at statistical cancer rates based on age and pick a cut off date for treatment?
You still haven’t answered the question. If the needs of the many outweigh the needs of the few then where would you start making the cuts? Tell us about your vision for death panels. When would you pull the plug and on whom?
May 10th, 2011 at 4:26 pm
All of you make some excellent points. What is the cost and profit margin on every procedure and and supply afforded the patient? Why does it cost a million dollars to save a baby? Isn’t that the real question?
May 10th, 2011 at 8:22 pm
Sam.,
I have been thinking alot about your last comment to me. And, I guess mythinking is this: what matters now is the baby that is in crisis now. sure, you could have used the same financial resourceson check-ups, etc to dignose some immediate, early detention treatable scenarios. But that’s only a what if. Maybe there will be more kids you can save. Maybe not. You might have a different perspective of course if it was your kid. Your kid could die, if that money helps prevent MY kid from dying. Is that the world you want to live in?
May 11th, 2011 at 7:19 am
Dear Dr.
I would rather live in a world where rational rather than emotional decisions control healthcare.
Should taxpayers or insurance companies have to pay for fifty years of heart lung because some parents refuse to acknowledge their kid is brain dead?
That’s just what we need, healthcare driven by the emotional demands of desperate/irrational parents.
No system is without faults but compared to your ideas death panels look mighty good.
May 11th, 2011 at 7:46 am
Fields world is one of emotionless robots driven by “rationality”. He is a cold fish and I pity that his children, if he has any, never get sick.
May 11th, 2011 at 8:29 am
@Tiny Bubbles,
Or what happens when Sam gets sick. After all, he’s not a young man….
May 14th, 2011 at 10:52 am
Fields,
First everyone should read your ‘report cards’ from the students who take your pathetic classes. Indeed, you should be ashamed to promote yourself as a ‘professor’, spewer better fits you me thinks.
In any event, your argument really shows how little you know about medicine and science in general too. So, I’ll dumb it down for you with one phrase ‘on the shoulders of giants’. Each new exploration leads to the next breakthrough. Maybe someday you or a loved one will benefit from the miracles that are happening all around you, and maybe just maybe your feeble brain will make the connection to the stupid comments you made here.
May 14th, 2011 at 11:39 am
it could be an illusion… people think they are so lucky getting a million dollars worth of free healthcare for their child, when in actuality the kid is being used by dr. frankenstein for an experiment. after all, they can legally chop you up and put you back together in a freakish scientific experiment and call it prolonging life and act as it’s a gift when really they are using the “patient” as a human guinea pig. ARFF would me mad if it was a monkey, but we humans think someone is getting “free” healthcare. you couldn’t pay someone a million dollars to volunteer fo that.