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Wendell: You think this boy Moss has got any notion of the sorts of sons of bitches that’re huntin’ him?
Ed Tom Bell: I don’t know, he ought to. He’s seen the same things I’ve seen, and it’s certainly made an impression on me.No Country for Old Men (2007)
A personal note on Covid-19, healthcare consumption, and … pain. Three things that have certainly made an impression on me.
For the past five months, ever since I published this note about the biology of the virus and the lies China was publishing about its spread in Wuhan, Covid-19 has been a daily companion.
China is fighting nCov2019 exactly like the US fought North Vietnam … with policy driven more by narrative control than by what’s best to win the war. That was a disastrous strategic mistake for the US then, and it’s a disastrous strategic mistake for China today. … Continue reading
My other daily companion has been pain.
I’ve got the genetics for varicose veins, and unfortunately mine manifest themselves in a nerve-rich area of the body – my ass. I have terrible hemorrhoids.
There’s nothing for it except surgery. I’ve tried every non-surgical therapy my doctor can suggest. Ditto Dr. Internet. None of them provide meaningful relief. As for medical intervention short of an __ectomy, banding was successful in the past, but I’m way past that now.
There’s nothing life-threatening about this. It’s not an emergency.
There’s only the pain. Intermittent … excruciating pain.
It’s exactly like having a red-hot poker stuck up your ass. Or so I imagine. Sometimes the pain is so bad that the entire situation becomes incredibly funny to me and I just start laughing.
Opiates scare me to death, plus they have digestive side effects that you really don’t want in my condition. So I “manage” the pain with Advil, ice packs, and traditional central nervous system depressants – tequila, mostly. Cannabis helps a bit. Nothing helps much.
The worst part is not sleeping for more than an hour or two at a time. Hmm. Actually, the worst part is literally blinding pain. Though not sleeping is the most health-damaging part, I suspect. The weirdest part: as I write this, I can feel tissues moving inside my body. Like a worm.
We’ve all got crosses to bear, many a lot worse than mine. This note isn’t for sympathy (although now you know why I’m on Twitter so much – it’s all I can manage much of the time). This note is for what my situation means for healthcare consumption. Because I’m not alone. We all know someone who is in urgent-but-not-emergency need of some medical procedure that can’t be scheduled while Covid-19 is storming the hospital ramparts.
Connecticut is opening up a bit, so I’ve got an outpatient surgery scheduled at the big local hospital (specialty clinics are still closed) next Friday. I feel lucky to get on the calendar so soon. I also feel nervous. My dad was an ER doc. My brother is a healthcare lawyer. Again, these are things that have certainly made an impression on me.
To be clear, my lack of healthcare options today and over the past 3 months isn’t because of the lockdown. That’s how a child would see this.
My lack of healthcare options is because of the virus.
In its acute phase, Covid-19 shuts down non-emergency healthcare provision entirely.
In its endemic phase, Covid-19 forces enormous and costly changes in healthcare provision. There is no “v-shaped recovery” for medicine.
Covid-19 is now in its endemic phase.
Our leaders have botched the Covid-19 war, and we are defenseless against a now endemic disease. The free world does not easily survive a globally endemic Covid-19. … Continue reading
The enormous and costly changes in healthcare provision that Covid-19 requires and the resulting impact on healthcare consumption lead me to three conclusions about the healthcare industry and national politics.
Conclusion #1: Endemic Covid-19 permanently dents healthcare provision (and consumption). The days of “efficient” (i.e., insanely lucrative) specialty medical clinics where docs go through 3 knee replacements or 10 lasik procedures in an afternoon are GONE.
Conclusion #2: Although both acute and endemic Covid-19 sharply reduce my healthcare options and healthcare consumption, my healthcare insurance costs have not gone down. They’ve gone up. Healthcare payers (insurance cos) are a public utility. They should be regulated as such. #BITFD
Conclusion #3: For the past 30 years, US fiscal policy has been largely driven by Boomers’ insatiable demand for more and more healthcare, to the advantage of both the Dems AND the GOP. Covid-19 destroys that cozy political dynamic, but neither party realizes this yet.