WHAT IF?


A person in their twenties lies in extremis with what appears to be a post-appendectomy intussusception.  The appendectomy was routine, although costs for appendectomies these days are probably well into five figures.

The individual, a marathon runner, died two days later.  Yes, in America, previously healthy people in their twenties can die from appendectomies.  I could go on that we need to learn what happened, so we can drive the mortality from appendicitis closer to zero, but I have long since given up on our learning from medical mistakes.  It is nearly 11 years since I offered a solution, strongly supported by the person in charge of the FAA’s Aviation Safety Reporting Program, that was blown off by 60 different medical organizations or leaders.  I count things.  No, today I’ll discuss the “what ifs” in life, which lead to buying insurance to protect ourselves from “what ifs”.

Did this person have insurance?  No idea.  It is clear that the likelihood of insuring all Americans will have as much success as my error reporting program.  One side:  “I’ve got mine, and the hell with you.”  The other side:  “I’ve got mine, and you need to be helped.”  It is a law that every driver must carry insurance.  Is it perfect?  Nope–only some of are drivers.  All of us are patients, sooner or later.

What if somebody T-bones me at Campbell and River some day?  Not likely, but it sure can happen, and I can be critically injured even by doing everything right except the location and the timing.  What if I have an ACA (anterior communicating artery aneurysm) that blows out, not killing me, but putting me in a nursing home for the rest of my life (blissfully short, since I have addressed this sort of thing in my living will.  Have you?)  ?

What if I slip and fall on a solo canoe trip, strike my head, and drown in 3 cm of water?  That happened to a classmate of mine in medical school.  This stuff happens.  What if I don’t need hospitalization, but I need long term at home medical care, like hyperalimentation, or chemotherapy, or palliative care?

You see, it isn’t just a matter of growing old.  All age does is increase the probability of bad things happening to a person.  But that probability is not zero at any age.

I wear seat belts because they improve the probability I will survive a car crash.  I don’t smoke, and  I am vegetarian.  None of these will protect me from things they don’t help.  All I can do is try to do the right things and hope those things that are really bad don’t strike me.  I don’t expect to live to 90 and then die in my sleep.  I suspect I will get more and more disorders, and if I live long enough, a lot of things will come crashing down, hopefully quickly, the way they happened to my father, whose grandfather’s greatgrandson knew enough to let nature take its course.

What or how each person insures, of course, is up to them.  How they pay for it, and how much the government should be involved should be a matter of discussion, and I happen to be one of those pointy headed liberals who has his and thinks others deserve a chance, too.  And yes, as a percentage of income, I am wayyyyy beyond Mitt Romney, 50% more taxes, for more than 99% less income.

What if I eliminate all my policies?  Wow, the dollars I would save would be great.  But what if?  It goes back to Dirty Harry, whom I wrote about many years ago in these pages.  “I know you’re thinking, did he fire five shots or six? How lucky do you feel?”

The problem is that most of us during our lifetime only have to be moderately unlucky to have a five figure medical bill before we are 50.  When a third of the people in an emergency department get some sort of multiple imaging procedures, the cash register rings up really, really quickly.

And where does the money come from for paying for the care?  Or do we do what Dr. Ron Paul, revered by many, said at a debate?  If a 25 year-old doesn’t have the money, he dies.  Many of the young love Ron Paul, because in part they think they are immortal.  They are a car crash or an aneurysmal blow out away from real problems, and the former has a higher probability for them than it does me.  A nurse I had dinner with one night once said those without insurance ought not to crowd our emergency rooms.  Yes, a nurse.  If you read Harry Potter, you know she and Dr. Paul are Dementors.  They suck the happiness out of others.

I am really analytical.  I can do things with numbers in my head that you cannot believe, like squaring 3 digit numbers ending in 5 or squaring any number that is all “9”s.  But I had one saying I used a lot as a medical director:  “Count what is important and countable.  Honor what is important and not countable.  And know the difference.”

How much does my insurance cost me?  In dollars, I know.  But how much is it worth to me to sleep each night, knowing my wife won’t be bankrupted by my medical care?  How much is it worth to be knowing that if I have long term care needs, there will be coverage?  How much is it worth to the country, and to the people affected, to have coverage?  You see, not everything has a dollar value, and the Dementors out there are missing that point.  Doing the right thing is worth something; I just don’t know how much it is worth.  What if it is worth a lot?  What if we actually did something?

 

*Squaring numbers end in 5.

The last two digits are 25.

The first two digits are the number before the 5 multiplied by 1 plus that number.

 

(x+5)  [a number ending in 5]  (x+5)= X^2 +10x +25.  (x^2 +10x)=x(x+10), and x+10 is simply the number before the 5 (which is a tens) plus one.

 

**Squaring numbers that are all 9.  Look at the pattern.

9*9=81

99*99=9801  9 in front, eight, zero, one (one less nine than what is squared)

999*999=998001  (two nines, eight, two zeros, one)

999999*999999=999998000001   (five nines, eight, 5 zeros, one).

 

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