Aspirin can teach us all a lesson

The debate about health care reform is complex. Not as complex as going to the moon, but sufficiently complex to call for a story. This is a story my father told many times about his encounters with Medicare, private insurance, a long-term care provider and the power of one citizen to make a difference.

If you have a bottle of aspirin in your house, look it over before or after reading.

When my mother's brain cancer returned there wasn't much that could be done. Before she died, she spent several months

in a long-term care facility near Dixon, Ill.

Each month my Dad would go over the bills. He noticed a lot of "deliveries" that were being charged at $20 each. He called his friend the director and asked what the deliveries were for. His friend said, "Ted ... it's not your problem ... Medicare will take care of it or your private insurance".

Dad replied, "Those bills have my name on them, I still pay taxes and pay for private insurance. I want to know what they're for." It turned out they were for aspirin, delivered, at $20 each.

My Dad thought about this for several days, went over the bills, and then called the director back. Dad went into his office will several pages of bills with the cost for aspirin circled. He asked why they charged so much for aspirin. The director went into a long-winded explanation of labor costs, billing costs, hidden costs, etc.

When he was finally done, my dad reached into his coat pocket and with a little extra force for emphasis, put a bottle of 200 aspirin on the director's desk. He then asked the director what he thought that bottle was worth. The director read the label and said "a buck or two ... less for us because we buy in bulk".

This was the moment my Dad had awaited for. "No," said my Dad, "I can tell you haven't been listening. That's 200 hundred aspirin delivered to your desk. That's worth $4,000 by your standards, and I'd like to see a credit in that amount to our bill."

My Dad claimed that a credit was made. He was never specific about the amount. He was a man who loved to talk, knew every business within 30 miles, and had sold retail newspaper advertising most of his adult life. He could be persuasive when he wanted to be. I have no reason to doubt his word.

In the complex interactions between a now 44-year-old health plan (Medicare), private insurance, a for-profit care facility, its director, and my Dad there are many twists and turns.

But a few lessons seem clear as a bell. When the profit motive over-rides common sense, the bills sent to Medicare or a private insurance firm can escalate quickly. Perhaps more important, citizens who read their bills can help call a system to account if they know which levers to push. Informed and vigilant citizen-consumers are the pivot of both justice and common sense, at least in a democracy.

One final point, I would add. In the 25 years since my mother died, we've learned a lot about that bottle of aspirin.

Taking a small, coated aspirin on a regular basis can significantly reduce the risk of heart attacks and perhaps reduce the risk of colon cancer.

If you think about the cost of treating either of those diseases, that little bottle of aspirin, self-administered, can be worth a good deal.

And self-delivery is usually free.

Tags: opinion, commentary