Controlling Health Care Costs in Vermont

Years of pecking away at a keyboard churning out op-eds in which I typically carp about aspects of society have come home to roost. Like many repetitive motion workers, I’ve developed a nasty affliction called carpal tunnel syndrome. Not being an expert in either etymology or anatomy, I’d like to believe that the name of this painful syndrome derives from relentless “carping” and the unique tunnel vision we essayists bring to our opinions. I must look further into the etymology. But I digress.

One might think such a painful consequence of writing would dampen the spirit of an inveterate and opinionated carper, but no, I decided to see a doctor to alleviate the affliction with very minor surgery so I could continue carping and exhibiting tunnel vision. I now have on my desk a schedule of, count them, eight medical consults pre- and post-surgery. The surgery, I am told, lasts about as long as it takes to cook a soft boiled egg…snip snip…one stitch and back to the keyboard.

Now as you may know, healthcare is reimbursed on transactions, not quality or outcomes. Therefore the shorter the transaction and the more of them there are, the greater the reimbursement. My eight office visits will generate thousands of dollars in healthcare costs to someone, even though the length of the visits will in most cases be only a matter of minutes.

Meanwhile, I’m thinking about all this for another op-ed while abandoned in a dentist chair waiting for the verdict of my terrific dentist who shall remain nameless. She interrupted this reverie announcing that my fifty years of defending my wisdom teeth against the predations of her colleagues was coming to an end and I had one wisdom tooth that was beginning to look like an outdated French cheese and would have to come out. She further explained that she would refer me to an oral surgeon who would review her findings then schedule an extraction. This again seemed like an inordinate number of inconvenient visits and billings so, in a fit of pique and inspiration, I asked, “Why send me to more dentists? You’re the best in Vermont. Just get the fifth of whisky and pliers and let’s get on with it.”

I seemed to have caught her off guard. She nervously scanned my chart to see if I had been dispensed narcotics for my routine cleaning. “That’s not how we do it,” she responded.

“But I’m here now,” I answered, “I know you know how to extract a tooth. Let’s finish the job.”

She looked askance at her assistant as if I might be demented, left the room and returned with a needle that to me resembled the spire on the Empire State Building and a pair of pliers. No whiskey, perhaps because it was 7:30 AM.

I left her office drooling, with a wad of cotton in my mouth and a bill for a hundred bucks. Good deal. I thought.

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