Carroll County Times
Carroll County Times Opinion

Pyatt: Medicine improving, but costs of care keep climbing

Not surprisingly, health care — arguably to make us all live longer — has become our No. 1 national priority. Being Americans, we also want to eat fast food, work two or more jobs with less sleep, park next to our favorite shop if we actually buy stuff at a store, buy most things online, and have our marvelous doctors and researchers perform miracles for us. Stints and bypass surgeries eliminate many heart attacks. Artificial knees and joints are routine. Cancer treatments are gradually making big strides.

If I had to do it again, I would train to be a biomechanical engineer — OK, I’m already an engineer — with some medical training thrown in. Some of the expectations of what’s to come are breathtaking. Reverse engineering the human body, a marvelously complicated yet efficient thing, is the ultimate Lego.


There’s just one little snag: This nice technology with an army of physicians and supporting technologies — typically, 3.5 staffers are needed for every M.D. or equivalent — is very expensive, and the costs are climbing. In order to be effective, some large-scale cost sharing is needed.

Health care providers — CareMark Blue Shield in my case — are really struggling to keep up. But not to have health care at all is almost considered to be a death sentence in our overfed, underexercised, and overstressed society. Many self-employed businesses and mom-and-pop operations, allegedly our future growth, cannot make it because of the prodigious costs of health care insurance for nongroup participation.


The dynamics on this topic have flipped fairly quickly. Until as recently as a year ago, people were pretty divided about the repeal of Obamacare, which provides health insurance to folks who cannot get it by conventional means. The Republicans signature agenda when they took over in 2016 was repeal of this infernal leftist and outdated program. Now, whoa! We have to do something.

First, I am a devotee of exercise, in my case walking, and of relaxation programs, in my case tai chi. This has done a lot to keep weight, blood pressure, cholesterol and sugar levels under control. Health care providers love when you do this, but the premiums are essentially the same. They reward you with attaboys.

Lifestyle is a personal choice, but who doesn’t rely on new medical practices? I’ve had two laparoscopic surgeries in the past eight years — both appendix and gall bladder removal — one in which I was treated as an outpatient. At one time, these surgeries were life-threatening.

One thing health care providers have done a good job with is to prioritize each and every health procedure, perform a risk study on how effective it is, and assign a fee that is allowed for each procedure. Most doctors go along with this. Pharmaceutical costs are now larger than doctor visits and hospital stays. Health care providers negotiate bulk rate costs on all prescriptions and provide excellent advice on use of lower cost generics.

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On the other hand, the medical and health care industry do not want you to be too healthy, since they have a very well calibrated yet uncanny sense of how much money they can extract from your mind and body in the remaining portion of your life.

The interaction of health care and Medicare is also complex yet subject to cut backs at the state level, especially those in Republican hands.

Sen. Leader Mitch McConnell has made some noise about repealing Obamacare after the midterm elections. I know a lot of politicians, I was one myself for 24 years, and in some ways they are the biggest babies when it comes to their own well being — one of my physicians suggested I worried a little too much about my health, and I received a mild reprimand from someone in my tai chi group for focusing too much on blood pressure readings. But I’d like to see Sen. McConnell voluntarily forego his own health care coverage to fight this repeal battle to see if he’s really serious or committed.

There is a constant struggle between diet, exercise, overeating, eating a relatively poor diet considering what’s available, and stressing out. Yet more and more people are living well into their 90s, and it may soon become the norm. The health care issue, both coverage and costs, aren’t going away.


In retrospect, the Republicans lost this gamble in the first two years, and the Democrats now appear to have the high ground. But I am reminded that many really smart, devious, and crafty folks swarm around the halls in our nation’s Capital and in the White House. I’m sure this advantage will not last too long.

This already scrambled and complicated issue of eligibility for health care will soon be re-scrambled, and we won’t know who is in favor for what. Or for that matter, what is the difference between the good guys and the bad guys. I plan to continue my daily walks and doing tai chi, hoping some of this “chi” (Put simply, chi [qi] is that which gives life. In terms of the body) rubs off on the right folks.

David Pyatt writes from Mount Airy.