Thoughts on hospitals and funerals

My grandmother died last Monday. We laid her to rest on Thursday between her two children, one of which was my mother. But for the last month or two, I’ve been making repeated trips to Louisville and Salem to visit with her, prepare for the funeral, and ultimately handle her estate. Going through the process as an adult instead of an adolescent like I was with mom, I have a few thoughts.

First, stop treating old people like children. Nurses and doctors would come into my grandmother’s room and call her “Miss Wilma” and always with the same tone as a kindergarten teacher. You do not need to speak to the elderly as if they have a child’s brain. My grandmother remembered every second of everything that was happening to her. Her mind never dulled, she maintained the ability to make her own decisions, and she was never childish. She helped a country fight literal Nazis and you’re talking to her like you would your dog.

Hospitals have to stop pretending they can fix every problem. Of the half-dozen doctors parading in and out of her room for months, only one said what we all knew: her age was working against her, this would likely not end well. All the others were on some Grey’s Anatomy-induced medical mission to fix every problem.

We pay nearly no attention to diet or exercise in this country. Our medical facilities are equally inept. You can’t feed an 84-year-old woman liquid pudding for a month and stand around wondering why she’s losing weight. Likewise, you can’t tether someone to a bed and scratch your head in confusion why they’re not getting up to move around.

Funerals cost a suspiciously round amount of money. Things seem to jump in increments of $1,000 at every turn.

People who show up to funerals had better be dressed for it. I felt like Clint Eastwood in Gran Torino as random people paraded through my grandmother’s funeral wearing flip-flops, jeans, t-shirts, and hats. Even the preacher didn’t bother to put on a tie. Have some class — because my grandmother did despite having next to no money nearly all of her life.

Embalming is a weird thing. I don’t know why we do that. Equally odd to me is how we’ve become comfortable sticking people’s bodies into a box in the ground. It’s literally the most terrifying thing I can think of.

Fixing Healthcare, Part II

Indianapolis-based Wellpoint is in hot water for raising premiums on individual policy holders by nearly 40%. Except, they’re not really in hot water because no one that can do anything about it got screwed:

WellPoint, in its year-end earnings report, said its medical costs rose 8.9 percent in 2009. And Binns said reform must address the main drivers of rising health-care costs, such as price increases from hospitals and doctors.

Still, some of Anthem’s individual customers in Indiana are left wondering how their rates could jump so much more than that in a single year.

Strickland, 60, the bread distributor, said his premium is about to rise from $301 to $401 a month for a plan that carries a $5,000 deductible.

“It doesn’t bother me that they’re making money,” Herchenroeder, 53, said. “I just don’t see how anyone can justify a 31 percent increase in a year.”

He said that’s how much his WellPoint premiums increased in December — giving him a $941.78 a month premium for a family plan with a $6,000 deductible.

$941.78 a month is more than my mortgage, and almost as much as my mortgage and car combined. That’s $12,000 a year in some cases, or about a third of the average Hoosier’s income. Plus a high deductible! That’s a third of your income that, in most cases, doesn’t even go towards anything!

I’m wondering when our healthcare debate is going to refocus attention on doctors and hospitals instead of insurance companies. It doesn’t bother me that insurance companies make money, either. Most of them don’t make more than a 2% profit each year which isn’t much when you consider any good person or company or government should have 10% of their operating budget in savings.

The insurance companies, or our government, can’t be expected to just lose money on these things. They at least have to break-even, otherwise it’s just an unsustainable mess. Yet, for reasons no one seems to understand the cost of healthcare keeps going up because somehow, hospitals have to keep raising their rates.

For that reason, I’m left to believe that hospitals are seeing expenses go up because of increased demands from something. I doubt it’s doctor and nurse salaries; most of them only make a respectable amount. I doubt it’s equipment – you buy an MRI machine once and you pay it off and it should be good-to-go for a while. I doubt it’s malpractice – that doesn’t seem to add up to much nationally. I doubt it’s drugs because that market is too competitive and generics are always in the pipeline.

Or, it could be that hospitals are so overwhelmed with uninsured people that can’t afford health coverage that hospitals are forced to eat the costs because you can’t let a guy bleed to death and you can’t bleed that turnip, either. That, in turn, leaves the hospital to raise the cost of other services on insured people to help them break even. That translates to higher premiums for those with insurance. It’s a vicious chain right up to the top. The poor person comes in and his expenses keep defying gravity and keep getting dumped up the chain until it reaches the insurance companies, and then you.

If only there were some sort of national healthcare system where people could afford coverage based on their incomes from larger pools of people with competition across state lines…