Medical Emergencies & Your Money
18 October 2016 10
This time, I want to talk about being smart with money during medical emergencies. I request the readers’ indulgence and want to share my learning from a medical emergency and how we can be smart with our money. The medical industry is designed to exploit the ‘fear’ and ‘ignorance’ factor and transfer wealth from the average individual to the group of players who dot the medical industry—doctors, hospitals, pharmaceutical companies, etc.
When medical emergencies arise, logic and reason take a back seat. You are ready for exploitation by the healthcare industry. The situation is compounded by the fact that corporate hospitals are sharply focused on their bottom-line and the doctors have to recover the exorbitant cost they have incurred on their medical education. Many of the emergencies would involve either a cardiologist or a neurologist or both. Most of us have not ventured into this space and are, generally, at the mercy of a hospital that is closest, or a hospital that advertises, or some other recall that is based on hearsay. Such emergencies can, often, involve one or more of the following:
- A large single-ticket expense that will involve a few lakh rupees;
- Medical intervention or procedures all of which may not be necessary;
- Medical intervention costs that are exorbitant;
- Post-operative care and medicines that will burn a big hole in your pockets;
- Choice of medications that may not be the best for you.
I had a medical emergency a few months ago. It was mid-morning. A kindly neighbour rushed me to the nearest big-name hospital. The doctor advised some checks. The first two checks showed things were fine and no cause for concern. At this stage, I could have been kept under observation. However, the doctor and another accomplice persuaded me to have an angiogram. We had to trust that gentleman in the white coat. After the angiogram, he told us that I had two blocks—one of them was supposedly 90% and the other, 70%. I started getting a severe headache. The doctor said that it was a side-effect of some medication that he had put me on and that he would change it to some other.
The doctor then went into a huddle with my family and suggested that I go through a stenting process; he recommended that I go for the ‘absorbable stents’ that were, supposedly, better. I was told that the two stents would cost around Rs4 lakh. During all this, the hospital had discovered that I was covered for medical insurance up to some five lakh rupees.
By this time, my friends had arrived. They talked to the doctor who said that the surgery was imperative and that there was some specialist who would be coming to that hospital in two days and there were a series of these ‘absorbable stent’ insertions that day. My friends persuaded the doctor that we would source the stents directly. Reluctantly, the doctor agreed. The distributor, who supplied the stents, told us that the doctor was his biggest client and that more than half of the price would be a rebate to the doctor! So we got the stent at less than half the price and the distributor invoiced the stents to the hospital at one rupee. Obviously, the money he collected from us would have been given in part or full to the man in the white coat.
My family doctor was upset at this gentleman in the white coat. He said that if the blockage were so severe, he could have done the stenting at that moment and not have had to open me up again. An angioplasty meant that I had to undergo another intervention which necessitated more medication and extra care. My headaches were continuing. Finally, the stents were inserted and I was shifted out of the ICU (intensive care unit) and told that I could go home the next day.
Now, having completed the surgery, I tried to read some papers or books and found that my vision in one eye was badly impaired. My headaches refused to go. The doctor kept on giving me Crocin and reasoned that the stress must have caused this headache and the vision problem and that it would set itself right.
This gentleman in the white coat then performed his final act of cruelty. Post-stenting, we have a choice of medicines. Some cost Rs5 a tablet and some cost Rs50 a tablet. The company selling the Rs50 tablet ‘promotes’ the product by offering incentives for prescription. Once you are on a particular medication, you have to continue the same thing for one year. So, I was locked in for the Rs50 tablet, twice a day for one year. I did not have the sense to ask the doctor about the choices.
By this time, my faith in the doctor, his team and the hospital had evaporated. I went to an eye-hospital to check the problem with my eye. It was a week after the surgery. During the eye check-ups, the doctor told me that I should go for a brain scan, since he suspected that there could have been a haemorrhage in the brain that could have compressed the nerve supplying blood to the eyes. A brain scan confirmed this. Apparently, the excess dosages of blood thinners (one when I got admitted, one for the angiogram and another for the angioplasty—given in rapid succession) had caused this haemorrhage. Luckily, we knew a good neurologist who helped us out. Now my vision is recovering as the haemorrhage heals.
I do not want to sue this man in the white coat, because he has far more resources than I have, to fight a legal battle. After all, everything he did was ‘opinion’-based. A top-notch cardiologist, who I now consult, went through the history and opined that the blockage seemed far lower and that stenting may not have been necessary at all. So, in this opinion business, I have been at the receiving end. Some lessons for everyone:
- Keep all medical insurance cards/papers easily accessible and known to ALL members in the family;
- Do some basic research on doctors and hospitals in your neighbourhood. Find out who the good or reliable ones are in disciplines like cardiology, neurology, orthopaedics, etc. We cannot cover everything, but some primary ones are essential;
- Find out what your medical policy covers by way of limits on surgery, on stent, on hospital rooms, etc;
- Have one family doctor who can be consulted during medical emergencies;
- Identify hospitals closer to home which will not rob you blind;
- Talk with friends about medical treatments, costs, etc;
- Once someone is admitted, have some friend or relative who will be entrusted with thinking about money alternatives and is willing to question doctors;
- If a major surgery is involved, take some time. Ask your family doctor before you go ahead with any medical intervention;
- While the patient is in the hospital, it would be useful if one family member or friend visits another hospital to find out costs, processes, etc. Shopping for this is important, given the fact that the medical profession treats us like any commercial object;
- At every step, question the process and the medicines. If the doctors cannot respond to your questions, it is best that you switch doctors;
- Record critical conversations with doctors on your mobile phone. Before the final discharge, make a list of questions. Ask them clearly and write down the responses.
There are many more issues that you will come across. I know, it is not easy to keep one’s calm and reason things out, during a medical emergency. So, it is best to do our homework well in advance. And, yes, an ounce of prevention is better than a pound of cure. Spend time and money on your diet. It is cheaper than paying hospitals which, today, are corporate entities out to boost their bottom-lines at any cost. Stay healthy. Health is, indeed, wealth.